Commentary: San Antonio, what are your ideas to reverse loneliness?

This commentary first appeared in the San Antonio Express News on Nov. 17th

San Antonio — Nothing brings San Antonians out of their homes like Fiesta in the spring or the arrival of the Spurs’ Victor Wembanyama. We love to get together, yet many suffer in the shadows.

Loneliness or social isolation affects people across all income levels, races, ethnicities and ages. Someone can be lonely even when surrounded by others.

Earlier this year, U.S.  Surgeon General Dr. Vivek Murthy warned that America is facing a loneliness epidemic that will lead to an “ever-increasing price in the form of our individual and collective well-being.”

Social isolation increases the risk of dementia by 50%, heart disease by 29% and stroke by 32%, according to the Centers for Disease Control and Prevention. A lack of social contact among older adults is also associated with an estimated $6.7 billion in additional Medicare spending annually, according to a study by the AARP Public Policy Institute.

I’ve built social infrastructure at the University of Texas Health Science Center at San Antonio for two decades. My team of community health workers now use Health Confianza (Spanish for confidence or trust), an initiative focused on improving our community’s health literacy and rebuilding trust in health organizations and systems.

In a little over two years, we’ve trained nearly 100 community health workers and community members in San Antonio to address the lack of social connection and low levels of health literacy through a peer-to-peer health promotion model known as community health clubs. The club format is what you see with Boy Scouts, book clubs or meet-up groups, only our clubs are focused on discussing health and social action to promote wellness.

Community health clubs are a scalable social infrastructure program that is now well-established in Texas’ Lower Rio Grande Valley. Since 2017, five community health workers have established and sustained clubs in Brownsville — mainly working with Spanish-speaking women to address health priorities ranging from nutrition to mental health and COVID-19.

Our members tell us they remain engaged due to the acknowledgement of their lived experiences and a sense of convivencia (Spanish for living/being together). This enhances their mental and physical well-being.

Although there’s a desire and need for social connection, few clubs have gotten off the ground in San Antonio. One challenge we hear from community health workers is that some have lost connection. Some in our most marginalized communities have seen outsiders come in, execute short-term projects  and leave. This has engendered a deeper sense of mistrust that can only be overcome by consistency and genuine connection.

For our part, we know that we must continue to show up, listen and evolve in a way that fits the culture and needs of our city. We persist because we’ve seen the value that clubs bring in terms of community engagement, social connection and collective action related to health.

Our question for San Antonio is: What would bring you as a community together? Could it be a block party or a supper club? Let’s figure out ways to come together and acknowledge that social isolation and loneliness is a local problem that we can address by building common unity.

Jason Rosenfeld is an assistant professor of medicine and director for global health education with the Charles E. Cheever Jr. Center for Medical Humanities & Ethics at UT Health San Antonio.


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