Social Determinants Related to Social Isolation and Loneliness

Jillian Racoosin CESIL • June 6, 2022

There is growing awareness of the negative health outcomes associated with social isolation and loneliness in the United States and across the globe. Social isolation, defined as having objectively few social relationships and infrequent social contact, differs from loneliness, a subjective feeling of a lack of connection to other people and a desire for more satisfying relationships. Some individuals may experience social isolation without loneliness and others may experience loneliness without social isolation (GILC).


While individuals of all ages and backgrounds can and do suffer from social isolation and/or loneliness, older adults can be affected disproportionately and are much more likely to suffer from health complications and related health care expenses. In fact, a report from the National Academies of Sciences, Engineering, and Medicine (NASEM) found that nearly one-fourth of adults 65 and older are considered to be socially isolated.[1] Researchers have pointed to older adults being more likely to live alone, lose a family member or friend, suffer from a chronic illness or hearing loss as risk factors for social isolation and/or loneliness.[2]


Understanding social determinants of health can be valuable in reducing the harmful effects related to social isolation and loneliness. Increasingly, researchers have looked outside the healthcare sector, such as ensuring equitable access to stable housing and transportation, notably for older adults.


Researchers and experts in senior living have claimed that living alone can contribute to feelings of loneliness. Some older adults have looked to co-live to bolster their social connectedness. Programs like The Villages Network - consumer-driven, grassroots community-based organizations formed with the goal of helping older adults age in place and stay connected to their communities - have been shown to improve population health, reduce isolation, and increase independence.



There is evidence that when transportation is accessible and affordable, it can be used as a means to foster connection. According to the National Council on Aging, 41% of older adults believe transportation in their communities is inaccessible or inadequate.[3] Companies like Uber Health have a role in reducing these barriers to transportation for the older adult population. In 2021, Uber Health partnered with Papa, a startup tackling loneliness among older adults to mitigate isolation and the
  [1] National Academies of Sciences, Engineering, and Medicine, Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System (Washington, DC: The National Academies Press, 2020), https://doi.org/10.17226/25663.

[2] Sara J. Czaja, Jerad H. Moxley, and Wendy A. Rogers, “Social Support, Isolation, Loneliness, and Health Among Older Adults in the PRISM Randomized Controlled Trial,” Frontiers in Psychology 12 (2021): 728658, https://doi.org/10.3389/fpsyg.2021.728658; Medical Advisory Secretariat, “Social Isolation in Community-Dwelling Seniors: An Evidence-Based Analysis,” Ontario Health Technology Assessment Series 8, no. 5 (2008): 1–49; Toby O. Smith et al., “Association between Musculoskeletal Pain with Social Isolation and Loneliness: Analysis of the English Longitudinal Study of Ageing,” British Journal of Pain 13, no. 2 (May 2019): 82–90, https://doi.org/10.1177/2049463718802868.

[3] Claire Samuels, “Understanding the Shocking Facts About Senior Isolation,” January 31, 2022, https://www.aplaceformom.com/caregiver-resources/articles/senior-isolation-facts.

negative health outcomes.[4] Through coordination between Uber Health and Papa, older adults are able to get to medical appointments, errands, and community events, as well as gain social interaction and companionship.

 



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Regaining Our Groove After Being Cooped Up (Part 1)

By Bernice Lowe Flowers • May 2, 2022
I enjoy going to the gym, exercising, outdoor activities, and walking the neighborhood when the weather is good. For so many of us, these activities were halted because we were housebound and instructed to adhere the social distancing mandate to prevent the spread of COVID-19. Being an avid walker, I was not too thrilled about these restrictions, so I maintained my exercise routine the best I could indoors. Believe it or not, many of us felt confined and are still struggling with the effects of physical, emotional, and cognitive challenges following months of being cooped up indoors. Do you agree? Stopping normal activities, or even mingling with other people can have a tremendous bearing on older adults especially when many of us are postponing going to the doctor for routine medical checkups because we are still afraid of becoming infected and gravely ill from the virus. Well, if we don’t address or confront these fears and issues, we are likely to face poorer health challenges and increased medical problems. So, what are our next steps? Since most of us are vaccinated and boosted, and anxious to venture outdoors again, let’s begin with scheduling our medical appointments to make sure we are physically ready to be active after being housebound for almost two years or more. If we have concerns about going to the clinic or doctor’s office, another option is to schedule a virtual visit, which is a new and convenient way to connect with healthcare professionals. Stay tuned for Part 2-Tips To Get Us Moving! Bernice Lowe Flowers, Board Member

Are We Being Unsociable While Socially Distancing?

By Carla Pettus, J.D. • July 23, 2020
 During the coronavirus pandemic, we have become overly concerned with maintaining the six feet distance designations and wearing our masks. We are annoyed when individuals do not follow the markings for six feet; ignore the directional markings in stores; or simply refuse to wear a mask for their own or loved ones’ protection. Conscious of our potential exposure to the virus, most of us are not spending a lot of time in grocery stores. We have a list and we hurriedly go through the aisles collecting our items and rush to the checkout. We avoid eye contact with anyone, i.e., other people in the aisles, stockers, workers, etc. If anyone sneezes or coughs in our immediate area, we are devastated and give the individual the “evil eye”. While I must admit, some of my actions resemble some of the above. However, I decided that I must consciously work on undoing some of these responses. I am a social being and realized that it was not sustainable for me to continue behaving this way. (My friends have tagged me the “Pied Piper” -- knowing no strangers.) So, I have made it a concerted effort to reverse some of these unsociable behaviors while socially distancing. Even under our current conditions, mask wearing and all, we can still smile with our eyes. Eyes have been called the windows into our hearts. So, I challenge you to just imagine how your sharing a small twinkle or displaying that gleam in your eye can bring calm and joy to those you encounter. Also, think of engaging in small mindful gestures such as a little wave of acknowledgement to someone you encounter or waiting a few feet away to allow someone to grab a grocery cart in isolation. I think if we each think of how we can restore some of the social niceties that are missing in today’s environment, that we would come up with endless possibilities that will work while socially distancing. Let us take the challenge by each of us trying to restore some civility or nicety into our society by being sociable as we are socially distant.    

Is it Just me?......

By Carla Pettus, Esq. | • July 23, 2020
 Is it just me that think a lot of advertisements depict the 55+ community as people simply waiting at death’s door? They, in general, seem to send the message that we are lackluster; out-to-pasture; and no longer contributors to society. Nothing could be further from the truth. Some of us are still working, others are volunteering in schools, food banks, and other charitable initiatives (some a little less now due to the coronavirus pandemic); and there are those that are enjoying life by participating in activities such as marathons, skiing, swimming, dancing, cycling, etc. Based on news stories, we see more grandparents are raising their grandchildren and not missing a step to ensure that their grandchildren attend a myriad of activities; and 80+ individuals are living active lives to the fullness in so many ways, i.e., SCORE volunteers providing business advice to new entrepreneurs; obtaining college and advanced degrees; and so much more. I  must admit with much amusement, I witnessed a 90+ woman in my church raise up her walker and do a little jig! Our minds are still sharp, our bodies are able, and we still participate in society in so many meaningful ways. We share our wisdom and knowledge with the next generation(s) while at the same time we re-tool ourselves to keep current with the latest technology. So, let us dispel the myths (or mis-messaging) of aging and let everyone know that, #aging it’s a good thing!     

The Secret Behind The Mask-Be Aware

By Donna Satterthwaite • July 22, 2020
The COVID-19 pandemic has really turned all of lives upside down, coping with this new phenomenon, wearing a mask. Older adults of late have become victims to unscrupulous predators wearing a mask. Since the COVID-19 pandemic, the enforcement of masks wearing has left our older adults vulnerable targets for abuse and robbery. While they are not able to see the entire face of an individual behind the mask, at times this has caused some older adults to be less observant of their surroundings. As result older adults may be caught unaware of someone following them or aggressively moving towards them.  During this COVID-19 pandemic period, please encourage your older adult family member, friends, and neighbors, to stay alert while they are venturing out into the public to take care of whatever need they might have. If you have an older adult relative, or if you know of an older adult who lives alone, please offer to run errands for them or go with them. This will help in increase their safety and ensure they are able to have their daily needs met.        

It’s Physical Distancing, not Social Distancing!

By Donna Satterthwaite • July 12, 2020
 Older adults and people who have severe underlying medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing more serious complications from COVID-19.      On the website of the Centers for Disease Control and Prevention (CDC) it is referred to as “social distancing.” I was never comfortable with that phrase because of the pictures it brings to the mind’s eye about isolation and especially about older adults in isolation.     There is a difference between being alone and being isolated or lonely. Google the words cigarettes and isolation together and you will see stated many times that loneliness and social isolation can be as damaging to one’s health as smoking 15 cigarettes a day. This statement has been out for five years B.C. (before COVID). With the onset of COVID-19 and older adults being a target demographic to become ill from it, the focus on isolation has become amplified.     It is important to have solutions that help each of us with social isolation while we continue to physically distance from others. And you know what? This also means each of us should commit to taking affirmative steps to help ourselves and others in a post-COVID world as well. AARP provides recommendations to help mitigate the harmful effects of isolation . Some of them are to:     Connect with family, friends or loved ones. Make the effort to do it, even if you must push yourself. Just a few minutes will go a long way. Take breaks from watching, reading, or listening to news stories, including social media. Care for living things like pets or plants Take care of your body: walking inside or out, light stretching, eat as healthy as possible. Listen to music, find activities that bring joy. Find ways to laugh.  Visit the AARP Foundation’s Connect to Affect to find access to other resources and to learn more about social isolation.