Reducing social isolation among older adults helps everyone

A new report from the National Institute on Ageing gives stark insights into how lonely older Canadians are—and argues that real solutions should touch all of us.

Efforts to tackle social isolation among older Canadians could produce a wealth of health and lifestyle benefits for the country’s aging population. But the National Institute on Ageing also argues compellingly that such efforts, if guided by structural and equity-based approaches, could improve social connectivity throughout Canadian communities—and help head off an apparent oncoming epidemic of isolation affecting everyone.

The National Institute on Ageing (NIA), a “think tank” based out of Toronto Metropolitan University, recently released a report, “Understanding Social Isolation and Loneliness Among Older Canadians and How to Address It (PDF).” NIA Research Fellow Dr. Ashley Flanagan also presented some of the findings and recommendations at Hey Neighbour Collective’s Living Together Symposium

“We’re calling for a national strategy,” Flanagan said in a recent interview with HNC. “That’s our number one recommendation.” The NIA’s goals in producing the report, Flanagan explained, are not only to educate and influence government policymakers, but also to raise awareness and “destigmatize” isolation and loneliness in hopes that all aging people will feel more comfortable reaching out to each other to share their needs.

The need is clear: Statistics Canada estimates that nearly a quarter of Canadians aged 65 and older wish they could participate more in social activities. And the NIA report describes how social isolation and loneliness have been linked with negative health conditions such as alcohol over-consumption, physical inactivity, cardiovascular disease, and heightened risk of mortality. One well-known study—discussed in a TedX talk by the lead author—found that people who were more socially isolated had worse overall health at about the same rate as did people smoking fifteen cigarettes a day.

The 100-page report provides a comprehensive, well-organized, accessible review of research studies and on-the-ground initiatives related to social connectivity, such as how isolation affects people, what’s being done here and in other countries to address it, and how the pandemic and lockdowns have “created a stronger mandate” for reducing isolation. However, the report is especially helpful for its ongoing elucidations of the similarities and differences between “structural” approaches to tackling isolation as compared to approaches that are more “individualized.” 

The NIA distinguishes on the one hand between loneliness as a subjective perspective, “an undesirable internal experience, related to unfulfilled intimate and social needs,” and on the other hand social isolation as a more objective condition, “a measurable lack of contacts, family or friends.” These differences then lead to distinctly different proposed solutions—some more individualized, and others more structural.

For combatting feelings of loneliness, the NIA found that cognitive behavioural therapy, mindfulness and positive psychology can be important tools, along with “social prescribing” that involves medical doctors writing “prescriptions” to their patients for “non-pharmacologic interventions such as engaging in social activities or exercise.” 

By contrast, older adults who are low-income, immigrants, less educated, hearing impaired or otherwise disabled are at much higher risk of social isolation. The NIA report concludes that we should therefore prioritize accessibility and promote social inclusion, beginning with involving members of at-risk subpopulations at all stages of research, funding, and program design. And program implementation could target structural and equity issues such as improving public transit, assisting people with use of technology, and altering physical environments in urban centres and buildings for better accessibility.

Of course, it’s much easier—and on the surface may appear cheaper—for governments to support individuals in getting mental health therapy or medications to help with their inner feelings of loneliness rather than to, say, support significant expansions to public transit. Is there a risk that those kinds of individualized approaches will get funded more than the suggested structural changes?

“There is a risk of that individualized, sometimes highly pathologizing way of approaching things, or of medicalizing people’s distress,” agreed Flanagan. In part for that reason, the NIA’s main emphasis is on structural and equity-based approaches. However, Flanagan added, “When I think about the risks, I think the bigger risk is not doing anything.”

After all, Flanagan pointed out, the problems appear to be worsening.

One of the findings that the NIA found surprising from its own formal survey of some 1,500 Canadians, said Flanagan, was that young people appear to be feeling even more lonely than seniors. While 40 percent of those aged 55 years and older reported experiencing a lack of companionship and regular social connections, 51 percent of those aged 54 years and younger reported feeling the same way. (And those high numbers weren’t related to the pandemic and lockdowns alone.)

Such findings raise the spectre of a dramatically worsening cultural problem, as these socially disconnected young people age. Therefore, whenever possible, Flanagan said the NIA is always keen to collaborate with others working towards more socially connected communities, whether they focus on older people or not.

So, are there ways that neighbours and small groups of people can come together to collaborate simultaneously on connecting individually and also on tackling bigger “structural” issues affecting the older adults?

“Absolutely,” said Flanagan, pointing for example to “naturally occurring retirement communities” (NORCs), where groups of neighbours come together to meet and socialize, and then often end up sharing their concerns and working on initiatives such as improving accessibility in their buildings, leading multi-generational home-sharing initiatives, or bringing in community and government services. 

Such efforts, said Flanagan, ultimately benefit everyone across society, because the factors that reduce the social participation of older people can often have impacts on others as well. “If we can create communities that are more age-friendly, then disabled people, and young parents with children, and people who experience language barriers, and many other types of people will also likely feel more supported.”

Read the full National Institute on Ageing report (PDF).
Watch Dr. Ashley Flanagan’s presentation (starting at 1 hour 48 minutes on the video).