Togetherness – Fight Loneliness
Social Determinants of Health 

Togetherness – Fight Loneliness
Social Determinants of Health 


“What will future generations condemn us for?” In addition to our prison system, industrial meat production, and our treatment of the environment, Appiah listed America’s treatment of “the institutionalized and isolated elderly.”  The most common pathology I saw was not heart disease or diabetes; it was loneliness.”

CareMore Health, introduced its Togetherness Program, a comprehensive initiative aimed at identifying and intervening in the loneliness among its senior patients;  


The United Kingdom appointed a Minister for Loneliness to address the finding that nine million British people often or always feel lonely.

Social connection significantly affects health. When you believe that you have people in your life who care about you, and you interact with them regularly, you are better off. For instance, you may be less likely to catch a cold, have a stroke or heart disease, slip into early cognitive decline and developdepression. You may even be more likely to overcome socioeconomic disadvantages, recover quickly from illness and live longer.

Among Caremore’s  efforts, they screen for loneliness during appointments, have regular phone conversations and home visits with at-risk senior patients to show they care, and provide informal social hubs at their clinics to foster connection.    


The seclusion that comes with aging in America is more than just unfortunate; it’s a health problem that CareMore CEO Sachin H. Jain, MD, MBA, FACP, says affects 43% of seniors over age 65. A study in 2016 showed a direct connection between the size of one’s social network and health, and CareMore cites research that compares extreme isolation to smoking 15 cigarettes a day.

Connect seniors with local resources, including CareMore gyms at existing facilities. In some cases, home visits are needed.


loneliness is a common emotional distress syndrome with a high risk factor for early mortality and a broad variety of physical health and psychiatric issues, it still gets little attention in medical training or in health care more generally,”  Business





NPR – Men can have better Friendships, here’s how  

Harpers Bazaar men don’t have friendships thus dump their feelings on women



“Some experts think that when you feel isolated you’re more likely to feel unsafe and perceive that the world is more threatening in some way, which leads to stress and anxiety and low self-esteem, and those can create health issues. Others believe that those who are socially isolated from others are having a harder time taking care of themselves regulating themselves. They’re not guided by social norms or cues and may engage in more unhealthy behaviors like eating poorly, substance abuse, smoking, and then others may argue that loneliness is tied to other physical issues like sleep disturbance or increased cortisol, which creates and exacerbates health issues.”

Often, she adds, they face financial problems.

“Forty percent of high-need isolated adults have incomes below $15,000 a year, and 80 percent of those people say they worry about having enough money to pay bills or afford healthy food — a rate more than double that of the total sample of adults. And even more concerning is that because of this financial hardship they’re more likely, three times more likely than other adults, to skip doses or not fill their medications.”

Social Determinants of Health

Biblical Mandate to Smile

Smiles are not just good for others; they are good for you too. Smiles reduce stress and enhance the immune response. They make you look younger and more attractive. Smiling releases endorphins and serotonin, elevates the mood and keeps you happier.

Smiles are contagious, they light up the world. Like a candle, a smile can light many lights without itself being diminished. If you smile at 5 people, and they pass the smile on to 5 people and they pass it on to 5 more… then by the 15th passing on, you have smiled at the whole world J

Greeting every person with a smile is healthy advice. The law of greeting with a smile is rooted in the the bible. “His eyes shall be red with wine, and his teeth white with milk” (Gen. 49:12).  Thus, smiling at another is greater than giving him a glass of milk.   Or as I heard in a lecture, the white teeth of a smile is better than how white the milk is.  It’s better to be around people who smile, than someone who has material possessions, but are not pleasant company.

What if you don’t like someone?

Look deep inside each one. Uncover that which is unique and special. Use your  thoughts and intellect, to find what’s good inside. Look for thetheir inner goodness. Everyone has some. Shammai is telling us to find it, connect to it, and respond to it, with an affirming, accepting, tooth sparkling smile. Your white teeth are more delicious than milk!

Consider smiling more often. And as you do, see if you can look past the outside, past the parts of a person that are hard for you like. Take an extra moment and seek out, their inner goodness, and build a bridge from your heart to theirs.  A Bite of


6 comments on “Togetherness – Loneliness Social Determinants of Health

  1. Anonymous says:

    How is Blue Shield and other Medicare Advantage companies are now offering so much extra, like hearing aids, help I can’t get up, vision, nutrition, etc and wellness and not before?

    • Some of it has to do with Social Determinants of Health

      which are the economic and social conditions that influence individual and group differences in health status. They are the health promoting factors found in one’s living and working conditions (such as the distribution of income, wealth, influence, and power), rather than individual risk factors (such as behavioral risk factors or genetics) that influence the risk for a disease, or vulnerability to disease or injury. The distributions of social determinants are often shaped by public policies that reflect prevailing political ideologies of the area

      In 2003, the World Health Organization (WHO) Europe suggested that the social determinants of health included:[4]

      The social gradient
      Early life
      Social exclusion
      Social support
      Transportation wikipedia

      Trump administration’s efforts to increase competition among Medicare Advantage and Part D plans so patients get higher quality care at lower costs. These changes will increase plan choices and benefits, and include important actions to address the opioid crisis.

      give plans the ability to be innovative and offering benefits and services that address social determinants of health for people with chronic disease

      With Medicare Advantage enrollment at an all-time high, plans need greater flexibility in offering benefits that they focus on preventing disease and keeping people healthy

      Beginning in 2019, Medicare Advantage plans can now offer supplemental benefits that are not covered under Medicare Parts A or B, if they diagnose, compensate for physical impairments, diminish the impact of injuries or health conditions, and/or reduce avoidable emergency room utilization. For example, plans may offer adult day health services, and/or in-home support services under the expanded definition of supplemental benefits when they meet these standards.

      meal delivery in more circumstances, transportation for non-medical needs like grocery shopping, and home environment services in order to improve their health or overall function as it relates to their chronic illness. For a patient with asthma, for example, a Medicare Advantage plan could cover home air cleaners and carpet shampooing to reduce irritants that may trigger asthma attacks. For someone with heart disease, a plan could provide heart healthy food or produce. And for someone with diabetes, a plan could provide transportation to a doctor’s appointment, diabetes education program or to see a nutritionist.

      new flexibilities to offer targeted supplemental benefits, cost sharing reductions for patients with chronic pain or undergoing addiction treatment

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