Integrated approach to social loneliness among elderly people living in a low-income neighborhood from Barcelona, Catalonia, Spain

Abstract

Introduction: Socioeconomic, community and health factors contribute to social loneliness, which is reinforced by certain experiences associated with ageing. Moreover, loneliness and impaired health can create a feedback loop reinforcing anxiety, depression, malnutrition, loss of motor function, toxic habits and even suicidal behavior in lonely elderly people. Both social loneliness and health impairment have risen due to COVID-19 crisis in elderly people, which is even worse in low-income areas. Ciutat Meridiana is a neighborhood with a score of people at risk of poverty or social exclusion (AROPE) (43,3) which is almost two-fold higher than Barcelona’s (24,4).Aim and methods: Our main aim is to create a program to approach social loneliness among older people living in Ciutat Meridiana, involving primary care center staff, community pharmacists and social workers. Healthcare professionals detect elderly people who report feeling lonely during consultation, spontaneously or when assessed about the topic. Then candidates are referred to a social worker, who discusses with them the possible activities and resources for social prescribing. A constantly updated map of resources and activities is created to help during the process. Participation, health and social indicators are monitored for all participants, including the social loneliness ESTE II score (1). Results: 67% primary care staff, at least one pharmacist from each community pharmacy and 2 social workers were trained for the program.23 participants were recruited from June 3rd to September 30th 2021. They are mostly women (83%), being 75.0±1,3 years old. Many are treated for mental health issues such as depression, anxiety and insomnia. Many report feeling lonely despite living with their families and having applied for basic income assistance in Barcelona Social Services. All participants have enrolled in some kind of local activity or resource due to the program’s social prescription, attending during the period to 2.48±4,15 sessions. The program has a Net Promoter Score of 76.2% participants with a score of 9.48±0.20 out of 10.78% participants report feeling less lonely and more social thanks to the program with an average 2.64 reduction in ESTE II score.  Conclusions: The results indicate that participants reduce their loneliness perception by getting involved in social activities, which may buffer some mental health issues. Piloting this program has been successful, despite being executed during the 5th COVID-19 outbreak in Barcelona. Applicability and limitations: The program will endure beyond this pilot and be transferred to urban and rural areas. Healthcare administrative assistants and recently hired psychologists will lead such Emotional Well-being and Community Health programs in many primary care centers in Catalonia. However, social loneliness score inclusion in healthcare professionals’ workstation softwares is needed.References1Pinel Zafra M, Rubio Rubio L, Rubio Herrera R. Un instrumento de medición de soledad social: Escala ESTE II. Granada, 2009 URL http://envejecimiento.csic.es/documentos/documentos/rubio-soledad-este2.pdf.