Risk of Social Isolation - Age 65+ in Hawaii

Hawaii

Across the United States, nearly a quarter of adults age 65 and older are at risk for social isolation. Social isolation is generally described as the absence of 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. 

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 as well as self-management of chronic illness. However, many 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, gender identity, and family and community support. Older adults at greater risk of experiencing social isolation include:

• Those who live alone. Although not everyone who lives alone is isolated, living alone is a well-documented risk factor for social isolation. Older adults who are divorced, widowed or separated, as well as those who never married, are therefore more vulnerable to isolation.
• Those with a disability and those who are homebound. Physical and mobility impairments may limit older adults’ ability to attend events or participate in activities, leading to fewer social contacts and greater loneliness.
• Those living in poverty. The effects of economic hardship on one’s time, resources and safety can pose complex barriers to social engagement, leading to isolation.

Interventions to reduce social isolation among older adults are most successful when they directly involve older adults rather than simply providing services or training.

• Although not appropriate for all older adults, technology-based interventions have been used internationally to enhance communication and connectedness, particularly among those with geographical or mobility barriers. 
• Expanded collaboration between public transportation and public health at the community level can reduce geographical and mobility barriers for older adults.
• Service-provision interventions where volunteers act as intermediaries between older adults may help sustain short- and long-term social connectedness. 
• Medicare Advantage plans have begun to offer more flexible supplemental benefits that address social isolation directly or indirectly, such as home-delivered meals, ride-sharing services and companionship initiatives.

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 on finding and maintaining social connections and 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.

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