May is Older Americans Month, the opportunity to celebrate the contributions of older adults and highlight opportunities to address their most pressing issues and challenges. As we continue to navigate our way through the COVID-19 pandemic, the Health Foundation is raising awareness of two closely linked issues affecting older Americans more than ever: social isolation and loneliness.
Addressing social isolation is part of the Health Foundation’s overall efforts to achieve our new strategic plan and organizational vision, a healthy central and western New York where racial and socioeconomic equity are prioritized so all people can reach their full potential and achieve equitable health outcomes.
Our strategic plan includes a midterm goal to address these issues specifically: Social isolation and related behavioral health issues among older adults and caregivers are addressed. This supports our long-term goal that individual well-being is promoted and addressed for both children and older adults. You can read more about this midterm goal and how we plan to pursue it in an overview here (opens as PDF).
Social Isolation and Loneliness – What’s the Impact?
Social isolation refers to objectively fewer social contacts and social relationships, while loneliness is the subjective emotional experience of feeling alone. According to a 2020 study by the National Academies of Sciences, Engineering and Medicine, “Social Isolation and Loneliness in Older Adults,” approximately 24 percent of people 65 years old and older are considered to be socially isolated, with 43 percent of adults over 60 reporting that they feel lonely.
The effects of social isolation and loneliness have a major lasting impact on the mental and physical health of older Americans, as well as family caregivers. Chronic loneliness is closely associated with the onset of depression, sleeping issues, impaired cognitive functioning, hypertension, and physiological and psychology stress, in addition to other mental and physical health issues.
The health crisis of social isolation and loneliness has been severely worsened by the COVID-19 pandemic. Social distancing regulations, while imperative for preventing community spread and keeping older adults safe from the virus, also resulted in a greater risk of isolation. Trusted family members and other caregivers have been unable to visit older adults with regularity, and often not at all. Challenges that existed for older adults pre-pandemic, such as inadequate access to transportation or technology, also compounded the risk of social isolation during this crisis.
Family Caregivers Are Affected, Too
Family caregivers also face an increased risk of suffering from loneliness and social isolation. In a 2020 report on caregiving from AARP, one out of five caregivers of adults admitted to feeling alone. This loneliness is associated with stress, strain and decreased health.
It may be surprising to think of caregivers as isolated because of the time they spend with the care recipient, but this relationship often does not meet all of their social and emotional needs. This can result in greater feelings of isolation and loneliness due to the commitment and stress associated with their duties as caregivers.
The challenges of serving as a family caregiver have only worsened during the pandemic, especially before vaccination efforts began. Caregivers faced the nearly impossible challenge of ensuring their loved ones received needed care and support while following necessary social distancing requirements.
Restrictions on visitations in hospital and care facilities meant some caregivers went several months without seeing their family member in person—a heartbreaking situation for both caregivers and their loved ones that only increased their risk for loneliness and social isolation.
More Mental Health Care Access is Needed
Social isolation and loneliness are strongly associated with poorer overall mental health and depression, and local data shows these are prevalent issues throughout western and central New York, with higher rates in rural counties. Wyoming County leads the western New York region with 17.9 percent reporting 14 or more poor mental health days in the past month. In central New York, Herkimer County leads with 19.3 percent.
This data supports the need for increased access to mental health care and medical professionals, particularly for people of color. Data from the Kaiser Family Foundation found that Native Americans in New York report significantly more poor mental health days per month that other racial and ethnic groups. In general, older adults from minority groups are less likely to receive mental health services and are more likely to be misdiagnosed based on racial and neighborhood characteristics.
The Health Foundation’s Work Addressing Social Isolation
The Health Foundation’s interest in social isolation and loneliness emerged over the past several years as staff explored predictors of poor health in older age identified within the Triggers of Decline framework. That framework highlights several individual, community, and society-level factors that put older adults at risk of decline, including mental and behavioral health, and emotional well-being.
In 2016, the Health Foundation launched Aging by Design with the goal of working with older adults in the community to identify what they believed were the most significant challenges they faced as they aged, and to co-design better solutions for addressing those challenges. During the initial learning phase, social isolation and loneliness were the most frequently cited concerns by older adults. Several of the grantee teams developed projects to address barriers that led to social isolation such as lack of transportation and language barriers. Others focused on increasing socialization opportunities and addressing attitudes that marginalized older adults.
The Health Foundation has also supported several small pilot projects that promote healthy aging and show promise as a means of reducing social isolation and loneliness, and building connections with others. These projects often incorporated the arts, music, and storytelling.
Going forward, the Health Foundation will continue to explore innovative approaches to addressing the broader problem of social isolation and loneliness. Our efforts will also include a focus on depression in older adults and how to improve access to care.
As with many other health care challenges, the COVID-19 pandemic exacerbated the issues that can lead to social isolation and loneliness in older adults and caregivers. However, these conditions existed before this crisis, and will persist beyond the pandemic unless we come together as a community to recognize and address them. Our team looks forward to continuing to collaborate on new solutions to addressing social isolation and loneliness in older adults and caregivers.