21st Century Strategies to Combat Loneliness in Older Adults

Friday, October 2, 2020

Originally published here.

21st Century Strategies to Combat Loneliness in Older Adults

A new article by renowned scholar on health in aging and longevity, Linda P. Fried, MD, MPH, argues that the growing problem of  loneliness in older people is a product of our social environment, and solutions to ameliorate the condition are available by reimagining our built environment, transportation, and technology to connect people; and developing institutions to foster social capital and engagement within and across generations for the greater good.

The article is published in a special issue of the journal Generations focused on loneliness and social isolation. Fried is Dean of Columbia University Mailman School of Public Health and director of the Columbia Aging Center.

Loneliness—defined as the subjective feeling of pain due to unmet human needs for meaningful, satisfying connection to other people—is a growing problem in older adults, as well as all ages of adults. According to one study, the portion of older adults experiencing loneliness has ballooned from 11 to 17 percent in 1970 to 40 percent in 2010. One chief reason is the growing number of older adults who live alone. In 2012, 30 percent of U.S. older adults lived alone, compared to in 1950 when 10 percent did, another study finds.

Other factors linked to older adult loneliness include being single, whether through widowhood, divorce, or never marrying; loss of family and friends; childlessness; retirement and loss of connections to peers the work role once provided; and isolation stemming from a car-dependent culture and older-adult housing that is often situated at the periphery of communities. These factors are compounded by economic precarity, including food and housing insecurity, as well as exposure to unsafe environments—experiences disproportionately felt by women, renters, and ethnic and racial minorities.

The COVID-19 pandemic has further increased the risk and the reality of older adult loneliness and isolation, which are associated with negative health outcomes. Moreover, ageist narratives suggesting that protecting older people from infection is causing everyone else to suffer from the economic consequences of lockdown worsens the sense older adults have of being worthless to society.  There is no evidence to support that this needs to be the case.

More broadly, Fried argues that many of the conditions for loneliness are socially constructed.  Older adult loneliness is the product of society-level ageism, “which makes older individuals invisible and devalued in society, and age segregation in housing and in work and volunteer roles have resulted in the United States being the most age-segregated society in the history of the world, with loss of intergenerational contact and solidarity,” Fried writes.

To counter these negative trends, Fried enumerates three main avenues for social investment which demonstrate promise in ameliorating loneliness in older adults in the 21st Century:

1. Build Connectors. Physical transportation and technological approaches can bring people together and foster engagement in society, regardless of functional abilities. Policymakers should provide alternatives to driving that match older adult needs. Technology is allowing older adults to maintain ties with distant family and friends, and to foster new connections and interests, yet more can be done to foster online opportunities for older adults to serve the public good, such as reading to children.

2. Design the Built Environment as Social Infrastructure. Age-friendly cities must be designed with attention to factors such as safe and walkable sidewalks and crossings and proximity to basic amenities like grocery stores, pharmacies, public parks and bathrooms. Programs to support aging-in-place and multigenerational housing can foster connection and cohesion and enable older adults to be located in the action, rather than at the margins.

3. Develop Institutions to Foster Social Capital and Engagement. Numerous models exist to foster social bonds, including programs that pair homebound and lonely older adults with members of their neighborhood who visit weekly; neighborhood activity groups for older adults centered around shared interests, from book clubs to arts and culture; and volunteer programs with opportunities for older people to connect with and provide social capital to benefit all generations.

“This latticework of social infrastructure in tech, transport, the built environment, and societal institutions would overcome the structural determinants of loneliness, and promote intergenerational and community cohesion and resilience,” Fried concludes. “Solving loneliness for older people can be a gateway to solving loneliness of the young and building new models of inclusive, intergenerational connections that support the well-being of all.”