SOCIAL ISOLATION : REINFORCING FACTORS, HEALTH CONSEQUENCES AND SOLUTIONS

SOCIAL ISOLATION IN THE US :

 REINFORCING FACTORS, HEALTH CONSEQUENCES AND SOLUTIONS

INTRODUCTION

Social isolation has been defined in myriad ways in the literature. Some studies (Hall and Havens 2001; Van Baarsen et al. 2001) have differentiated between two constructs: social isolation, an objective measure of social interaction, and social loneliness or emotional isolation, and the subjective expression of dissatisfaction with a low number of social contacts.

In this paper these two constructs are combined into a single definition. People as socially isolated if they had poor or limited contact with others and they perceived this level of contact as inadequate, and/or that the limited contact had adverse personal consequences for them (Findlay, 2008).  American’s social isolation has increased radically since the 1980s and nowadays a quarter of Americans had no close confidents at all (Glen, 2008).

The magnitude of risk associated with social isolation is found to be comparable with that of cigarette smoking and other major biomedical and psychosocial risk factors (Brummett et al, 2001).

After defining the concept of social isolation, the first part of this paper will highlight the reinforcing factors. The second part of the paper is devoted to present the health outcomes as a consequence of the social isolation in the different segments of the U.S population. The third part of the paper part will present some solutions to address the problem.

I-              REINFORCING FACTORS OF SOCIAL ISOLATION

These factors will be analyzed at the national, local and individual level.

·      At the national level

The most recent U.S. Census Bureau statistics continue to show an increase in the number of people living alone or who have relocated in the past several years (Cacioppo & Hawkley, 2003).Under the pressure to be totally independent and separate, which is impossible, the American society is manipulated into created dependencies. Therefore, those who build the best boundaries, who are the least influenced by others, and who gather the most material stuff are seen as successful and powerful. Also American’s culture endlessly amplifies fear. People live in a culture of violence, terrorism and are exposed to it. The easiest response to this perpetual fear seems to live in armed isolation (Jordan & Judith, 2008)

·      At the individual level

Changes in marital and childbearing patterns and in the age structure of U.S. society are projected to produce a steady increase in the number of people who live alone.  The average household size declined from 3.1 in 1970 to approximately 2.6 in 2000, for instance, and households with only one or two people increased from 46 to 59 percent during the same time period (Fields and Casper 2001). By 2010, the number of people living alone is projected by the U.S. Census Bureau to reach almost 31,000,000—a 40 percent increase since 1980 (Cacioppo & Hawkley, 2003).

II-          HEATH CONSEQUENCES OF SOCIAL ISOLATION IN THE SEGMENTS OF THE POPULATION

Social isolation is a curse, which affect all the strata of the society from the adolescents to the elderly. The deleterious effects on health of social isolation, first recognized in epidemiologic research of the late 1970s and 1980s and replicated and extended for more than a decade since then (House et al , 1988) Social isolation, which is heightened by living alone and recent relocations, is a major risk factor for broad-based morbidity and mortality, even after statistically controlling for known biological risk factors, social status, and baseline measures of health.

 Social isolation has been shown repeatedly to prospectively predict mortality and serious morbidity both in general population samples (House and al, 1988) and in individuals with established morbidity (Berkman & Glass, 2000) especially coronary heart disease.

·      In adolescents

Social isolation during adolescence is often a very painful emotional experience. Adolescent’s perceptions of the quality and closeness of their peer relationships are consistently associated with issues of self-esteem, perceptions of social competence, and internalizing problems such as depression (Weinberg, 2001). Higher levels of loneliness have been consistently associated with significantly lower levels of self-worth in adolescents (Qualter & Munn, 2002). Then we need to connect to survive and thrive. Correlations between social connectedness and positive child development are robustly high (Putnam, 2000).

·      In the elderly

 As the proportion of older people in the population increases and more live alone (World Health Organization 2002), the problem of social isolation among the age group is of growing concern. Factors contributing to social isolation include loss (in its many forms), poor physical health, mental illness, low morale, being a career, geographic location, communication and transport difficulties (Hall and Havens 1999). Moreover, the negative health consequences of social isolation are particularly strong among those most in need of societal support: those over 65 years of age, the poor, and minorities.

Furthermore, social isolation has been linked with increased mortality rates for people aged over 65 years (Bower 1997); rural stress (Monk 2000); depression (Gutzmann 2000; Silveira and Allebeck 2001); and suicide (Conwell ,1997).

·      People living with disabilities

Predictors of loneliness have been observed to be higher numbers of chronic conditions (Hall and Havnes, 1999) such as arthritis and lung disease (Penninx et al, 1999), poor mental health status or reduced cognitive functioning (Hall and Havens, 1999; Victor, et al,2000), poor vision, poor hearing and poor general health (Havens and Hall 1999; van Baarsen, 2002).

Most of the deaf are excluded from the rest of society because of hindrances in their communication. In the psychological field it manifests as social isolation and loneliness, distrust of the rule of law, low self-esteem, stereotypes & prejudices about the public opinion. Lastly, the difficulty in communicating, scarce feedback from the rest of society, & inaccessibility of cultural events (theatre, concerts, etc.) are evidence of their deprivation on the social field (Gerencer, Simona, 2004).

·      Minorities

The negative health consequences of social isolation are obviously strong among some of the fastest growing segments of the population: the elderly, the poor, and minorities such as African Americans (House, Landis, and Umberson 1988). Finally, isolated people’s health may deteriorate because “they lack the environmental support, social ties and assistance by others that become critical factors in the maintenance of their independence later in life”.

III-       SOLUTIONS

Designing effective interventions to address the problem of social isolation is difficult. Many of these factors are often beyond the socially isolated person’s control and are therefore ‘ not obviously susceptible to amelioration (Findlay, 2003). Nonetheless numerous interventions have been implemented worldwide to address the problem of social isolation amongst people.

·      For Individuals

Addressing individual isolation may require to make regular contact with older family members and neighbors, ensure older people feel needed and value, and include older friends and neighbors in family gatherings.

·      For Local Community and Groups

 Increase availability of seniors programs and services, improve information about and access to seniors’ supports, involve seniors in all levels of planning, establish/enhance availability of transportation, encourage intergenerational activities, attempt to reduce the stigma of aging, retirement information should include social as well as financial changes, establish/enhance availability of low-cost leisure and educational activities, provide congregate meals.

Tele-conferencing appears to be a strategy for reducing loneliness and bringing people together, especially in geographically isolated areas.

Support groups: The types of support include educational and friendship enrichment or empowerment programs and discussion groups.

·      For Program Planners and Policy Makers

Given the projections of health care costs and the looming budget deficits, there is a critical need for a national health care plan that both supports palliative care and promotes preventive medicine, health behavior, and healthy lifestyles to address the rising incidence of chronic disease. Policy implications, such as the need to develop formal channels of support for these populations, are unprecedented.

 The policies should take in consideration to increase housing options,  increase barrier-free access , establish mechanisms to eliminate ageism , increase opportunities for social interaction , involve seniors in all levels of planning ,enhance communication/cooperation among all levels of government to foster or improve links among social services, health and education ,  improve availability of resources for rural and northern communities (programming, transportation, etc.) , increase awareness of resources, provide resources for continuing research on issues of isolation and loneliness .

 Findings further show that institution-based support (assistance from charity and others social organizations) constituted an important alternative source of support for those who lacked network support (Offer, Shira , 2007).

CONCLUSION

Social isolation is nowadays a huge problem in the American Society which affect all the age group  and need to be effectively addressed. The findings revealed that social isolation was associated with an increased risk for depressive symptoms, suicide attempts, and low self-esteem. Overall, the most disadvantaged, such as the poorest, immigrants, the elderly and those who have poor mental health, were also most at risk of experiencing social isolation (Offer, Shira, 2007). Social isolation contributes to higher risk of disability, poor recovery from illness and early death  (Lubben, J; Gillman, G; 2004). New policies and Programs should adopt screening for social isolation in these aforementioned groups.

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