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A sense of community may be the best medicine

  • September 13, 2019

The English town of Frome has seen a significant drop in emergency hospital admissions since it began connecting ill residents with volunteers and support groups.

“It takes a village to raise a child,” as the saying goes, but one could just as easily say, “It takes a village to care for the elderly and infirm.” A fascinating experiment in the town of Frome, England, has discovered that building a sense of community goes a long way toward improving people’s health and happiness.

It began in 2013, when family physician Helen Kingston launched the Compassionate Frome project. Kingston had noticed that many of her patients felt “defeated by the medicalization of their lives.” They were treated more like a “cluster of symptoms” than human beings with health problems. Together with the town council and representatives from the National Health Service (NHS), Kingston created a directory of local support groups and volunteers. New groups were formed to fill any gaps.

The goal was to reconnect ill or depressed residents with the rest of society, which would give them new purpose in life and improved access to care. The system relied strongly on volunteers called ‘health connectors’, who provided a broad range of informal support services, many of which are atypical in today’s world of overmedicalized care. George Monbiot described it in the Guardian:

“Sometimes this meant handling debt or housing problems, sometimes joining choirs or lunch clubs or exercise groups or writing workshops or men’s sheds (where men make and mend things together). The point was to break a familiar cycle of misery: illness reduces people’s ability to socialise, which leads in turn to isolation and loneliness, which then exacerbates illness.”

Monbiot goes on to explain some of the science behind this cycle of misery:

“Chemicals called cytokines, which function as messengers in the immune system and cause inflammation, also change our behaviour, encouraging us to withdraw from general social contact. This, the paper argues, is because sickness, during the more dangerous times in which our ancestral species evolved, made us vulnerable to attack. Inflammation is now believed to contribute to depression. People who are depressed tend to have higher cytokine levels.”

The project’s results have been remarkable. While emergency hospital admissions have risen 29 percent across the entire region of Somerset, where Frome is located, they have fallen in Frome by 17 percent. Julian Abel, a physician who co-wrote a paper on the project, said, “No other interventions on record have reduced emergency admissions across a population.”

As Abel explains in Resurgence Ecologist, severe illness often comes at the avoidable end of a lengthy process:

“People can endure months, even years, of social isolation before they are finally rushed into crowded hospital wards. An urgent need to revive and sustain our community life is demanded by the recognition that warm social interaction has been fundamental to human evolution. It remains so, and deprived of it we suffer enormously.”

These findings come at a time when England’s NHS is struggling greatly to meet demand for health services. Similarly, the government is more concerned than ever about the ‘epidemic of loneliness’ afflicting millions of citizens and has just appointed a minister for loneliness, to help combat this problem.

Happily, Frome can be a model for the rest of the world — living proof that it doesn’t take much more than a hand extended in kindness to make a significant difference in people’s lives.

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