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Index of social isolation risk factors (living in poverty; living alone; being divorced, separated or widowed; having never married; having a disability; and having an independent living difficulty) among adults age 65 and older; normalized values are 1 to 100, with a higher value indicating greater risk
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Index of social isolation risk factors (living in poverty; living alone; being divorced, separated or widowed; having never married; having a disability; and having an independent living difficulty) among adults age 65 and older; normalized values are 1 to 100, with a higher value indicating greater risk
<= 37
38 - 48
49 - 57
58 - 70
>= 71
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Index of social isolation risk factors (living in poverty; living alone; being divorced, separated or widowed; having never married; having a disability; and having an independent living difficulty) among adults age 65 and older; normalized values are 1 to 100, with a higher value indicating greater risk
Top State(s): Utah: 1
Bottom State(s): Mississippi: 100
Definition: Index of social isolation risk factors (living in poverty; living alone; being divorced, separated or widowed; having never married; having a disability; and having an independent living difficulty) among adults age 65 and older; normalized values are 1 to 100, with a higher value indicating greater risk
Data Source and Years(s): U.S. Census Bureau, American Community Survey, 2018-2022
Suggested Citation: America's Health Rankings analysis of U.S. Census Bureau, American Community Survey, United Health Foundation, AmericasHealthRankings.org, accessed 2024.
In the United States, social isolation affects about a quarter of adults age 65 and older. Social isolation is generally described as the absence of meaningful social relationships. Social isolation differs from loneliness, which is the feeling of lacking meaningful social relationships, while social isolation addresses the objective lack of social relationships. An individual can be socially isolated and not lonely or feel lonely and not be socially isolated.
Approximately 34% of older people report feeling some degree of loneliness. Life events such as retirement, loss of loved ones, and age-related mental and physical decline can make it difficult for older adults to maintain social connectedness. Strong social networks have been shown to improve physical and cognitive health and self-management of chronic illness, but many isolated older adults go through the stressful life events common to aging without the benefits of social support. Further negative impacts on physical health and mental well-being associated with social isolation include increased risk of mortality and higher rates of dementia, coronary heart disease and stroke.
The health care costs of social isolation are comparable to those of some chronic illnesses, accounting for an estimated $6.7 billion in Medicare expenditures annually.
Factors that influence social isolation include race/ethnicity, immigration status, level of English proficiency, sexual orientation and gender identity, meaningful social participation, and support of family and community. Older adults at greater risk of experiencing social isolation include:
Interventions to decrease social isolation among older adults are most successful when they directly involve older adults rather than simply providing services or training.
AARP points to the importance of senior and community centers in facilitating group interactions. They also offer resources for older adults experiencing social isolation, including tips to find and maintain social connections, as well as an assessment to understand your risk level.
Healthy People 2030 has identified social cohesion as a key issue in the Social and Community Context domain of the social determinants of health.
Chen, Yi-Ru Regina, and Peter J. Schulz. “The Effect of Information Communication Technology Interventions on Reducing Social Isolation in the Elderly: A Systematic Review.” Journal of Medical Internet Research 18, no. 1 (January 28, 2016): e18. https://doi.org/10.2196/jmir.4596.
Cornwell, Erin York, and Linda J. Waite. “Social Disconnectedness, Perceived Isolation, and Health among Older Adults.” Journal of Health and Social Behavior 50, no. 1 (March 1, 2009): 31–48. https://doi.org/10.1177/002214650905000103.
Cotterell, Natalie, Tine Buffel, and Christopher Phillipson. “Preventing Social Isolation in Older People.” Maturitas 113 (July 1, 2018): 80–84. https://doi.org/10.1016/j.maturitas.2018.04.014.
Dickens, Andy P., Suzanne H. Richards, Colin J. Greaves, and John L. Campbell. “Interventions Targeting Social Isolation in Older People: A Systematic Review.” BMC Public Health 11, no. 1 (August 15, 2011): 647. https://doi.org/10.1186/1471-2458-11-647.
Elder, Katie, and Jess Retrum. “Framework for Isolation in Adults Over 50.” AARP Foundation, 2012. https://www.aarp.org/content/dam/aarp/aarp_foundation/2012_PDFs/AARP-Foundation-Isolation-Framework-Report.pdf.
Flowers, Lynda, Ari Houser, Claire Noel-Miller, Jonathan Shaw, Jay Bhattacharya, Lena Schoemaker, and Monica Farid. “Medicare Spends More on Socially Isolated Older Adults.” Washington, D.C.: AARP Public Policy Institute, November 27, 2017. https://doi.org/10.26419/ppi.00016.001.
Fratiglioni, Laura, Hui-Xin Wang, Kjerstin Ericsson, Margaret Maytan, and Bengt Winblad. “Influence of Social Network on Occurrence of Dementia: A Community-Based Longitudinal Study.” The Lancet 355, no. 9212 (2000): 1315–19. https://doi.org/10.1016/s0140-6736(00)02113-9.
Gallant, Mary P. “The Influence of Social Support on Chronic Illness Self-Management: A Review and Directions for Research.” Health Education & Behavior 30, no. 2 (2003): 170–95. https://doi.org/10.1177/1090198102251030.
Henning-Smith, Carrie, Christina Worrall, Madelyn Klabunde, and Yingling Fan. “The Role of Transportation in Addressing Social Isolation in Older Adults.” The National Center for Mobility Management, July 2020. https://nationalcenterformobilitymanagement.org/wp-content/uploads/2020/06/FINAL_CONDENSED_SOCIAL-ISOLATION-RESEARCH-PAPER.pdf.
Holt-Lunstad, Julianne, Timothy B. Smith, Mark Baker, Tyler Harris, and David Stephenson. “Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review.” Perspectives on Psychological Science 10, no. 2 (March 2015): 227–37. https://doi.org/10.1177/1745691614568352.
Moran, Nora. “Aging in the Shadows: An Update on Social Isolation Among Older Adults in NYC.” New York: United Neighborhood Houses, September 2017. https://uploads.prod01.oregon.platform-os.com/instances/542/assets/documents/Aging%20In%20The%20Shadows%202017.pdf.
National Academies of Sciences, Engineering, and Medicine. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, D.C.: National Academies Press, 2020. https://doi.org/10.17226/25663.
Steptoe, Andrew, Aparna Shankar, Panayotes Demakakos, and Jane Wardle. “Social Isolation, Loneliness, and All-Cause Mortality in Older Men and Women.” Proceedings of the National Academy of Sciences 110, no. 15 (April 9, 2013): 5797–5801. https://doi.org/10.1073/pnas.1219686110.
Valtorta, Nicole K., Mona Kanaan, Simon Gilbody, Sara Ronzi, and Barbara Hanratty. “Loneliness and Social Isolation as Risk Factors for Coronary Heart Disease and Stroke: Systematic Review and Meta-Analysis of Longitudinal Observational Studies.” Heart 102, no. 13 (July 1, 2016): 1009–16. https://doi.org/10.1136/heartjnl-2015-308790.
America’s Health Rankings builds on the work of the United Health Foundation to draw attention to public health and better understand the health of various populations. Our platform provides relevant information that policymakers, public health officials, advocates and leaders can use to effect change in their communities.
We have developed detailed analyses on the health of key populations in the country, including women and children, seniors and those who have served in the U.S. Armed Forces, in addition to a deep dive into health disparities across the country.