by Kristine A. Schaan, MA, NHA, CPG
In my previous article I introduced the work being convened by the United Nations towards the Sustainable Development Goals. If you have yet to read the primer Can a Trishaw Ride Make the World a Better Place, please visit this introductory article first so you have greater context as we journey through our four-part series.
The United Nations has set forth an ambitious target for the goal Good Health and Well-being (no. 3):
By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
Non-communicable diseases encompass overwhelmingly chronic conditions such as heart disease, lung disease, cancer, and diabetes. Estimates from a range of research cite that up to 90 percent of chronic conditions are preventable by means of lifestyle and health promotion.
Optimized Health and Well-being
As a gerontologist, my passion resides within my research on optimized longevity: leveraging healthy life expectancy while diminishing or delaying chronic disease incidence. This can also be referred to as optimized health and well-being. I devoted my master’s thesis work to studying the longest-lived, healthiest seniors and uncovering their secrets to longevity. My studies and research conducted eight years ago come full circle as I incorporate into my present-day work with the seniors of Singapore. What can we learn from the longest-lived, healthiest seniors? It is that their longevity (health and well-being) is attributed to three things: physical activity, whole foods diet, and social connectedness.
The latter, social connectedness, warrants greater weight than physical activity and whole foods diet. By way of example I present my most frequently cited sources:
- Studies reveal that loneliness is as deadly as smoking and that social isolation and loneliness is likely to be more harmful to one’s health than, obesity, lack of exercise or poor nutrition.
- A study on social integration throughout 139 countries reported that quality social supports and interactions consistently associate with positive health outcomes.
- Research by Blue Zones Founder, Dan Buettner, indicates that social connectedness has the opportunity to add a combined eight healthy years to life expectancy, whereas physical activity and whole foods diet have the opportunity to add four healthy years, respectively, to life expectancy.
These citations in tandem with a supporting literature review strongly suggest that efforts to increase social interactions serve as an important intervention in reducing chronic disease incidence while also promoting health and well-being. Within the global movement convened by Cycling Without Age, we seek to do just that – use the trishaw and the opportunities it brings for social connectedness as a social intervention.
Two Beneficiaries, A Mutual Impact
Prior to rolling out our intergenerational bonding project, our CWA Singapore research team sought to understand the impact of trishaw rides on not only the passengers, but the pilots as well. We implemented a system to collect quantitative data by conducting baseline measures prior to any trishaw rides and then follow-up surveys on the same measures after the trishaw rides. Qualitative data was also collected through interviews and surveys.
What we found from our initial wave of data collection and analysis has been remarkable. With respect to the passengers, they report increased opportunities and frequency of social interactions as well as improved feelings of happiness and positive emotions.
“What I enjoy most is when I can meet people on the way during the trishaw ride.” -Madam Lee*
“The trishaw rides make me very happy and to see smiles on so many faces.” -Auntie Goh*
“Most of the residents become more sociable and calm, especially those with dementia. I can see the lovely smiles and hear laughter as they share with one another upon their return trip.” -Nurse Manager
Our qualitative results from pilots indicate the following: enhanced communication skills, increased desire to initiate a conversation with a senior, as well as enhanced relational skills and relational bonding. An emerging theme is the number of pilots sharing how their participation in trishaw rides has helped them with overcoming depression and anxiety.
“I learned from the seniors about the many relationships we have like friendships, family and even romantic relationships. They taught me the importance of sustaining all these miraculous relationships through trust, loyalty, love, honesty, patience, and understanding towards each other. Lastly, they taught me if you’re afraid of getting hurt you can’t grow and learn from that relationship. I feel happy being able to interact with the seniors.” Nur Aadil*
Results from our quantitative measures are equally encouraging: seniors report a 19.5% increase in current mood and outlook on life, and a 17.4% increase in social connectedness and community connection. Pilots report their comfort level communicating and interacting with seniors increased by a staggering 36% upon receiving our comprehensive skills training and after cycling with seniors.
An Unusual, Yet Effective Social Intervention
So what does this all mean for sustainable development? It means our narrative can be supported with measurable impact, illustrating a trishaw ride is a successful intervention that can combat social isolation and thereby promote health and well-being. Further, it informs both providers and funders that resource allocation towards these categories of social programs is cost-effective. With an estimated 75 percent of health spending attributed to chronic disease, our social intervention offers a considerable return-on-investment. 
Throughout my professional experience I still see that the large majority of health efforts grossly underestimate the significance and power of the social realm. One challenge is that providers often face difficulties quantifying the impact of prevention and potential cost-avoidance. Moreover, healthcare delivery is built upon a medical model and the entire system is largely designed to treat and cure. A final challenge is that social determinants of health are often left unaddressed yet prove a critical component within the value equation. (I speak more to social determinants of health in the proceeding article of this four-part series: Social Inclusion: The Fight Against Inequality.)
The good news lies in the demonstrated success and growing capacity of social interventions to impact health. These results call us to be more intentional in designing as well as funding programs that address social aspects of wellness. I end here with a few questions for both providers and funders:
- Providers: What challenges do you currently face in measuring and demonstrating the impact of social interventions? What social innovations have you implemented that align with good health and well-being?
- Funders: In the context of health promotion and wellness, what specific measures and impact do you look for when providing financial support to a program? How can providers best demonstrate impact?
About our partner: CWA Singapore has been engaged with Steward Redqueen throughout the past several months, serving as our industry expert. Steward Redqueen is a specialized consultancy that works across the globe advising organizations on impact and sustainability. Their vision is to make business work for society with a focus on integrating sustainability, quantifying impact, and facilitating change.
*Names attributed to the quotes have been changed to protect privacy.