Residents in several Western Pennsylvania counties are at particularly high risk of social isolation, according to a map developed at the University of Chicago for the AARP Foundation. Social isolation — which has worsened for many older Americans during the COVID-19 pandemic — carries risks not only for loneliness but also for health consequences such as an increased risk of heart disease, dementia and high blood pressure.
"Social isolation is a serious public health issue," said Lisa Marsh Ryerson, president of the AARP Foundation, which serves vulnerable people 50 and older. "Studies have found that social isolation and loneliness are worse for health than obesity, and that prolonged isolation is comparable to smoking 15 cigarettes a day."
One study from 2010 found that the effect of social isolation on mortality was even higher than known risk factors such as physical inactivity and obesity.
The new mapping tool attempts to quantify and track social isolation in every county nationwide through a composite measure of the risk of social isolation using factors such as poverty, living alone, being divorced, separated or widowed, having never married, having a disability, and having difficulty with independent living.
In Pennsylvania, Cameron County, the state's least populous, has the state's highest composite social isolation risk, with 91% of those over 65 at risk for social isolation. Locally, other counties that rank highly are Cambria at 73.9%, Fayette at 73.7%, Potter at 72.7% and Lawrence at 66.7%.
The results show Allegheny County as having a large population percentage who never married, contributing to a social isolation risk of 60.5%. Among the counties at a higher risk due to a large population percentage who live alone were Armstrong County, with a social isolation risk of 64.1%; Beaver County at 61.6% and Westmoreland County at 58.9%.
While some adults were isolated before the COVID-19 pandemic, the limits that the pandemic put on in-person socialization and the cancellation of many events and activities geared toward seniors have created new problems.
"Social isolation was on a lot of people's radar before COVID," said Elizabeth Mulvaney, board president for the Southwestern Pennsylvania Partnership for Aging. "Then COVID came and we said to everyone who is older, don't go anywhere, don't see anyone, not even your family, and stay well."
One study from the University of Michigan found that one in five adults age 50 and older said that their mental health was worse since the pandemic started, and they were experiencing depression, anxiety, insomnia, substance use or another mental health disorder.
A study from the AARP Foundation and the United Health Foundation in 2020 found that the COVID-19 pandemic was disproportionately impacting women ages 50 and older in terms of anxiety and isolation. Women older than 50 were more than twice as likely as men to describe themselves as overwhelmed and also felt more anxious and stressed compared to men.
Even as vaccinations have allowed many people to resume socializing, others have been slower to bounce back from social distancing.
Various senior organizations tried to pivot to offering virtual programming, or expanded virtual programming already in place, said Mulvaney, citing local efforts from Age-Friendly Greater Pittsburgh to expand computer access for seniors and programs offered by the Virtual Senior Academy and the Osher Lifelong Learning Institute at the University of Pittsburgh. And while some in-person senior activities have resumed, outdoor programs such as those run by Pittsburgh Citiparks will likely be curtailed in the winter months. "We are not where we were pre-pandemic," she said. "Is it enough? Probably not. Is it a start? Yes."
Ryerson noted: "As new variants continue to gain momentum and cases are rising throughout the U.S., people are once again coping with increased safety concerns, stay-at-home orders and other restrictions. This realization that the pandemic's end may not yet be in sight is having a devastating impact on mental health, depression and anxiety."
To combat social isolation, Ryerson recommends developing a "Friendventory" — a list starting with your inner circle but expanding to include former co-workers, classmates and distant relatives. She also recommends talking about those feelings of social isolation in recognition of it as a real public-health issue. "We need to normalize not being OK," she said.
She also recommended taking small steps to improve social isolation and making them a regular part of an older adult's schedule. Those could include a designated time for weekly or bi-weekly video chats with family or friends, setting aside a regular time to write or email friends, or taking a scheduled 15-minute walk.
She also suggested volunteering, citing two programs that allow virtual volunteering: AARP Foundation Tax-Aide, where people can help others with tax preparation, and Experience Corps, where they can tutor elementary school students.
There are also many other opportunities for volunteering in your own community through local houses of worship or resources such as the United Way or Pittsburgh Cares.
A website from the AARP Foundation, connect2affect.org, has a three-minute questionnaire that can help individuals or family members determine their own risk of social isolation and connect to resources, Ryerson said.
Ryerson noted that for some, feelings of social isolation can be particularly intense during the holiday season. "Although many people are looking forward to seeing family and friends, others are preparing to spend the season alone," she said.
"At this time of year, people who are alone may feel especially vulnerable and lonely. I urge people to check on their friends, neighbors and loved ones to help them avoid social isolation."