Social isolation should be considered a health risk.

Why is social isolation a health problem?

Human beings are social animals. We live with others, and we support each other; that’s what has given us an evolutionary advantage. So, what happens when a person doesn’t have others to be with when they are socially isolated? Older people are especially at risk of being socially isolated. By the time people reach their eighties, the majority live on their own, mostly because of widowhood. This is particularly the case for older women who are more likely to be widowed than older men. Older people’s social networks often get smaller for other reasons as well – children may have moved away, along with grandchildren, and ageing siblings and friends may have died.

For many decades, researchers have been interested in social isolation and what impacts it has on people’s health. One question that has been looked at is whether people who have more social relationships or more supportive relationships live longer than those with fewer or less supportive ones. In these studies, people are asked about their social relationships at one point in time; some years later, researchers follow up and determine who is still alive and who has died in the meantime. In one study researchers reviewed 148 studies that had previously looked at social relationships and mortality. Across the 148 studies, people with more or better social relationships lived longer.

The obvious answer to reducing social isolation would seem to be to get people connected to each other and many programs are available that try to do just that. For example, there are many clubs or senior centres that allow people to get together. We don’t know whether these programs reach those most at risk of being socially isolated. If people don’t come forward on their own it can be a challenge to identify those who are socially isolated and help them to become more socially engaged.

We believe that many older adults are socially isolated, but we have no way of knowing who these people are unless they come forward, and this should be of concern to all of us. We need to watch out for older people who live alone, who hardly ever go out of the house, who hardly ever get visitors. Making a phone call to or visiting a family member or checking on a neighbour doesn’t take much time, but could make a big difference in somebody’s life. Communication via the internet also makes it increasingly easy to stay in touch across geographic distances. And there are many organizations that provide opportunities for social engagement, such as senior centres. Service providers should be aware of these opportunities and refer their clients that may be socially isolated to them.

More on social isolation

While there are many things that can put us at risk to become socially isolated, there are also other things that can help to ensure that we remain socially engaged. Protective factors, traits, situations or circumstances like these can help us to socially integrate and reduce the risks of social isolation:

Ø    being in good physical and mental health;

Ø    having enough income and safe housing;

Ø    feeling safe in our neighbourhood;

Ø    having communication and literacy skills to find and get needed services;

Ø    having satisfying relationships;

Ø    having a supportive social network;

Ø    feeling connected to and valued by others;

Ø    having access to health and community services;

Ø    feeling beneficial to society;

Ø    having access to transportation; and

Ø    having a higher level of education

Social isolation can put seniors at greater risk of death than factors such as obesity and physical inactivity. One study found evidence that shows that lacking social connections can increase one’s chances for early death to a similar degree to smoking cigarettes a day

Along with the personal effects of social isolation come significant costs to society. For example, socially isolated seniors are not able to fully participate in or contribute to their communities by volunteering or supporting local businesses and events. The adverse effects of social isolation can lead to increased costs in health care and social services.

Seniors who are socially isolated, compared to those who are not, make more visits to their doctor and to emergency rooms; they use more medication; fall more often, and enter residential care sooner. Some socially isolated seniors may, however, hold back from using health care services or use them in later stages of illness or disability.

Whether social isolation results in increased or delayed use of health care (i.e. until health worsens), it is harmful to the health care system and to the seniors involved.

Social isolation is also linked to undervaluing seniors in our society—negative images of seniors make them feel not needed, valued or able to contribute. People, organizations and society all suffer when seniors become socially isolated and stop contributing to their communities.

Given the opportunities and challenges accompanying Canada’s changing demographics, now is the time to address this issue. Individuals and organizations can work with each other and with seniors to create resources and solutions to improve seniors’ social inclusion. The risks of social isolation are:

Ø increase the chance of premature death

Ø a lower sense of well-being

Ø more depression

Ø dementia

Ø more disability from chronic diseases

Ø poor mental health

Ø increased use of health and support services

Ø reduced quality of life

Ø caregiver burden

Ø poor general health

Ø increased number of falls

Ø inability to participate in and contribute to the community

Social Isolation

As more Canadians become seniors, there will be proportionately fewer Canadians of working age. In 2038, there will be about 40 seniors for every 100 adult Canadians (between 18 and 64 years of age)— double the number of seniors in 2013.

Seniors will continue to have a growing role in the labour market and the volunteer sector, which contributes to retaining knowledge and skills in the Canadian workforce, sustaining the economy, and helping community organizations function. In all, the social and economic contributions of seniors will likely be increasingly connected to the success of the entire country.

For seniors to continue and even expand their participation in society they need to remain healthy and engaged in their communities. However, research shows that an estimated 30 percent of Canadian seniors are at risk of becoming socially isolated. According to the International Federation on Ageing, “the number one emerging issue facing seniors in Canada is keeping older people socially connected and active.”

Social isolation and exclusion are related to serious negative health effects and reduced quality of life for seniors. Social isolation is also linked to the undervaluing of seniors in our society and the loss of seniors from the volunteer sector and the paid economy. The National Seniors Council also asserts that the social isolation of seniors can cause communities to suffer from a lack of social unity, higher social costs, and the loss of the wealth of experience that seniors bring to our families, neighbourhoods and communities

Not all socially isolated seniors suffer negative consequences from social isolation. For example, some seniors may prefer to be alone and do not experience loneliness. On the other hand, because loneliness is a subjective experience, some socially active seniors may feel lonely. Whether or not people consider themselves socially isolated is a very personal and sensitive matter.

Social isolation is different from the feeling of loneliness, though the two are often related. “Loneliness is the distress that results from discrepancies between ideal and perceived social relationships.” This discrepancy perspective makes it clear that loneliness is not synonymous with being alone, nor does being with others guarantee protection from feelings of loneliness. Social isolation can generally be recognized by others observing a person’s relationships, while loneliness is a personal experience.

Social isolation among seniors can be a result of several factors. Many seniors experience physical changes (such as sickness or disability) and life changes (such as the loss of a spouse), which can reduce the number of social contacts and limit activities. Social and environmental factors, such as poverty and inadequate transportation, may also increase a senior’s chance of becoming socially isolated.

Social isolation can result from major events or from a combination of small events. How much these incidents affect people depends on the economic, personal, material and social resources that they have available to help them cope. Seniors can draw on their life experience in managing difficult times to help them with the challenges of ageing. However, too many changes, especially one after another, can make it difficult to cope.

About 30 percent of Canadian seniors are at risk of becoming socially isolated. Reports by Statistics Canada estimate that 19 percent of Canadians over age 65 feel isolated from others and 24 percent wish they could participate in more social activities.

The National Seniors Council’s Report on the Social Isolation of Seniors 2013–2014 states that the following factors may place seniors at risk of social isolation and loneliness:

·                   living alone

·                   being age 80 or older;

·                   having compromised health status

·                   having multiple chronic health problems

·                   having no children or contact with family

·                   lacking access to transportation

·                   living with low income

·                   changing family structures

·                   being left behind by younger people migrating for work

·                   location of residence

·                   experiencing critical life transitions such as retirement,             the death of a spouse, or losing a driver’s license

·                   lacking awareness of or access to community services           and programs

·                   being a caregiver

Having a lower level of education and being born outside of Canada are also identified as risk factors for seniors’ social isolation