Tag Archives: confidants

Doctors prescribing social capital?

Flickr photo by carf

I wrote earlier about some insurers using social capital in making decisions of whom to insure.

That post and a story sent to me by Lew Feldstein about doctors prescribing outdoor time got me thinking about doctors and social capital.  In the same way as doctors ask questions of patients around smoking, exercise, diet, etc., why shouldn’t doctors also ask patients to fill out a short survey about social capital activities they engage in:  number of confidants, how many of their neighbors’ first names they know, how often they go to friends’ houses or entertain others in their home, etc.?

These data could be used for 3 purposes:

1) to track real changes in the patient over time:  e.g., if a patient used to report 2 confidants and now reports zero it would be a chance for the doctor to find out what had triggered this (a friend moving, serious arguments, a close friend dying, etc.) that might help identify patients at risk of being socially isolated or going through stressful times.

2) to benchmark against others of the patients’ education, race and age.  In larger practices, or if this information was aggregated anonymously by affiliated hospitals, the computer could help patients understand the degree to which they far less involved in community or other associations or less trusting than comparable others nationwide or in their area.  If one was significantly below what others were, the doctor might want to bring this to the patient’s attention:  “did you know that most others like you are far more active in their community?”  or “did you know that most others like you volunteer much more their community?”  “This is something that has clear health impacts;  would you like more information about how to get more involved?”

3) to prescribe social capital “treatments”.  We’re far more used to a doctor prescribing an antibiotic or an aspirin than recommending that a patient get actively involved in a group (on a topic he/she cares about).  And some social capital deficits are more easily treated than others — it’s hard to suddenly develop a confidant.  But doctors might note to patients that there are real health consequences of being socially isolated and being socially and civicly uninvolved: i.e., getting sick more often and recuperating more slowly.  If acquiring a confidant in the next year is not a doable goal, maybe deciding which of ones’ friends have the potential to be confidants and taking some steps to start to deepen these relationships might be doable over the next 6-12 months.   Patients might agree to certain steps they want to take and put them on a card in a sealed and addressed letter that gets sent to them in 4 months.  Nudges can also be used to help people keep promises (through ongoing social groups that hold their members accountable for their promises, checks that go to disliked groups if commitments are broken, etc.).

And as to why?  Doctors might point out that they would rather be prescribing social capital now than prescribing hypertension drugs five years down the road.

[Read related story in NY Times about prescribing outdoor time: “Head Out for a Daily Dose of Green Space” (Jane Brody, 11/30, 10]

Only the lonely die young (UPDATED 5/2013)

(picture by moann)

(picture by moann)

John Cacioppo (from Univ. of Chicago) has a new interesting trade book out (with William Patrick) called Loneliness: Human Nature and the Need for Social Connection.

His interview with the Boston Globe appeared in the Sunday Magazine over the weekend. Among his quotes/observations:

  • “Social isolation has an impact on health comparable to the effect of high blood pressure, lack of exercise, obesity, or smoking,”
  • Loneliness is not simply a matter of being alone.  The lonely often spend as much time with others as the less lonely.  The key difference is that the lonely have the feeling that any real connection with others is lacking.
  • Loneliness is half heritable and half environmental, but the heritable part seems to be associated with how much disconnection hurts.
  • “In 1984, the question was asked [in the GSS survey], ‘How many confidants do you have?’ And the most frequent answer was three. That question was repeated 20 years later, in 2004, and the most frequent response was zero.”

Cacioppo and Patrick highlight some interesting experiments among the lonely, among them:

  1. That faced with a task of trying enough cookies to rate their flavor, on average, people who have been told that co-workers didn’t like working with them ate twice as many cookies as people who had been told that co-workers loved working with them.
  2. Those who are lonely, for example in playing the Ultimatum Game, settle for far worse outcomes or  distributions than those who are not lonely (similar to people with low self-esteem choosing partners or dates who mistreat them, subconsciously justifying that they are not worthy of better treatment).
  3. The lonely sleep less well and less efficiently.
  4. The lonely can’t think as clearly.
  5. The lonely were more likely to describe a gadget anthropomorphically and the lonely were more likely to believe in the supernatural (e.g., God, angels or miracles), and believed in the supernatural more when they were feeling lonely.
  6. Lonely people had higher levels of chronic inflammation, a condition associated with heart and artery disease, arthritis, Alzheimer’s and other illnesses.

The Boston Sunday Globe interview with Cacioppo can be read here.

See article “The Science of Loneliness” (New Republic, Judith Shulevitz, May 2013)