An interesting study by the AARP sheds some light on isolation and health, which I have posted about before, but as we age we lose our support group unless we work on keeping it. So to help find a reason to maintain a strong social network you might want to review this study (pdf file)
“Social
isolation is the distancing of an individual, psychologically or physically, or
both, from his of her network of desired or needed relationships with other
persons. Therefore, social isolation is a loss of place within one’s group(s)” (Biordi & Nicholson, 2009)
One of the underlying factors determining prevalence of
people considered “isolated” is whether they live alone. According to a recent
study by the National Council on Aging, an estimated 17% of all Americans over
the age of 65 are isolated because they live alone and face one or more
barriers related to geographic location, language, or disability. In addition,
half of those older Americans are considered economically unstable (Ortiz,
2011).
People who have limited income are considered to be more
susceptible to isolation because they have limited resources to overcome
barriers associated with isolation. Many researchers agree, however, that a
solitary lifestyle alone is not an accurate indicator of isolation.
Based on a synthesis of the
scientific research, this paper proposes the following unifying definition of
isolation. Isolation is the experience of diminished social connectedness
stemming from a process whereby the impact of risk factors outweighs the impact
of any existing protective factors. A person’s lack of social connectedness is
measured by the quality, type, frequency, and emotional satisfaction of social
ties. Social isolation can impact health and quality of life, measured by an
individual’s physical, social, and psychological health; ability and motivation
to access adequate support for themselves; and the quality of the environment
and community in which they live.
Isolation in adults aged 50+ occurs due to a complex set of
circumstances and factors that exist at the individual, social network,
community, and societal levels. The primary risk factors associated with
isolation are:
· Location:
rural, unsafe or inaccessible neighborhood/community;
·
Small social network and/or inadequate social support;
·
Language (non-English speaking); and
·
Membership in a vulnerable group.
These factors can be grouped into psychological, physical, and
social categories.
- Isolation can
also be triggered by the following major life changing events:
o
Change/Loss of Social Network
o
Social Role
o
Physical Health
o
Mental Health
o
Resources
- Contextual
factors that are relevant to the occurrence of isolation include
individual psychosocial states that play a role in isolation, as well as social
factors such as social networks, social supports, social engagement and
integration, income, mobility, societal factors, and the physical environment.
- Health and isolation
are strongly linked, although further study is required to delineate the specific
pathways through which isolation impacts health.
- Events, including
changes in/loss of a social role, physical and mental health, social network,
resources, and location of residence, can also trigger factors, both risk and
protective, that can lead a person closer to or away from isolation.
There is a great deal of diversity
among intervention designs, target populations, and outcome measures for interventions.
The most common interventions reviewed in the literature fall into group and
one-on-one categories and have been implemented with people living in community
settings (as opposed to residential care settings). These interventions have
aimed to: Reduce loneliness and/or depression;
·
Increase social network size;
·
Improve quality of supports; and
·
Increase frequency of social contacts.
THE
RELATIONSHIP BETWEEN ISOLATION AND HEALTH
A strong
link has been established between isolation and morbidity, and isolation is
considered a risk factor in development of illness and impairments in the
presence of illness (Berg & Cassells, 1992). The link between social relationships
and health has been widely studied. Cacioppo and his colleagues examined the
mechanisms through which loneliness can impact health. In their study results
and reviews of previous literature, they identified a long list of health
conditions with which loneliness (subjective isolation) is associated (Cacioppo
et al., 2009).
Additionally,
research has found loneliness to be a predictor of depression and suicidal
ideation In her study of loneliness in a sample of adults aged 50 and older,
Theeke found that chronic loneliness was associated with higher numbers of
chronic illness and higher depression scores, among other health-related issues
(Theeke, 2007). Isolation has also been demonstrated to be predictive of cognitive
impairment in older women .
Tomaka et
al. (2006) found isolation to be related to disease outcomes including
diabetes, hypertension, arthritis, and emphysema. Evans et al. (2008) stated
that risk exposures of isolation including likelihood of having reduced social
networks could offer a major connection between income and health. Isolation
resulting in lack of transportation can also have health consequences.
A 2006
report from the Transit Cooperative Research Program of the Federal Transit
Administration identified that 3.6 million Americans, a large portion of whom
are older, low income, and minorities, have deferred or altogether missed routine
medical care due to lack of transportation. In turn, such a trend could lead to
higher national health care costs
Berkman et
al. (2000) propose a framework that illuminates the path from isolation to
health through social networks: We have identified five mechanisms by which the
structure of social networks might influence disease patterns:
1) biological and psychological pathways proximate to health
status,
2) health behaviors,
3) psychological mechanisms,
4) physiologic pathways, and
5) the social environment in adulthood.
While social
support is the mechanism most commonly invoked, social networks also influence
health through additional behavioral mechanisms including:
(1) forces of social influence;
(2) levels of social engagement and participation;
(3) the regulation of contact with infectious disease; and
(4) access to material goods and resources.
These
mechanisms are not mutually exclusive. In fact, it is most likely that in many
cases they operate simultaneously (Berkman et al., 2000).
Cornwell and
Waite (2009) found an independent association between their two measures of
isolation and health. Higher levels of social disconnectedness and perceived
isolation were associated with lower levels of self-rated physical health.
They
also determined that there is a benefit to considering both of these dimensions
simultaneously (Cornwell & Waite, 2009). Evans et al. (2008) confirmed in a
sample of community-dwelling (non-institutionalized) older adults that there is
a relationship between lower income and poorer health.
