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COVID-19 poses an unequal risk of isolation and loneliness

COVID-19 poses an unequal risk of isolation and loneliness
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The current COVID-19 pandemic is a visceral reminder of the ways in which we are all connected. 

Social distancing is crucial to “flattening the curve” to give our health care system a fighting chance. The short-term loneliness and isolation that will come from limiting interactions with one another will be hard. The potential of COVID-19 to cause long-term isolation and loneliness is particularly troubling, given the importance of social connections for health and wellbeing. 

But, loneliness and isolation are already a fact of life for many people. More than 60 percent of Americans reported feeling lonely in 2019, an increase of 7 percentage points from the year before. The percentage of American adults reporting that they have no one to confide in has tripled since the mid-1980s, with more than one-quarter reporting that they have no one. We are all at risk of feeling loneliness and isolation more profoundly during this time of social distancing, but the risk is not equally distributed. Many of the people at greatest risk of isolation and loneliness are also those most vulnerable to the worst of the COVID-19 pandemic. 

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People living in institutional settings — nursing homes, assisted living facilities, prisons and jails – are, quite literally, isolated from many parts of society already. And they are particularly vulnerable to viral outbreaks like COVID-19, should it make its way inside their walls. Residents of these same institutions are already particularly susceptible to loneliness. Restrictions on visitors are important for protecting the health and safety of residents and staff of these institutions, but they may also exacerbate already strong feelings of loneliness and isolation. 

Similarly, living alone is not synonymous with loneliness, but it does place individuals at higher risk. More Americans live alone today than ever before (nearly 15 percent of all adults live alone and 25 percent of all households consist of one person). Older adults (65+) are the most likely to live alone, with rates particularly high among older women. Older adults are also most at risk from COVID-19. Sheltering in place is a responsible step to protect those living alone and their communities. But again, doing so may  heighten feelings of loneliness and isolation and may present barriers to meeting one’s daily needs — getting food and running errands — especially for older adults or people with underlying health conditions. 

Rural areas are likely to be hit later by COVID-19 because of their geographic isolation, but will be impacted especially hard when they are, owing to older populations and scarce health care resources. Those same areas already face unique barriers to countering social isolation and loneliness, including transportation barriers, and more limited broadband Internet and cellular connectivity. As recommendations to counter the loneliness and isolation of social distancing center around maintaining connections with others online, many rural residents will be left out. 

Finally, the looming health and economic impacts of this pandemic will have devastating implications for social isolation and loneliness. Financial insecurity already puts people at higher risk of isolation and loneliness, as does losing a loved one or being in poorer health. As a result, risks of COVID-19 will be compounded for many groups already most affected: older adults, hourly workers and the uninsured, to name a few. Without quick and significant support for the safety, health and emotional wellbeing of all Americans, especially those at greatest risk, this pandemic will make loneliness and social isolation much worse in the long term. 

As schools and workplaces increasingly move online, and ideas abound for how to stay connected virtually, people will be left out. Nearly one-fifth of American adults don’t own a smartphone; one-quarter don’t own a computer. Access to technological devices and broadband Internet is lower among rural residents, older adults, members of racial and ethnic minority groups and people with lower incomes. Those same groups will likely be hardest hit by the health and economic consequences of this pandemic. 

Efforts to address pandemic risk should include thought on how to mitigate isolation and loneliness among those most susceptible, including increasing access to technology and ensuring that essential needs —  food, housing, safety, childcare, paid sick leave — are met for people who are most isolated. COVID-19 is an immediate threat. Let’s not let it fracture us further. Ultimately, our shared humanity is what makes us vulnerable to this in the first place, but it is also what makes life worth living and saving. 

Carrie Henning-Smith, PhD, MPH, MSW, is an assistant professor in the Division of Health Policy and Management at the University of Minnesota School of Public Health and deputy director of the University of Minnesota Rural Health Research Center. Follow her on Twitter at @Carrie_H_S