While social isolation among older adults has always been a concern, it has gained increased attention as individuals engage in social distancing to stem the tide of the COVID-19 pandemic. Even before the outbreak, nearly one-quarter (24 percent) of community-dwelling adults age 65 and older were socially isolated. Today, with social distancing guidelines in place, we can assume that number has increased substantially. This edition of A Kansas Twist provides insight into this important issue.
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What is social isolation? Often confused with loneliness, social isolation has been defined by the National Academies of Sciences, Engineering, and Medicine as “the objective lack of (or limited) social contact with others.” Loneliness, on the other hand, is “the perception of social isolation or the subjective feeling of being lonely.” While closely related, the two concepts are distinct; individuals can be socially isolated without feeling lonely, and vice versa.
Last fall, AARP Kansas and the Kansas Health Institute (KHI) partnered to assess social isolation among older adults in Kansas as part of the broader AARP Disrupt Disparities initiative, a multi-year, national effort to identify disparities that exist among older Americans and to find solutions to disrupt those disparities. Through that partnership, KHI conducted a literature review of the current research on social isolation, focusing on the overlap between social isolation and health disparities. The findings culminated in our recently released report, Disrupting Disparities in Kansas: A Review of Social Isolation Among Older Adults.
The report found that there are many risk factors for social isolation, including retiring from a career, becoming a caregiver, losing a partner, having a small social network, and living in an unsafe or inaccessible location. Health issues, such as experiencing vision or hearing loss, can also be risk factors. Having one or more of these risk factors does not mean an individual will become socially isolated, as risk factors affect each individual differently and to varying degrees. Instead, the risk factors increase the likelihood that a person could become socially isolated.
Numerous societal factors, such as poverty, racism and discrimination, can influence opportunities for social connection and create barriers to social engagement for vulnerable groups. These factors can put people with lower income, people of color, immigrants and those identifying as LGBTQ at greater risk of social isolation. More research is needed to better understand how specific risk factors impact different populations.
Experiencing social isolation has been linked to a poorer quality of life and reduced health outcomes, including an increased risk of all-cause mortality. The link to mortality puts social isolation on par with other major health risk factors, including smoking and obesity.
Many groups have implemented interventions in recent years to mitigate the impacts of social isolation. This includes interventions that facilitate social interaction, encourage new friendships, utilize animals in therapy, involve intervention by health and/or social care professionals, help individuals develop new skills or encourage them to use technology.
While evidence is limited on the effectiveness of these approaches, researchers have identified common elements of successful interventions:
- They can be adapted to reflect local needs, especially if the intervention was initially developed by a national organization;
- They use a community development approach, where users help design and implement the intervention; and
- They support productive engagement through a purposeful activity.
The current social distancing measures used to address the COVID-19 pandemic, while necessary, have resulted in diminished social contact that can increase the risk of social isolation. In response, many local and national groups have taken steps to decrease isolation. For example:
- AARP has launched a new website, AARP Community Connections, where individuals can request a friendly call from an AARP volunteer or find mutual aid groups in their local community.
- Shawnee County has created the Shawnee County Community Cares Line, a “warm” line staffed by local volunteers to foster community connections during this time of social distancing.
- The Unified Government of Wyandotte County and Kansas City, Kansas, Public Health Department have created a sign-up form on its COVID-19 webpage where individuals can volunteer for community efforts.
- The Johnson County Department of Health and Environment has a social connectedness focus in its community health assessment.
See our report for additional information on interventions, as well as considerations for assessing social isolation in Johnson County and Wyandotte County.
Social isolation can impact anyone and can lead to negative health outcomes. Some older Kansans experienced social isolation before the COVID-19 pandemic, and will continue to be at risk after the pandemic subsides. While social distancing is important to reduce the spread of COVID-19, it could lead to even more older Kansans experiencing social isolation. It is important that we learn from the current situation how to minimize the overall risk and address disparities in Kansas.
The Kansas Health Institute supports effective policymaking through nonpartisan research, education and engagement. KHI believes evidence-based information, objective analysis and civil dialogue enable policy leaders to be champions for a healthier Kansas. Established in 1995 with a multiyear grant from the Kansas Health Foundation, KHI is a nonprofit, nonpartisan educational organization based in Topeka.