Reviewed by: Rachael Grantham, Psy.D

What is the thread that links all of the photographs (see above) together? The thread, or theme, that all of these photographs share is, the expression of social connection. Social connection has become a popular topic of discussion due to the technological advances and globalization of society over the past couple decades. As social creatures, we are understanding that maintaining satisfactory social connectedness proves to be important in maintaining health.

In the scientific literature, the phenomenon of social connection has been explored by looking at concepts like isolation, loneliness, social engagement, social network analysis, aloneness, perceived isolation, and social relationships. By analyzing all these topics, researchers have found that quality social connection serves as a protective factor for your health throughout your lifespan.

Research has highlighted the amount of scientific literature supporting the idea that high-quality close relationships and social connectedness is associated with decreased risk for all-cause mortality and a range of disease morbidities. The following review aims to summarize the literature on social connectedness and provide applicable information that can assist in improving your health and well-being. 

What Is Social Isolation and Loneliness

Social isolation is defined as “discontinuing actual relations with society members, groups and communities, which leads to weakened or discontinued joining and participating in official and non-official groups.” This type of social phenomenon, whether a result of voluntary isolation or not, may lead to loneliness. For example, moving to a new city which resulted in no longer attending a weekly book club may be a form of social isolation. Or maybe you are confined to remaining in your home and you are no longer able to visit your local farmers market and engage in some conversation with your neighbors. This too, can be considered social isolation which can then lead to the phenomenon of loneliness.

Loneliness is defined as a negative feeling resulting from a perceived deficit in companionship, quantity or quality in one’s relationships with either an attachment figure or a community. Older individuals are more at risk for experiencing the phenomenon of loneliness because of variable health factors (i.e., chronic diseases that impact functioning) and circumstantial factors such as relocating to a care facility or loss of loved ones. Such factors can lead to a sense of separation from others, which is perceived by some as loneliness. Another facet of loneliness to consider is that it is influenced by a social network, social contact, and social support

Social network is defined as the number and structure of one’s relationships. Are you employed at a small business? Do you have membership in a local organization or club? How many people are involved in your workplace or organization? Who do you live with? These are all questions that can start to paint the visual picture of what your social network looks like. Furthermore, social contact is defined as the frequency of interaction with others. How often do you make eye contact with another person during a day? 

Whereas, social support is identified as the amount of assistance received from others.  How many people were involved in the process of growing, cooking, preparing, and the discarding of your last meal? Understanding the frequency, duration, intensity, and quantity of your social interactions and the “players” in your social network can help you begin to construct what the web of what your social connectedness may look like.

Social networking, social contact, and social support also relate to the inverse of loneliness which is, social connectedness. Although the triad described above may provide a greater boost in overall health for older adults, if the individual does not perceive a sense of connection in their social network, social contacts, or social support, the benefits of social interactions are diminished. Social connectedness is defined by researchers as “a positive subjective evaluation of the extent to which one has meaningful, close, and constructive relationships with other individuals, groups, or society indicated by: 1) feelings of caring about others and feeling cared about by others, such as love, companionship or affection and 2) feeling of belonging to a group or community.”

These concepts of loneliness and social isolation are important to understand when considering the complex risk that loneliness poses for older adults.

Impact of Social Distancing on Your Health

As social creatures, we are wired to use social interaction to aim and reach goals of daily living. For example, how we feed, clothe, love, and thrive is dependent on social interactions. Whether the interaction involves the waitress that delivers lunch to your table, or your local bus driver… social interactions allow us to achieve individual and community level goals. If the quality of these encounters is absent or of poor quality, completing activities of daily living can become rather difficult and is just another risk of social isolation. The next layer of the complex impact that social isolation and loneliness have on your health, is the fact that researchers have not reached a consensus on the possible causal nature of the relationship between loneliness and health. One assumption is that social isolation and loneliness disrupt healthy habits and behaviors which then indirectly causes a decline in health.  

What to Consider

It is important to consider the ethnocultural implications for how loneliness and social isolation are experienced. Blue zones are areas in the world where groups of people consistently live over 100 years. An explorative study conducted in the Sardinia Blue Zone, found that older adults from this zone exhibited remarkably low presence of mental illness and high rates of perceived well-being. This was even more notable, due to the fact this region is of low socioeconomic status (SES) which is most typically seen in the literature, to be associated with worse mental health, well-being, and mortality rate. Researchers endorsed growing evidence that social support plays a key role in the resilient psyches of Sardinian Blue Zone older adults.

Another consideration worthy of mention is that it is possible to be alone (isolated) and still experience a sense of social connectedness. The combination of older age, high instances of interpersonal conflict, and depression at baseline decrease the effectiveness of physical contact, or social connection. Therefore, it is important to again consider the quality of social connection before attempting to increase in social connectivity. 

Some Potential Consequences

Depression, anxiety, schizophrenia, suicide, neurocognitive decline (i.e., dementia and Alzheimer’s disease), are some of the adverse consequences that can result from lack of social connectedness. The American Cancer Society also analyzed data of over 500,000 adults and found “social isolation increases the risk of premature death from every cause for every race.” In short, without feeling connected to something or someone beyond yourself your vitality and the bodily and mental processes that are needed to engage in social interactions begin to slow down at a faster rate. 

What Can Help

To measure your social connection “vital signs” take a look at the following questions that are part of one of the many social well-being assessments created by researchers:

1. Who are the people in your life with whom you discuss important matters? 

2. Who are the people you can really count on?

3. Is there anyone who always wants to talk to you about your important matters in your lifewhether you want them to or not?

4. Who are the people, whether or not you have mentioned them before, who are always talking about your mental and physical health and trying to get you to do things about them?

This is a small example of six ways you can address the health of your social connections. If you feel as if you are lacking social connections and are unsure what to do about it, below are some easy tips on how to feel more socially connected.

1. Identify your healthy social connections and all the ways you express social connection: Saying hello to your neighbor, calling your mother 1x week

2. Spend more time with your companion animals.

3. Volunteer or participate in non-stressful care taking rolesAttendance in meaningful activities, generally in the form of friendship and organization participation, is one of the key elements of improving quality of life which leads to reduced disabilities during aging

4. Schedule time to virtually connect: Facetime dates, phone calls, Zoom virtual game nights, text a friend. If you are not able to have physical contact with your healthy social connections than get creative!]

5. Diversify your social network: Join a new club or organization near you or join a social network virtually like an online book club.

6. Look inward!Research led by Christopher Masi, MD, and a team of researchers at the University of Chicago suggests that interventions that focus inward and address the negative thoughts underlying loneliness in the first place seem to help combat loneliness more than those designed to improve social skills, enhance social support or increase opportunities for social interaction. 

Further Considerations for Older Adults

Research shows that it is important for older adults to understand that regardless of the physical or environmental restrictions that may create a perceived boundary between them and feeling socially connected, there is always the option to do the internal mental work. This can be done by addressing the cognitions, or thoughts one has about isolation. It may also be beneficial to consider the concept of moais, a tradition of the Okinawan people that is described in the American Journal of Lifestyle Medicine as “at age 5, children are put into these committed social networksthey meet every day to drink sake and gossip.. If one of them does not show up, the other 4 put on their kimonos to walk across the village to check on their friend.” This type of social network and social connectedness is said to be a common denominator in the Blue Zones, where people live and thrive to be over 100 years old.   

That being said, take this information as a tool to inspire you to find ways to make both external and internal adjustments to your current daily habits and interactions that allow for an increase in feelings of solitude and social connection.

Summary

In summary, social connection is an important concept to understand and assess in your life because of the growing likelihood that you may experience a lack of social connection that impacts and accelerates the natural decline of health and vitality that all humans experience. Although it is a complex topic to simplify and understand, there is a reassuring amount of scientific evidence that shows solutions that can help buffer the negative health outcomes associated with social isolation and loneliness. These solutions include; identifying how socially connected you are currently feel, reflecting on ways you can feel more socially connected in your environment, and lastly, addressing the ways you can feel more connected within your own mind and body. 

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598785
https://www.phenxtoolkit.org/protocols/view/211101
https://www.phenxtoolkit.org/protocols/view/211101
https://www.aginglifecarejournal.org/health-effects-of-social-isolation-and-loneliness
https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-018-0897-x
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556198
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867483
https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-019-0968-x
https://www.apa.org/monitor/2019/05/ce-corner-isolation
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125071