By Sara Stevenson

With a focus on improving health outcomes in the communities it serves, Humana is in lockstep with medical, policy and grass roots professionals addressing social determinants of health. At the forefront of Humana’s work is research and understanding of loneliness.

Loneliness is the quality of relationships within a person’s network and their sense of belonging and social support. Loneliness is also a social determinant of health most of the population will experience at some point during their lives.

Even if other social determinants, such as food insecurity, safe housing and transportation are met, loneliness may be a concern and often manifests itself both mentally and physically. Loneliness and social isolation have been associated with worsening health-related quality of life (HRQOL), increased mortality and other poor health outcomes.

By identifying individuals at risk for loneliness and related outcomes, the healthcare system can better predict their healthcare needs and establish appropriate preventive and intervention strategies to improve their health.

Bold Goal

Humana decided several years ago to create a Bold Goal: a population health strategy to improve the clinical and social health outcomes of its members. To quantify our progress, we use the U.S. Centers for Disease Control and Prevention (CDC) assessment tool, Healthy Days, to measure the mentally and physically unhealthy days of individuals over a 30-day period.

Due to our active involvement and partnerships within Humana’s Bold Goal communities, we have seen a 2.7 percent reduction in unhealthy days since 2015.

Through this effort, in chosen markets where Humana sees opportunities to address social determinants and health-related social needs, we’re working with nonprofit organizations, business and government leaders as well as healthcare professionals to identify, screen and refer members to community resources and long-term support. By using data, technology and evidence-based solutions, we’re able to connect, learn and make health improvements easier and more attainable.

Much of the early work conducted by the Bold Goal, Office of Population Health, focused on how to identify Medicare Advantage (MA) members who are lonely as well as understand their drivers of loneliness. After evaluating validated tools, our team chose the three-item University of California, Los Angeles Loneliness Scale.

We then screened a sample size of MA members to assess their loneliness. These results, combined with demographic and claims data, allowed our Clinical Data Science team to build a predictive analytic model. As a result, we can better understand the risk of all MA members experiencing loneliness and tailor programs and benefits to better meet their specific needs.

Furthermore, our Humana Healthcare Research team completed a 2018 cross-sectional, observational study using 12 months of administrative claims and consumer data of MA members. The research found that:

• Individuals predicted to be lonely also reported higher numbers of unhealthy days across multiple chronic conditions.
• Individuals with behavioral health conditions had a higher prevalence of predicted loneliness and poorer quality of life compared to those with other conditions.

The intertwining of loneliness and health outcomes makes it imperative for clinicians and social interventionists to recognize the signs and provide support where needed.

Resources

If you’re new to learning about the social determinants of health space or would like to begin a screening program within your practice or clinics, Humana has resources for you.

Find our Physician Quick Guide, which elaborates on screening for loneliness, at PopulationHealth.Humana.com, where you’ll also find additional information on the Bold Goal and what partner communities nationwide are doing with Humana. Also available for download is an extensive toolkit with additional information on screening and a consumer one-pager for your patients.

Around the nation, we are working with our partners to create meaningful pilots that can be scaled as proven and appropriate. One of our most recent endeavors was with Papa Inc. to connect college students, known as Papa Pals, to seniors who were at risk for loneliness to provide companionship, assistance with house chores, technology lessons and other senior services. It helped us understand that engagement could reduce loneliness and Unhealthy Days.

Humana is a part of the Louisville Health Advisory Board and we welcome your input. Find out more about the board, its participants and efforts at louisvillecultureofhealth.com/louisville-health-advisory-board.

– Sara Stevenson is the Population Health Strategy Lead at Humana.