Translating the Surgeon General’s framework on social isolation and loneliness to actionable steps in primary care

Background & Goal: Prior to the COVID-19 pandemic, 20% of adult primary care patients identified as lonely, representing a higher prevalence than many diseases commonly seen in primary care such as diabetes. Social isolation and loneliness are increasing over time, which is not only associated with increased health care utilization in primary care patients, but also with increased risk of chronic health conditions. Social isolation is reported to be equivalent to smoking 15 cigarettes per day in terms of premature death. The U.S. Surgeon General recently released an advisory entitled, “Our Epidemic of Loneliness and Isolation,” presenting a framework for action that includes three main pillars for the health care sector: 1) train health care clinicians, 2) assess and support patients, and 3) expand public health surveillance and interventions. In this paper, the authors summarize the Surgeon General’s framework and present actionable steps for implementing the framework in primary care.

Why This Matters: All health care professionals will encounter social isolation and loneliness in clinical settings. While social isolation and loneliness were historically not considered within the scope of clinical care—and hence, few systematic attempts have been made to address social isolation and loneliness—we are now at a critical juncture where the health care workforce must recognize this as a medical issue. Infrastructural support is needed, and the primary care sector can be instrumental in addressing this epidemic through prevention, early identification, education, and intervention.

The Role of Primary Care in the Social Isolation and Loneliness Epidemic

Sebastian T. Tong, MD, MPH, et al

Department of Family Medicine, University of Washington, Seattle, Washington

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