Headlines & Features

Judith Shulevitz, science editor for The New Republic, shares her new article on The Lethality of Loneliness.

You can also read more about loneliness in this recent New York Times blog: Shaking Off Loneliness.

From its roots in psychoanalysis, the study of loneliness has found a place in biochemistry, evolutionary biology, genetics, and public health research. We now know that loneliness causes illness, exacerbates other diseases, and hinders recovery from diseases. Loneliness has been linked to the development or exacerbation of physical diseases such as Alzheimer’s, obesity, diabetes, high blood pressure, heart disease, neurodegenerative diseases, and cancer. One astounding finding showed that social isolation carries a higher mortality risk than smoking.

Recent findings in the United States may be signalling that we are already in the midst of a loneliness epidemic. Using the standard U.S. questionnaire, the UCLA Loneliness Scale, up to 30% of Americans report not feeling close to anyone. Some populations are especially susceptible to experiencing loneliness, such as retirees and older adults. For this population, loneliness can accelerate the decline of physical health vis a vis diseases associated with aging. A 2010 survey conducted by AARP found that over 1/3 of adults over the age of 45 reported being chronically lonely. As the population has aged, loneliness has become a growing public health concern.

Chronic disease self-management can be a daily struggle for people with conditions such as diabetes, heart disease, and cancer.  For these individuals, physical and emotional isolation is not only painful, but makes it difficult to manage their chronic illnesses. Peer support is a type of social support that directly addresses these feelings of isolation and loneliness. In fact, the emotional support provided by peer supporters is one of their most highly valued functions.

John Cacioppo, Professor at the University of Chicago and a leading psychologist on loneliness, believes that merely being in the company of other people is insufficient to protect against loneliness. For a person living with a chronic disease, a home visit from a healthcare worker may be both welcomed and beneficial, but professional visits have a clinical nature that restricts possibilities for emotional enrichment, deep empathy and understanding, and social acceptance. Peer supporters can do all of these things by building a relationship with the individual, making them feel like there’s someone out there that understands and cares about them.

Shulevitz’s thought-provoking article raises several interesting questions. For example, what is the differential impact of peer support on people with high and low levels of loneliness? Is there a pathway that links peer support, loneliness, and depression? Does peer support cause chemical or hormonal changes that signal a physiological reduction in the stress that’s associated with loneliness? As the science of loneliness develops, we would be curious to see how peer and social support can address this growing problem.

April 29, 2013

With support from the government, as well as diabetes experts and patient communities, patient support groups in Taiwan have grown in number significantly. To date, there are more than 450 patient support groups across the island, serving over 1.5 million people with diabetes. These support groups provide opportunities for people with diabetes to connect and learn from each other and one of their main functions is to provide social and emotional support. However, the group support model alone provides a limited range of interactions and inadequately promotes ongoing interaction among participants.

In early 2013, the Taiwanese Association of Diabetes Educators (TADE), headed by Dr. Neng Chun Yu, kicked off an initiative to work with their domestic partners and Peers for Progress (PfP) to promote and enhance peer support. The initiative has outlined three key strategies:

1. Clearly define roles of a clinical team and peer supporter (patient experts)
2. Organize joint efforts to conduct regional workshops to help train patient experts and CDEs
3. Provide resources and ongoing technical support to encourage development and enhancement of CDE-supervised peer support programs

In March, senior program manager Maggy Coufal was invited to facilitate the first in-country training workshop of this initiative. Approximately 50 potential patient experts and CDEs from approximately 15 hospitals, clinics, and patient organizations attended this workshop in Taipei.

The workshop was 8 hours long, and consisted of 8 training sessions for peer supporters and one for CDEs. Topics covered how to work with a clinical care team to provide self-management support, critical self-care behaviors, communication and support, interpretation of key indicators related to health, problem-solving techniques, and encouragement of peer supporters to build motivation and engagement.

Read more about peer support in Taiwan and Maggy’s reflections on the training workshop in our latest feature.

The Centers for Medicare & Medicaid Services (CMS) announced the availability of new funding to support Navigators in Federally-facilitated and State Partnership Marketplaces. Navigators are individuals and entities that will provide unbiased information to consumers about health insurance, the new Health Insurance Marketplace, qualified health plans, and public programs including Medicaid and the Children’s Health Insurance Program.

The funding opportunity announcement is open to eligible self-employed individuals and private and public entities applying to serve as Navigators in states with a Federally-facilitated or State Partnership Marketplace. The new funding opportunity provides up to $54 million in total funding and applications are due by June 7, 2013.

Last week, CMS released a proposed rule outlining standards for Navigators in Federally-facilitated and State Partnership Marketplaces.

To access the funding opportunity announcement, visit: http://www.grants.gov, and search for CFDA # 93.750.

To access the proposed rule released April 3, 2013, visit: http://www.gpo.gov/fdsys/pkg/FR-2013-04-05/pdf/2013-07951.pdf

For more information about Navigators, including continuing updates, visit:http://cciio.cms.gov/programs/exchanges/assistance.html