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1 Introduction
Pages 17-34

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From page 17...
... -- Lubben (2017) Social isolation (the objective state of having few social relationships or infrequent social contact with others)
From page 18...
... ; • Loneliness has been associated with a 59 percent increased risk of functional decline and 45 percent increased risk of death (Perissinotto et al., 2012) ; • Poor social relationships (characterized by social isolation or loneliness)
From page 19...
... Only recently have the adverse health effects of social isolation and loneliness received public attention nationally and internationally through governmental initiatives, the work of nonprofit organizations, and mass media coverage (Anderson and Thayer, 2018; Brody, 2017; DiJulio et al., 2018; Frank, 2018; Hafner, 2016; Khullar, 2016)
From page 20...
... . Aside from looking for differences among various age segments of the adult population, several studies have examined whether there are variations in the prevalence of social isolation or loneliness among subsets of adults related to demographic factors such as socioeconomic status, race and ethnicity, gender, educational status, employment status, and marital status.
From page 21...
... First, the committee was asked to examine how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low-income, underserved, and vulnerable subpopulations. Second, the committee was charged to identify and recommend opportunities specifically for clinical settings of health care to help reduce the incidence and adverse health impacts of social isolation and loneliness (such as clinical tools and methodologies, professional education, and public awareness)
From page 22...
... • Explore how social isolation and loneliness affect health care access and utilization. • Make evidence-based recommendations on translating research into practice within the clinical setting that could facilitate progress in reducing the incidence and adverse health impacts of social isolation and loneliness among the low-income 50+ population.
From page 23...
... unless we figure out the path for health care. RELEVANT NATIONAL ACADEMIES REPORTS The National Academies have produced many reports related to the social determinants of health, and several of them are directly relevant to this current study.
From page 24...
... Clinical settings offer major opportunities for identifying problems related to social isolation and loneliness and for advancing interventions to alleviate these problems either within the clinical care setting itself or by mobilizing broader social and policy resources that may be needed for effective intervention. To guide its deliberations, the committee developed a conceptual framework to better understand the relationships among several aspects of social connections
From page 25...
... , the committee identified social relationships as one of five domains of social risk factors "that are associated with health care outcomes independently of quality of care" (p.
From page 26...
... Most notably, variables in the box labeled pathways are hypothesized to mediate the effect of risk factors or social connections on health impacts, which in turn usually mediate these effects on mortality. Any of the variables in Figure 1-1, as well as other variables not specified there, may also act as moderators of any of the relationships between variables in the framework.
From page 27...
... Specifically, the different aspects of social connections are discussed later in this chapter, mortality is discussed in Chapter 2, health impacts are discussed in Chapter 3, and risk (and protective) factors are discussed in Chapter 4.
From page 28...
... Defining Social Isolation, Loneliness, and Related Aspects of Social Relationships The broad, interdisciplinary scientific fields that together form the modern science of social relationships have used a variety of terms (e.g., social isolation, social connection, social networks, social integration, social support, social exclusion, social deprivation, social relationships, loneliness) to refer to empirical phenomena related to social relationships.
From page 29...
... documented the powerful impact of social relationships on all-cause mortality and hence life expectancy, using the terms "social networks" and also "social integration" to denote the broad pattern of social relationships that they were examining; these terms are now part of the concept of social isolation. Beginning before the Berkman and Syme study and continuing over the succeeding four decades, the study of social relationships and health came to focus on social support.
From page 30...
... The committee recognizes that the literature on social isolation and loneliness uses all of these terms. To describe the evidence base as accurately as possible, when the evidence does not differentiate among or combines several related terms, this report uses the term "social connection" to refer to the various structural, functional, and quality aspects of social relationships.
From page 31...
... , direct care workers (e.g., home health aides, nurse aides, personal care aides) , and others involved in the delivery of health care (e.g., community health workers, health care administrators, health information technology professionals)
From page 32...
... . However, the literature on effective interventions, particularly for the role of the health care system, is less robust.
From page 33...
... Chapter 7 discusses the role of the health care system specifically in addressing social isolation and loneliness. Chapter 8 considers the importance of education and training of the general public and the health care workforce, particularly in raising awareness of the health impacts of social isolation and loneliness.


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