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Social Isolation

Situations of loneliness can have a serious impact on health and quality of life. This can include a farmer or farm family living in a remote and rural area, parents overwhelmed by caregiving duties and financial responsibilities, newcomers with no family or friends nearby and anyone unable to drive into town because of weather. These are all examples of social isolation experienced by rural people.  Health risks associated with social isolation are just starting to be understood.

 

Social isolation and loneliness are widespread. Studies show worldwide, one in five persons report loneliness or social isolation. Social isolation and loneliness are known to significantly increase risk for premature mortality and social connections are known to reduce the risk for premature mortality.  Social isolation and loneliness are also associated with increased illness and health issues such as inflammation. Public health policy is being considered affecting social connectedness across all sectors including health, transportation, education, housing, employment, food and nutrition and environment. There is still a lot to learn about what might help reduce social isolation and loneliness and in turn lessen their health impacts. 

 

Social isolation and loneliness are both terms that speak to being socially disconnected. Social isolation is where a person has few or infrequent social contacts.  Loneliness is where a person feels distressed and isolated. Loneliness may be the difference between what is and what is desired for social connections. Social connection is social support, social integration, social cohesion, all terms that define ways we are physically or emotionally connected to others. These factors can influence our health and wellbeing. Isolation is the experience of being separated from others. Isolation may result from being physically separated from others, such as when a person lives in a remote area. An isolated person may be lonely or have a low self-esteem. Over time a person suffering from social isolation may develop social anxiety, depression or other mental health concerns. Therapy can help people rebuild social skills, connect with others and recover from the effects of isolation.

 

What is social isolation? It is an absence of social relationships. It is different from solitude which is simply just being alone. Social isolation can occur when a person is alone or when they are with others.  Solitude can be forced, healthy or unhealthy. Social isolation describes an unwanted and often harmful experience. A person may be experiencing social isolation if they:

  • Avoid social interaction due to shame or depression.

  • Spend extended periods of time alone.

  • Experience social anxiety or fears of abandonment at the idea of social interaction.

  • Have only limited or superficial social contact.

  • Lack important social or professional relationships.

  • Develop severe distress and loneliness.

 Solitude, isolation and loneliness are similar terms but have distinctly different meanings.  Solitude is when you are alone.  Isolation is when you lack social relationships or emotional support.  Loneliness is when you crave social contact and is often linked to feelings of sadness and emptiness. 

Isolation inforgraphic.

How does age impact social isolation?

Loneliness reaches all age groups. Forty three percent of adults say they often feel isolated from others. Twenty seven percent of adults feel they don’t have people in their lives who truly understand them and 47% feel they do not have meaningful in-person social interactions such as quality time with family on a daily basis. 

 

Social isolation is often seen in older adults who don’t have family members nearby. For older adults even shorter distances may contribute to a feeling of isolation. Walking to the senior center or other place of social connections may be hazardous for seniors fearful of walking on sidewalks with snow and ice as it heightens their fear of falling and fracturing a hip. Older people just stay home in the winter which impacts their mental health, social isolation and feelings of loneliness. 

 

Though older adults are assumed to be the population most impacted by social isolation and loneliness, data shows that people younger than 50 years are the majority.  

Children and adolescents are also at risk for social isolation. For most children and adolescents school is the most important social place for social connections outside of the family. School absence for long periods of time results in limited interaction with other children and adolescents. These kids can be at risk for losing their entire social network. Most at risk are children with long-term illnesses requiring them to be out of school for long periods of time, children who live in rural or remote areas where transportation and weather (snow days) prevent them from participating in school. Most recently, children who are forced into home schooled situations or modified school schedules due to the Covid-19 pandemic can be at risk. Social behavior and engaging in social interaction is vital during childhood development. Creating social relationships is central to human well-being. Beyond the joy of being with friends, children learn social norms including how thoughts, feeling and behavior is influences and is influenced by others. Socially isolated children tend to have lower educational attainment, be part of a less advantaged social class in adulthood and are more likely to psychologically distress in adulthood. Long term social isolation and loneliness affects healthy development of the brain.  

 

What about gender? Men tend to be more isolated than women. Men are known to have fewer closer relationships. Men are less likely to admit feeling lonely. While men are more socially isolated than women they report similar satisfaction with their social support network. Researchers attribute the discrepancy to men’s reluctance to admit they are lonely for fear of showing vulnerability. 

 

A number of studies link isolation, loneliness and physical health issues. Loneliness may be as bad for a person’s health as smoking 15 cigarettes a day. Health effects of isolation and loneliness include:

  • Higher levels of stress hormones and inflammation.

  • Heart disease including high blood pressure and coronary artery disease.

  • Heightened risk of developing a disability.

  • Increased vulnerability to chronic illnesses such as Type II diabetes.

Social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly low-income, underserved and vulnerable populations are considered at risk.  Isolation can increase the risks of mental health issues such as depression, dementia, social anxiety and low self-esteem.  Isolation and mental health issues can also interact with one another in a feedback loop. A person might develop depression because of intense loneliness then feel even more isolated because of their depression. Extreme isolation can have catastrophic effects on mental health. Humans are social animals who need human contact to thrive, perhaps even to survive. Infants who don’t get enough physical touch may fail to thrive and die. Inmates held in solitary confinement for extended periods may experience hallucinations, insomnia, post-traumatic stress disorder (PTSD) and difficulty telling time.  

Risk Factors of Social Isolation

Social Isolation chart

Insights from rural clinical providers and others provide additional insight into social isolation and loneliness for rural residents. Dr. Kristi Phillips is a psychologist serving residents of rural Minnesota.  Dr. Phillips says social isolation is a significant problem, especially in winter months. Speaking to the definition of loneliness, a feeling sometimes associated with social isolation, Dr. Phillips said “Loneliness comes from a desire for satisfying social contacts. Often social isolation is linked to sadness or the feeling of emptiness. Loneliness differs from solitude, or living alone, which can either be chosen or forced and might be healthy or unhealthy. It’s also important to understand that people can have many relationships but not all of those relationships might offer satisfaction. When relationships are not fulfilling, a sense of social isolation can result, even if an individual is in the vicinity of others.” 


For Phillips, transportation, geography and weather, specifically the four to six months of winter, also contribute to social isolation and loneliness. Often isolation problems occur when there is a long distance between a person’s residence and where they can find meaningful activities or join friends or family. This is especially problematic during winter when people can’t drive because of bad roads or very low temperatures. It may be lack of confidence in their cars reliability possibly intensified by the financial stress of not being able to afford a new one. In rural areas there is no public transportation to fall back on. Larger rural communities may have public transportation for disabled or elderly residents, but most rural areas have no public transportation. 


Dr. Kimberly Becher is a family medicine practitioner who sees patients in Appalachia.  Dr. Becher talks about the impacts of geography-scattered family structures, transportation and technology have on isolation. Geography alone can cause barriers that contribute to the feelings of isolation and loneliness for many rural residents. 


In rural areas many people have fragile, crumbling or non-existent social networks – no friends, no family, no neighbors. By nature, most rural residents naturally trend towards being alone. It’s part of why they choose to live in rural or remote areas. Some studies believe social isolation and loneliness in rural areas is contrary. They believe many rural residents have more people in their lives, more friends, more family and are more likely to say they can rely on networks. These same researchers acknowledge that these conditions do not necessarily mean the person’s social needs are being met.  In fact, rural residents report feelings of being left out much more than others. While they may have a lot of people in their lives, geography and weather may exclude them from group activities leaving a sense of feeling left out which then leads to more sense of social isolation and loneliness.  


Whether a person chooses a quieter isolated rural life or is “stuck” in a rural community, identifying natural social support networks that exist in every community is one solution to ease social isolation.  The network of churches, schools, health and community organizations are opportunities to create social ties. People at risk for social isolation or loneliness need to think about isolation in terms of being concerned about the people who are in our life and those who are looking out for you. One good friend may not be enough. Perception is different from person to person. Happiness or loneliness may look different from one person to another. Being able to rate your own emotion is what matters for your own health. There are regional and cultural differences in how people respond to social connectedness. Social experiences, relationships and isolation among rural residents and between rural residents may be different. While researchers are starting to better understand the impact of social isolation and loneliness on all people no one knows quite what to do about it.  


There are things you can do to combat the effects of social isolation or loneliness. Find ways to connect with others. Allow yourself to be vulnerable and create a new support system for yourself, one that understands how you feel and what you need. Or maybe a support system that is just there for you even if you don’t know what you need. Celebrate special occasions. Be purposeful to look for moments to be with others in joyful celebration. Stay in touch with your people. Even if you are not physically close to them, stay in touch through telephone calls, social media and when possible in person visits. Use mindfulness to create a sense of calm within yourself. Accept that the situation is challenging and be kind to yourself. Seek help from a mental health professional, clergy or other trusted professional.  


Regardless of age, AARP’S Connect 2 Affect program has a self-assessment tool to help you identify if you are at risk for social isolation and tools to help overcome social isolation. Reachout.com has tips on how to deal with isolation if you live in a rural or remote area.

A man video chatting with a woman on his phone.