Ask an Expert: Solutions to Social Isolation in Rural Communities
Progress is being made to support those most impacted by loneliness
The vast majority of us, if asked, would say that we want to age in place, remaining with our friends and family in the communities where we have spent our lives and built our networks, even though these networks may shrink over time. For one in five older adults, that place to age is a rural community, and those individuals are more likely to experience the mental and physical consequences of social isolation on a greater scale than their counterparts in urban areas. The U.S. Surgeon General named social isolation and loneliness as epidemics of major public health concern last year. The advisory noted that a lack of social connection increases the risk of heart disease, stroke, dementia and even premature death.
Despite challenges, progress is being made to ensure older adults living in rural areas feel socially connected and less lonely. I spoke with the co-director of The University of Minnesota Rural Health Research Center, Carrie Henning-Smith, PhD, MPH, MSW, who highlighted recent progress to help rural older adults age well in their communities and shared resources to preserve their mental health. This is important for all of us, since healthy rural communities make the entire country stronger.
Our conversation below has been edited for length and clarity.
What is social isolation, and how is it different in rural areas?
Social isolation refers to a lack of people in one's life — not having enough people to turn to for support or companionship — and it happens in both rural and urban areas. However, being socially isolated in rural areas comes with distinct challenges related to transportation, internet and phone connectivity, and access to community gathering spaces, especially in very remote areas far from neighbors and community.
That said, rural areas also have unique strengths that can counter isolation. Rural communities often show greater social cohesion than urban areas, meaning that rural people are more likely to know and rely on one another. This may prevent some rural residents from being isolated — who otherwise might be — and offers opportunities to support residents who currently feel isolated.
What specific programs or initiatives has the University of Minnesota Rural Health Research Center developed to counter rural social isolation?
In addition to our research on this topic, we have a community-based program called Project REACH for rural Minnesotans, where community members identify a health problem they would like to address. For example, Ann B. was a retired Minnesotan living on the Iron Range. She understood the inherent challenges of living in such a remote area and used her experience to make change. Ann focused on addressing the social well-being of older adults in rural Minnesota by advocating for digital literacy, engagement and inclusion of older adults in Minnesota's libraries. Because of her efforts, the Minnesota five-year plan for libraries prioritized expanding access to digital inclusion and technical support for older adults.
The notion of using libraries to reduce isolation is terrific. My organization [The John A. Hartford Foundation] is in conversation with the American Library Association about this very topic. Are there other notable wins from your efforts to address rural social isolation?
I think the biggest win is the attention our work is receiving. The U.S. Surgeon General's 2023 report on social isolation and loneliness was a huge win in terms of increasing awareness, but more needs to be done to identify solutions specific to rural areas.
How do you involve the local community in your efforts to reduce social isolation?
Community input is critical. We created an expert work group comprised of rural health leaders and community members who inform and advise our work. Project REACH fosters mutual learning between community members and university researchers. Finally, in nearly all our research, we conduct interviews with community members and rural health experts to add important nuance to quantitative analyses.
You've previously written about initiatives related to accessibility, intergenerational programs, time banking, social media and personal interaction to counter loneliness. Are there updates to share?
I'm most excited about the increased attention social well-being in rural spaces is getting. This has helped direct resources and policy attention toward this issue and gives me hope for the future.
Recently, I had the opportunity to collaborate with the Foundation for Social Connection on a new report identifying ways that the built environment — the man-made structures that make up a community — can contribute to or hinder social well-being. Research shows that a well-designed built environment can foster social connection, promote a sense of belonging and promote civic engagement. At the same time, poorly designed spaces hinder social cohesion and exacerbate social isolation.
How do you measure the success of initiatives to reduce social isolation in rural areas?
Ultimately, success needs to be measured by fewer rural residents reporting social isolation and loneliness, and more rural residents reporting feeling socially connected. But we can also mark success by paying attention to the issue, increasing public conversation, allocating more resources, and urging greater policy action — all of which I see happening!
No matter the geographic location, The John A. Hartford Foundation believes all older adults should have access to age-friendly care to meet their physical and mental health needs. Learn more about care that addresses the goals and preferences of older adults at JohnAHartford.org.
The John A. Hartford Foundation is a private, nonpartisan, national philanthropy dedicated to improving the care of older adults. The leader in the field of aging and health, the Foundation has three priority areas: creating age-friendly health systems, supporting family caregivers, and improving serious illness and end-of-life care.
