16 April 2018

Healthy-communities-are-built-on-community

Do you remember hearing of research from the ‘40s that orphan babies that lacked human contact actually died? What about the study from 2010 that reviewed 148 studies involving 300,000 people over 7 years and discovered that those with strong social relationships had a 50% lower chance of death than those with weak connections.

Now something even more dramatic! Over 3 years, a community based intervention has reduced Emergency Department admissions by around 40%. Nothing has been previously recorded that comes anywhere close to such a huge benefit.

So this week we explore what could be one of the most dramatic medical breakthroughs of recent decades - the discovery of the power of community, but first


     Thought for the day

Illness is a part of every human being's experience. 
It enhances our perceptions and reduces self-consciousness. 
It is the great confessional; 
Things are said, truths are blurted out which health conceals.

             Virginia Woolf  





Frome is a pretty Somerset town not far from Bath, notable for being described in 2014 by The Times as the "sixth coolest town" in Britain. But a year before this accolade was issued, something way more remarkable was set in train.

Helen Kingston is a Frome GP who was not content with the norm. Her norm was patient after patient who seemed defeated by the medicalisation of their lives. Helen observed the system almost demanded she treat them as if they were just a bunch of medical symptoms, rather than a real person who had real human problems. The normal style of GP practice was distressing to her, her patients, and her staff.


Helen decided to act.

She launched the Compassionate Frome Project.

First, with the help of the National Health System and the town council, a directory of agencies and community groups was set up.

Gaps were identified, then filled.



Next, new staff called “Health connectors” were employed to help people plan their care, and soon voluntary “community connectors” were trained to help people find the support they needed - handling debt or housing problems, joining a choir or lunch club, locating an exercise group, writing workshop or men’s shed.

The aim was to break a cycle; a cycle of isolation.

So often illness reduces people’s ability to socialise.

And it is well known that social isolation is a major risk factor for many diseases, particularly the chronic degenerative ones.

And clearly, isolation and loneliness make it harder to heal and recover from illness.




The science is well known.
In days long gone, sickness made us vulnerable to attack. So messenger molecules called cytokines are released during illness that function in 2 ways. Firstly cytokines cause inflammation aimed at aiding the healing process; but secondly they bring on an interesting group of feelings.

Cytokines are linked with depression, but interestingly, while they do make us more likely to withdraw from society in general, they also cause us to seek out closer contact with those we love. How remarkable is this body of ours!



So the problem?

None really if you do have close support.

However, in crowded cities there is so
much loneliness and social isolation.

In America, one study found the number of people who say they have no confidant increased three fold in 20 years.



Again, in days gone by, social isolation meant more risk of sickness and attack. So our immune systems evolved to create inflammation when we become isolated, in the hope of protecting us.

Put simply, isolation causes inflammation. Inflammation causes further isolation and depression. Chronic inflammation creates greater health risks and a lowered ability to heal. A vicious cycle.

So is this reversible? 
Well a famous earlier review paper suggested the Frome project could well work. In 2010, examining 148 studies involving 300,000 people revealed those with strong social relationships had a 50% lower chance of death across the average study period (7.5 years) than those with weak connections. The researchers reported “The magnitude of this effect is comparable with quitting smoking.”

Dozens of subsequent papers reinforce these conclusions. For example, HIV patients with strong social support have lower levels of the virus than those without.

Women have better chances of surviving colorectal cancer if they have strong connections.

Young children who are socially isolated appear more likely to suffer from coronary heart disease and type 2 diabetes in adulthood.

Most remarkably, older patients with either one or two chronic diseases do not have higher death rates than those who are not suffering from chronic disease – as long as they have high levels of social support.

But how do you CREATE social support? 
How do you counter-act isolation?  What did they do in Frome?

The systems described above that Helen Kingston and her teams were able to establish to support isolated people with health problems were made possible by community groups and volunteers.

And the outcomes?
During the three years of the study, emergency hospital admissions rose by 29% across the whole of Somerset. However, in Frome they fell by a remarkable 17%!

Julian Abel, a consultant physician in palliative care and lead author of the draft paper, remarks: “No other interventions on record have reduced emergency admissions across a population.”

This is a landmark study and one every community warrants taking to heart.

So what to do?
The evidence strongly suggests that social contact should be on prescription.

If you are a social activist, become even more involved in creating communities. Set up support groups, volunteer, lobby councils and government.

If you have illness or want long-term good health, become even more involved in community activities. Join a support groups, volunteer, lobby councils and government. Reach out. It could reduce health problems by around 40%!

And as one commentator observed, “the innovative work of the Compassionate Frome project has shown how, by translating impulses of kindness born out of concern for one’s fellow human beings into effectively organised social action, a town can do more than restore a sense of value and purpose in both carers and those in need of care: it can also bring significant practical and financial benefits to the whole community”.

Speaking personally
Building community is one of the things I am now most interested in. Whether it be the on-line community my new meditation app enables (more of this in the next post) or by becoming more involved in local affairs; going to art classes or supporting my own spiritual group and its community, it is not hard but it does take time and resolve. A resolve that soon becomes effortless as the obvious multiple benefits flow for self and others.

Where are the new community opportunities for you?




3 comments:

  1. Where was the Frome study published please? Finding it difficult to locate the article. Other references would be appreciated too.

    ReplyDelete
  2. Beau - it was originally written up in https://www.resurgence.org, a magazine that unfortunately makes it hard to get back to the original reference. Also, the study has been submitted to a medical journal and is awaiting publication.
    Listing the other references is a bit beyond me at this point in time, but they should not be too hard to find on a Google search.
    Hope that helps...

    ReplyDelete
  3. This is SO good! I have always thought that connections are very important in all life areas.

    ReplyDelete