Our health services are at and in many places beyond breaking point. While we can hope the new government will restore some of the funding it is clear that health needs and costs are continuing to rise. In the next 15 years those living with a major illness are forecast to rise by 2.5 million to 9.1 million (i).
So what can tackle rising costs and massively rising ill-health?
In this blog I will look at part of the answer that is already being tried with some wonderful results in terms of cutting costs and improved health outcomes. Perhaps the best articulation of the approach is the book “The Community Cure. Transforming Health Outcomes Together” by James Maskell (ii).
Maskell notes that we are facing a profound and worsening epidemic of loneliness and this is exacerbating chronic disease. He cites many examples of isolation as a social determinant of health including a 2017 questionnaire-based study where Medicare recipients older than 50, who ultimately were defined as “lonely”, experienced death rates 31% higher than their peers who did not self-identify as socially isolated.
This research is not new - there is loads showing a range of health conditions associated with loneliness and social isolation, including heart disease and stroke, type 2 diabetes, rheumatoid arthritis and cancer. Even recovery following heart surgery can be compromised by isolation.
In the book Maskell argues that to counter this we should turn to group medical appointments; a supportive community provides the space to help develop healthy behaviors - a key to reversing chronic illness. This also can ‘shift our collective focus to prevention and root cause resolution’.
The book looks at the many ways group medical visits are being used - and the powerful evidence of them as a treatment for the loneliness epidemic.
One of the examples Maskell looks at is the work of Dr Jeffrey Geller’s. This doctor found that patients who lacked support systems accessed medical care at a greater rate, so he decided to create a support system by forming group visits with a cohort of diabetes patients. Geller notes “People’s loneliness improved, people’s depression improved, they lost weight … blood pressure reduced by 5-10 points, and hemoglobin A1C also reduced”.
I’ve personally seen the benefits of a group of people coming together and supporting each other - the peer-led Wigwam cancer support groups are a great example. See my blog post on this; ‘What makes the biggest difference to our healing’: https://yestolife.org.uk/what-can-make-the-biggest-difference-to-our-healing/
I’ve also seen benefits accruing from groups like the Cancer Exercise group at Stratford Park Leisure Centre supported by Stroud District Council. I believe there is huge potential for more of this intentional coming together.
One obvious possibility might be the one-off prehab talk now being run by local cancer services. Could that be expanded into a series of group activities looking more at nutrition, exercise, sleep, stress and more? This of course doesn’t mean there will not be some individual appointments but the bulk of issues can be raised in the groups. One of the findings into researching this approach showed that folk didn’t have time to raise key stuff in an individual appointment but there was time in the groups. Furthermore some patients were more shy to raise issues and found it useful that others in the group asked those questions.
‘Confidentiality’ I hear some folks cry. Yes any group work needs to consider this issue, Maskell has a section in his book on this, but it seems clear to me that group visits don’t destroy a patients privacy. What they do offer is a safe space for folks to be vulnerable and this can be a key part in healing.
Maskell writes: “We need more connection, more empathy, more social connectivity, and less loneliness, less social isolation. In a culture and society that emphases and prioritises privacy, we’ve inadvertently contributing to the very epidemic we’re trying to solve."
Maskell provides many resources for those interested in starting their own group visits, primarily through his website, “Evolution of Medicine.” I also know there are many skilled practitioners within our NHS who no doubt already have the skills to develop this approach.
With families and communities no longer meeting our needs we have seen what Maskell calls ‘total commodification’. We need ever more money to pay for counselling, babysitters, care and more - these were once shared by the community itself. It seems we now only look to the market or government for solutions. It’s time for a refocus…..group appointments are a way whose time has come. It would be great to see if there are opportunities to expand these ideas in Gloucestershire?
There are many other podcasts with James Maskell on his website and online. Here are a couple:
Dr Chatterjee interview: https://drchatterjee.com/the-secret-to-radically-improving-your-health-that-nobodys-talking-about-with-james-maskell/
Here are a couple more of my blogs looking at the impact of social support and community:
See blog about building a community of Wigwam Cancer Support Groups:
https://myunexpectedguide.blogspot.com/2021/05/building-community-of-peer-led-support.html
See blog on social prescribing and anti-social prescribing:
https://myunexpectedguide.blogspot.com/2019/12/social-prescribing-for-people-living.html
Notes:
- https://www.health.org.uk/reports-and-analysis/reports/health-in-2040-projected-patterns-of-illness-in-england
- https://thecommunitycure.com/getyourcopy
