Shift Your Mindset is a monthly series from CNN’s Mindfulness, but a better team. We talk to experts about how to do things differently to lead a better life.
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With friends, you’ll spend less nights, and you’ll have more takeaway meals, fewer theatres. Americans spend more time alone than ever.
Whether this trend arises from the prevalence of loneliness, the fact remains that many of us are more frequent, whether it is people want a company or leave behind a century of solitude where individuals prioritize solo time. However, humans are social creatures whose happiness depends on belongings, and too much loneliness has significant health effects for individuals and society.
At the same time, the US healthcare system is “expensive, complicated, dysfunctional” and perhaps “broken,” experts say. Higher costs do not lead to better outcomes, and uneven access leads to avoidable disparities among people of color and other marginalized groups.
“Social prescriptions” involve providing healthcare referrals not only to medications but also to community activities, and are useful in all respects, claiming solution-focused journalist Julia Hotz. In her book, The Connection Cure: The The Powerful Movementive Power of Movement, Nature, Art, Service, and Noveling, Hotz shares ways to improve individual physical and mental health and strengthen the community by fostering interpersonal relationships and promoting community engagement. It is cost-effective and already popular in the UK, and the social prescribing movement has gained traction in the US.
Just as evidence that meaningful relationships are just as important to our well-being as diet and exercise, Hotz explains the science of connection and makes practical suggestions to combat our growing isolation.
This conversation has been edited and condensed for clarity.
CNN: What is Social Prescription?
Julia Hotz: Social prescriptions are healthcare referrals for community activities and resources. Recognizing the important role our environment, relationships and communities play in our health outcomes, these prescriptions usually involve some element of movement, art, nature, service and belonging. When people struggle with issues like anxiety, depression, or even chronic pain, sometimes the most effective intervention is not just medication, but also reconnecting with the community. Social determinants make up 80% of our health, so it makes sense to incorporate them as healing modalities.
CNN: Is social prescription intended to replace traditional medicines?
cold: Not at all. This is complementing traditional medicines, treatments, and other treatments with evidence-based social interventions. I’m worried about overprescribing, but I also have a lot of empathy for doctors who find that medication, surgery, and other traditional treatments are the only option. The goal of social prescribing is to invest in alternatives rather than replacing or taking away standard treatment. You can take prescription antidepressants and take a walk with your friends.
CNN: Do social prescriptions work?
cold: Science supports the effectiveness of movement, nature, art and services prescribing to alleviate various diagnostic symptoms, including attention deficit hyperactivity disorder (ADHD), chronic pain, dementia, and loneliness. For example, exercise can help treat depression disorders, stress, anxiety and type 2 diabetes. Treatment of symptoms only through traditional treatments and medication, and thus misses the powerful impact on our health of meaningful interactions with others in our community.
Here is an example of someone I interviewed: She had to leave work when Akeela’s back injury developed into chronic pain. Without her job as a caretaker, she would have lost her sense of purpose and become extremely depressed. She tried all the treatments, pills and surgeries that the doctor prescribed for her pain. Some of that helped.
But what really made her feel better was the unconventional prescription. Volunteering for children’s healthcare charities. The focus was moved away from her pain and her pain, and towards caring for others, reducing the severity of back pain. In a time when so many people suffer from chronic pain, it is important to take advantage of all the treatments available to us.
CNN: Does the same social prescription work for everyone?
cold: This is because social prescriptions are personalized. It is not pushing everyone into the same activity, but connecting individuals with activities that resonate with specific values and interests.
When her patients struggle, pain psychologist Dr. Rachel Zoffnes suggests that they visualize pain as a dial. Just like experiencing negative emotions like sadness and anger, you can raise the dial of pain and other things, including distractions, can refuse. She asks her patients to consider opportunities to get caught up in what they are doing. When providers ask these types of questions, they help patients understand the social prescription that is best for them.
CNN: Do US healthcare providers issue social prescriptions?
cold: Social prescribing is more mainstream in countries with nationalized healthcare systems, such as the UK, but the movement is growing. An increasing number of providers are issuing social prescriptions around 50 states. Social Formulation, a nonprofit organization, tracks initiatives, pilots and research projects across the country on interactive maps.
On the other hand, I would recommend that people start by prescribing their own spots in the community, either free or donation-based activities. To find the ideal activity, people can ask questions such as: What did I like to do as a child? If there’s an extra 2 hours a day, what would you spend on? What is my tracking time?
CNN: How do social prescriptions help solitude?
cold: Loneliness has a major impact on not only your mental health, but also your physical and mental health. If you are lonely, you are more likely to die prematurely. You are more likely to worry, feel depressed or develop dementia. You are more likely to go to the emergency room. All the results equivalent to smoking 15 cigarettes a day.
Social prescriptions create meaningful connections because they align with the patient’s interests and values. This has great health benefits. The goal is not to “reach Kumbaya’s circle, hold your hands, become your best friend, and hold strangers in your arms.” Instead, social prescriptions reconnect with important things
CNN: Why is social connections so important?
cold: Humans are evolving and make social connections as important as food and water. But our record numbers have chosen to spend time alone. Life is tired. We work hard. We’re burning out. Digital media may feel like we are constantly moving, but it drains us so much that we don’t want to retreat into the house and leave anyone. We were not wired to live in the conditions that modern life requires.
CNN: How do online connections compare to face-to-face interactions?
cold: Online connectivity can be a lifesaver for some, such as those with limited mobility or those who feel isolated because of their differences from their community. However, most online interactions don’t offer a truly resilient element of connectivity, especially on social media.
A connection of quality provides the feeling of including who you are and what you are and what you are seen and asserted in a true sense of belonging. When you build a real connection, you feel like you know yourself well after spending time with that person. And it may be more beneficial to your health than spending time with 10 people you don’t know well.
CNN: How does creating a sense of belonging improve health?
cold: Loneliness is important to some of us. However, once being alone becomes the norm, you can begin to experience the health effects of loneliness without realizing it.
Science says that belonging is healing. A Harvard study of adult development, which has followed people for over 80 years, calls the strength of relationships the number one predictor of health and lifespan.
CNN: What is the social cost of a lack of attribution?
cold: This has great consequences. People who lack the sense of belonging elsewhere can sometimes be involved in very harmful and extreme political causes. For example, the story of former Qanoners includes discussions about depression, social isolation, loneliness, and lack of belonging.
People register social pain, such as physical pain, research shows. Witnessing social exclusion can also activate brain circuits. It can lead to despair that leads people to find themselves in places that deal a lot of damage. Society is not offered what it once was, so groups that mobilize to harm people are becoming more popular.
We can counter this trend by investing in other spaces – local opportunities to engage in movement, nature, art, service and belonging – sometimes truly healthy for us.
CNN: You call these 5 options – Movement, Nature, Art, Service, Attribution – The pillar of social prescriptions. What is their importance?
cold: These five pillars are more than just nice add-ons. These are the requirements of our lives. This proves true because of how our health improves when engaging in these activities.
As we move through our bodies, serotonin and endorphins are released, improving hippocampal function. Spending time in nature restores our attention and focus. Several studies have shown similar effects to taking ritalin. Engaging in the art reduces symptoms of anxiety and trauma. This makes sense given that humans used storytelling and art to deal with harsh emotions from the beginning of time.
Service and attribution are the largest. Because we were all big and bad wilds on our own and not survived. We survived in the group. Think about how last names reflect our function within our community for generations. Currently, many of us are not engaged in the community, but we choose artificial and often electronic sources of connection. That’s when our health began to suffer.
CNN: What is the future sense of social prescribing in the United States?
cold: Investments in the Social Prescription Bridge are split and provide a bipartisan solution to address issues that are important to people across the political spectrum. People on the left are concerned about access to healthcare and affordability. On the right, the Make America Heathy (Maha) move is concerned about the safety of our food and drugs and the decline in chemicals while fiscal conservatives focus on cutting costs.
Social prescriptions not only provide significant health benefits, but in fact they save money over time while reducing pressure on excess systems. Think of a 92-year-old who goes to the hospital just because she has no other place to go. Instead, prescribing her weekly phone calls with someone or knitting group spots saves medical resources and ultimately saves taxpayer money.
If you want to invest in an approach that can improve health outcomes, reduce health costs, and appeal to all politically persuasive people, recognize the ways the environment has an impact on our health and prioritize social prescribing.
Jessica Duron He is a book collaborator, writing coach, and author of “Saved at the Seawall: Stories from the Stories from the Stories from the Stories from the Stories” and “My River Chronicles: Adreakovering the America.”