Senior Report Spotlight

Executive Summary Senior Report Spotlight IntroductionFindingsOverview State Rankings Successes Challenges Disparities in Rural HealthCore MeasuresBehaviors Community & Environment Policy Clinical Care Outcomes Supplemental MeasuresState Summaries

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2018 Senior Report 2018 Executive Summary 2018 Senior Report – Report Data (All States)

Social Isolation: A Challenge for Seniors and their Health
Meaningful social relationships are essential to good health and well-being, especially during one’s senior years. Social isolation, or lack of these relationships, can have negative consequences for a person’s physical health and mental well-being. Life events such as retirement, loss of a spouse and friends, and age-related health conditions may make it difficult for seniors to maintain the same level of social interactions or the breadth of a support network they once had. Without these important connections to friends, family and the community, seniors grappling with loneliness and social isolation are more likely to experience poorer health, including health conditions such as high blood pressure, inflammation and even a greater risk of death.
Multiple Factors Involved in Seniors’ Risk of Social Isolation
Social isolation is measured and defined in a variety of ways reflecting the complexity of the individual, community and societal interactions. Despite the vast amount of research and interest related to social isolation, no single measure encapsulates the contributing factors at the state level. To fill this gap, America’s Health Rankings created a multifactorial measure that identifies locations where seniors are at higher risk of social isolation. The new measure was informed by the AARP Foundation's report, A Framework for Isolation in Adults over 50 and a review of existing social isolation literature. 
The new America’s Health Rankings measure, risk of social isolation, includes the following six factors related to seniors’ health and well-being. These factors are available across multiple geographic levels (e.g., state, county) among adults aged 65 and older:
Divorced, separated or widowed: Living with a spouse or partner tends to reduce the likelihood of loneliness among seniors. 
Never married: Seniors who have never married are less likely to be socially integrated compared to those who married at one point in life.
Poverty: Lower-income seniors and those with less education are not as likely to have robust social networks and more likely to be socially isolated.
Disability: Seniors who experience conditions that limit their physical or mental functions are more likely to have a restricted level of social interaction despite the potentially greater need for social, emotional and physical support.
Independent living difficulty: Seniors who have limited mobility are at further risk of social isolation given challenges such as limited transportation support options. 
Living alone: Seniors who live alone are more likely to be poorly socially integrated and experience feelings of loneliness.
Seniors’ Risk of Social Isolation Varies by States, Regions
Risk of social isolation among seniors varies widely by state (Figure 1), with a concentrated area of high risk from the mid-Southern region through the Appalachian Mountain states. States with the lowest risk are generally found in the Rocky Mountain region.

Four of the six factors that comprise the risk of social isolation measure are strongly associated with the overall risk (Table 1). While research indicates that seniors who never married or who live alone are at higher risk of social isolation, those factors are not strongly associated with overall risk in this analysis.

Table 2 shows the U.S. value and the highest and lowest values for the six risk factors for social isolation. Never married and living in poverty have the greatest variation across states and the District of Columbia.
County-Level Variation of Risk of Social Isolation Offers Further Insight on Impact among Seniors
Figure 2 shows the risk of social isolation for each U.S. county relative to all other U.S. counties. The data show bands of high risk areas in the Central Southern states, along the Southeast Atlantic coast and pockets of Texas and New Mexico. County-level maps of each state can be viewed on the state summary pages.
Large variations exist by county. The difference between the 5 percent of counties with the highest risk of social isolation and the 5 percent with the lowest risk is larger than the difference between the top and bottom states. Figure 3 shows the differences in the six individual risk factors for the top and bottom 5 percent of U.S. counties.
Large variations in the risk of social isolation also exist within states when comparing the top 20 percent and bottom 20 percent of counties. For example, Colorado has the largest variation between its top 20 percent of counties and its bottom 20 percent of counties in overall risk of social isolation. Figure 4 shows the variation by each individual risk factor for Colorado, highlighting the large gaps between the top and bottom groupings of counties.
Some states experience less variation when comparing the top and bottom 20 percent of counties at risk of social isolation. The states with the least variation are Iowa (Figure 5) and Vermont (Figure 6).

Understanding Social Isolation among Seniors is Important for Improving Community Health
As the senior population continues to grow, understanding, identifying and addressing social isolation among seniors will be increasingly important to promoting healthy communities. Recent interventions to target social isolation have used technology, such as the internet and computers, to enhance communication and connectedness among seniors. This may be particularly relevant for seniors living with geographic or mobility barriers, though the research also indicates there is no one-size-fits-all solution. Further exploration is needed to determine how to harness the power of technology to help alleviate social isolation among seniors. Notably, the AARP Foundation offers resources on social isolation on its website, including tools to find and maintain social connections.
The new risk of social isolation measure developed by America’s Health Rankings will equip policymakers and community leaders with the data needed to explore the variation in the risk of social isolation among seniors. With this information, they can work to effectively target programs to reduce social isolation and promote healthier communities for the nation’s seniors.