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Is there any connection between loneliness and social isolation? If someone has a group of friends and family but feels lonely, can that lead them to turn away from their contacts and become socially isolated? 听

There鈥檚 a lot more attention right now to how these processes play out over time. Social ties can be sources of stress and strain, but sometimes it鈥檚 not that easy to break a connection or withdraw from a social tie鈥攆amily, for example, or caretaking obligations. The stress of those obligations can cause people to withdraw or pull back from the social relationships. If so, do they have other social connections? Do they form new ones? Or do they become socially isolated?

What else explains the increase in social isolation?

It could be that we are more socially isolated because, as research shows, we鈥檙e spending less time with friends, we鈥檙e spending less time with family, we鈥檙e not volunteering as much as people were decades ago. But there are also these broader demographic trends that contribute to social isolation. So for example, people are living farther from their families than they did in the past. People are having fewer children. Marriage rates are down. When we look at trends in social connections and social isolation, if we鈥檙e looking at something like How many kids do you have? How many family members do you have? then yeah, that鈥檚 declining. All of these factors contribute.

Your research also looks at the ways that major life transitions as we age can affect our social connections.

Yes, retirement, for example, is a big shift in someone鈥檚 life that can disrupt their social network. If they鈥檙e going to work every day, going to the office, seeing people, and then that isn鈥檛 there anymore, it can contribute to social isolation. Widowhood is another contributor to social isolation, especially if someone shared a lot of social ties with their deceased spouse. Sometimes the spouse who passed away was the connector, the glue in the larger circle of friends.

So you lose your network of friends in addition to your spouse.

That can happen. Health is a huge factor as well. As mobility declines, it becomes harder to do things like get together with friends, engage in activities or religious services, or volunteer.

Why did you choose to focus on later-life adults in your research?

Later life is this part of the life course where there鈥檚 so much happening. There are these transitions, like I mentioned earlier: the loss of loved ones, retirement, becoming a grandparent, changes in health. All of these changes that alter the rhythm of everyday activity and can affect social connections. You kind of see the culmination of all of these things that happened from infancy through childhood and adulthood鈥攁nd to still be able to observe changes in people鈥檚 well-being at that later point in the life course is really fascinating.

You seem to be describing a situation in which our social connections can actually influence our physical health. Is that true?

Absolutely. There鈥檚 a lot of evidence that social ties can actually have as significant an effect on health as things like smoking and physical activity. And in some of my work, I鈥檝e found that older adults who increase their social network over a five-year period have better sensory functioning. We might not initially think of sensory health as being as important as, say, cardiovascular health, but we鈥檙e talking about the ability to see and hear and smell. These are things that affect the quality of everyday life in really important ways.

Do we know why improved social connections provide these benefits?

I鈥檓 not a medical doctor, but there鈥檚 the idea that our sensory systems may have these kind of features of plasticity, and that our social life is potentially a source of stimulation and enrichment. We see this with cognition, for example. There鈥檚 this 鈥渦se-it-or-lose-it鈥� thesis that if you鈥檙e using your cognitive abilities you can maintain them. People often think of things like doing crossword puzzles. But there are also things like going out and socializing with people, maintaining a large social network, and engaging in different social activities that can also contribute to cognitive health.

What were some of the highlights from the research you conducted for the 2023 paper you coauthored, 鈥淪tand by Me: Social Ties and Health in Real Time鈥�?

This was a fun study. We used data that we gathered from older adults who were living in Chicago, but we gathered the data a little differently than other studies on social life and health. Typically, surveys of older adults are done via an interview, or by having participants write their responses on paper. And these surveys are conducted once, or maybe every year or every five years. We did all of that but then we also asked older adults to carry around a smartphone for a period of a week. And five times throughout the day, they were pinged on the phone and asked to respond to a bunch of questions about what they were doing at that very moment鈥攚ho they were with, where they were, how stressed they were, how tired, how happy, how energetic. And so in this paper, we asked the question Does being with other people in a given moment affect the way that people feel in terms of their health?

And what were the results?

We found that being in the company of somebody else at a given moment leads to older adults feeling less fatigued and feeling less stressed in that given moment. This certainly mirrors a lot of findings that we already have in the literature, but the kind of contribution here is looking at this moment by moment, as opposed to asking more general questions about how socially connected someone is. This is suggesting that being socially connected is not just some kind of chronic, static thing. It鈥檚 not that we鈥檙e either socially connected all the time or we鈥檙e not socially connected at all. Being socially connected can change and unfold in what we call real time, or on a momentary basis.

It sounds like we may actually draw energy from being around people. Presumably people we like?

That鈥檚 a good question. We don鈥檛 know if these are people they like but we did find that these effects are especially strong when older adults report being with a friend or with a neighbor. They鈥檙e more likely to engage in recreational activities like socializing, going out to eat, doing something fun together. Whereas with family, older adults are more likely to do things like grocery shopping, going to appointments, things like that.

Did anything you found surprise you?

One surprise was that we didn鈥檛 see significant differences in how often people are with others based on their network size. So, someone who says they only have one close social tie in their network was just as likely to be with somebody during the day as someone who reported that they had five very close social ties. This really drives home that our social lives are dynamic and fluid, and to understand the effects on health, we have to look at these different levels and layers.

Are there things we can do as a society to promote and facilitate these beneficial social connections?

There鈥檚 been a lot of attention lately to the broader social environment鈥攕o not just someone鈥檚 interpersonal connections, but the social infrastructure of where they live. So things like libraries, parks, senior centers, and other community spaces that are conducive to supporting the formation and maintenance of social ties. In fact, after our paper was published, we heard from Middlesex (Massachusetts) District Attorney Marian Ryan鈥檚 office. It was really interesting to hear about this program she鈥檚 doing throughout Middlesex County called the 鈥淟et鈥檚 Connect Initiative.鈥� Part of the project is placing benches in certain areas, the idea being that the benches will kind of facilitate conversation and connection across generations. Then, in the Netherlands, there鈥檚 apparently a grocery store chain with a checkout line for people who want to chitchat with the cashier for a little bit. Time will tell if these kinds of initiatives have lasting effects in our increasingly socially isolated and lonely society. In chatting with a cashier at a grocery store, does somebody feel less lonely in the moment? Possibly. Does it build a lasting social connection that can be a reliable source of social support? I鈥檓 not sure. But our work does suggest that these momentary things still matter for well-being even if it鈥檚 a fleeting, momentary interaction. And when we think of health outcomes and premature mortality, our society typically focuses on things like changing someone鈥檚 physical activity or diet or prescribing a medication. I think social ties have been absent from that conversation. So it鈥檚 really exciting and important to start seeing more attention being seriously given to social connections.

You also have an NIH grant that鈥檚 looking at social connections and cognition.

It鈥檚 looking at interpersonal ties and close social networks but then also looking at the broader social environment. So aspects of the built environment, social infrastructure, socioeconomic measures of neighborhoods and surrounding areas, and thinking about how those factors shape cognitive function, cognitive decline, and the risk of Alzheimer鈥檚 disease and related dementias.

And social isolation is a contributor, we think?

Yes, it is. But it鈥檚 not just the presence or absence of social ties. That is important鈥攕omeone who鈥檚 socially isolated is at higher risk of cognitive decline鈥攂ut it鈥檚 also the question of what about the social networks that people do have can be protective against cognitive decline?

And what have we learned about protecting ourselves against cognitive decline? Have we identified any defenses in our听social networks?

I think that鈥檚 the big question that鈥檚 hopefully going to come out of a lot of the research that鈥檚 being done in this area. When somebody is sixty-five or seventy-five, can there be some sort of intervention, or is there something that can be done at that point to slow cognitive decline?

And what about our social network鈥檚 ability to positively affect our physical health?

Our social connections can be sources of stress, and it鈥檚 well established that stress can negatively affect health. But having supportive social ties can also buffer the effects of stress on health. So if you have a stressful experience in your life, a really supportive set of social ties to call on can maybe dampen the harm that event would鈥檝e otherwise caused. We also find that social ties can be really important in the way people manage their health and well-being, like taking medication, getting to appointments, and adhering to a prescribed health regimen.

And if someone doesn鈥檛 have a robust social network?

Someone who鈥檚 socially isolated, or who lives alone, can听be at much higher risk of not managing their health in those ways.

And if someone is feeling very lonely?

Loneliness itself can be a source of stress. Feeling lonely and being socially isolated can lead someone to engage in harmful health behaviors, such as smoking, or not engage in health-enhancing behaviors, like exercise. These effects can be exacerbated when someone who is lonely withdraws from social ties, and therefore does not receive support and resources that they otherwise might. Loneliness and social isolation can also activate the body鈥檚 stress response and related biological processes, which are implicated in various disease processes, and can manifest in blood pressure, immune function, and various markers for cardiovascular risk and other health risk factors. So there are various pathways through which our social relationships affect our health in significant ways, including physiological, psychological, and behavioral, in addition to being critical social resources and sources of influence that collectively shape our well-being.听