ABSTRACT
Background
Social isolation and loneliness are significant public health crises that can exacerbate stress and diminish health behaviors, leading to overall reductions in well-being. The effects of systemic upstream social determinants of health (SDOH) can worsen these effects. Partnerships between communities of faith and health systems have the potential to reduce social isolation and loneliness, address unmet social needs, and improve access to healthcare.
Methods
The Congregational Care Network (CCN), a collaboration between a health system and local congregations in neighborhoods with high poverty and gaps in other SDOH, provided 1 h per week of individual, volunteer companionship to older adult patients for 90 days. The health system provided training and professional support from social workers and chaplains. A program evaluation measured loneliness before and after participation and healthcare utilization in the 90 days before, during, and after the program.
Results
CCN recruited 28 congregations representing diverse religious affiliations and 335 patients participated in the CCN program. Patients who received CCN services had a median age of 64.9 years (standard deviation 11.5), were 27.2% male, and 58.8% Black. There were significant reductions in DeJong Gierveld loneliness scores from before to after program engagement (median change score: 1 (interquartile range (IQR) 0–2, p < 0.001)). The proportion with 1+ emergency department visits was significantly lower after CCN compared to before (16.8% vs. 24.6%, p = 0.007); the proportion with inpatient visits was lower during CCN compared to before (12.2% vs. 17.3% vs. p = 0.032). The proportion with outpatient visits was higher during CCN than before (71.0% vs. 63.8%, p = 0.045).
Conclusion
The CCN partnership between congregations and a local health system is a feasible model for at-risk older adults that may reduce loneliness and shift healthcare utilization from acute to outpatient settings, providing greater continuity of care and fewer burdensome acute care visits.