A child claims to feel sick to avoid going to school. A man with a chronic illness is not taking his medications because there is no one to take him to the pharmacy. An older woman living alone becomes depressed because she has no one to talk to.
These scenarios illustrate some of the effects of social isolation, and also show it is not just older people who experience it. In fact, social isolation can take a toll at any stage of life, said James Lubben, MSW, who also has a Ph.D. in social welfare.
“Isolation is something that occurs throughout the life course; infants, teens, adults,” said Lubben, inaugural holder of the Louise McMahon Ahern Chair in Social Work at Boston College, founding director of the Boston College Institute on Aging and professor emeritus at UCLA.
Social isolation is not a new problem. But as attention to it grows, efforts to diagnose and treat it are increasing. And social workers are on the front line, helping patients, developing treatment techniques and programs, and calling for cross-discipline attention and action as they work to help older adults, people with health problems or chronic illnesses, children and youths, and those isolated because of
technology or social media.
“I have a lot of passion for this topic, because I think it’s so critical,” Lubben said. “It’s finally getting the attention it deserves.”
The impact is critical because social isolation can be a killer, he said, and the number of people suffering from it are not known.
A ballpark estimate is at least one in 10 older adults is experiencing at least some form of isolation, Lubben said.
“Those numbers are hard to get, because we don’t have generational surveys,” he said. “That part of the message is very important, because the health issues it can create are on par with smoking. It’s something we don’t always give a proper status to in our regular lives, but it’s just as critical to our overall health.”
Eradicating social isolation is one of the 12 Grand Challenges for Social Work, outlined in the national initiative from the American Academy of Social Work and Social Welfare.
Lubben, an NASW-Massachusetts member who was on the executive committee that produced the initiative and took the lead on the social isolation challenge, said another reason the problem is important is because people are social creatures.
“There’s the idea that Americans are rugged individuals,” he said, “but none of us is capable of living alone. And those resources are needed when we have critical needs.”
“The first thing we have to do is recognize (social isolation is) important,” Lubben said. “Nurses, doctors and social workers need to start asking about it. That sends a message to clients that it’s important.”
Social isolation needs to be publicized so more people are aware of it, Lubben said, and he believes the issue can be successfully tackled.
“Whether we do or don’t depends on whether we respond to the grand challenge, mobilize resources and address the problem,” he said.
Numerous studies dating back decades have documented the impacts of social isolation on health.
A Kaiser Health Care study released in 2008 found social isolation was predictive of cognitive impairment, Lubben said.
“Some people think if they do crossword puzzles they will keep their cognitive abilities, but it’s conversation that does that,” he said. “When you’re in in a conversation, first you have to listen, then you have to think, and then you respond.”
And a 1979 study showed people with weaker social connections had a greater morality rate, Lubben said, adding that there is strong evidence that social health, mental health and physical health are connected.
The American Academy of Social Work and Social Welfare, as part of its Grand Challenges for Social Work initiative, released Working Paper No. 7 in February 2015, titled “Social Isolation Presents a Grand Challenge for Social Work.”
Its findings include:
Social support networks, or the lack of them, affect a person’s well-being.
The connection between social networks and health is consistent despite the differences in social network definitions and health care outcome measurements.
Prevention is possible if protocols are added that include the importance of social networks, and interdisciplinary and cross-sector collaboration is necessary.
Social workers are well positioned to meet the challenge, but innovation will be required.
In its conclusion, the paper notes the World Health Organization, National Institutes of Health and AARP have all studied social isolation and called for it to be addressed because it is a major health-risk factor.
Social workers already are addressing the issue as they treat the populations they serve.