The Killer in the Shadows

I want you to think back to a time when you were cooped up at home. Maybe you were doing work from home instead of going to work. No one was home with you. A couple of hours passed and you NEEDED to get out of the house. You needed to see someone, talk to someone, interact with anyone. You started texting your best friend. They didn’t reply. So you texted your next friend, but they didn’t reply either. You started to get desperate and just started going through your contact list trying to find some human contact.

lonely-old-manNow imagine if you didn’t have a phone, and weren’t able to get out of your room. This is how an older adult with a physical and/or cognitive impairment feels – isolated, alone, anxious.

Here’s another story for you – a bit more extreme. Have you ever heard of the SHU – the complete isolation room they put prisoners for bad behaviour for hours, days, or weeks on end? Studies have shown that within hours of complete isolation, people start to hallucinate, become delirious, and essentially lose their minds.

The effects of SOCIAL VULNERABILITY are astounding and are all too often discredited and underestimated.

So what am I talking about? I’m doing research in “Social Vulnerability” among older adults. Whenever I tell someone about my research, they always ask: “What is social vulnerability?”

Social vulnerability is the extent to which your social circumstances increase your risk of experiencing negative health outcomes (for example: cardiovascular disease, depression, etc). So if we look at all the social factors in your life (i.e., social engagement, communication abilities, control over your life, socioeconomic status/money, social networks, social support, etc.), we want to count up the ones you are deficient in. For example, say you can’t speak the same language as others, you don’t engage much with the people in your community, and you don’t have someone you can rely on; then you have 3 social deficits. The more social deficits you have, the greater your risk to adverse health outcomes such as going to hospital, or dying!

So why should we be concerned with social vulnerability? Well first of all, studies have shown that no older adult is completely free of factors that make them socially vulnerable. So everyone is somewhat at risk for a negative health outcome. If we could target the social deficit, then we could reduce the risk for the negative health outcome! Second, social vulnerability has been found to increase the risks of cognitive decline and DEATH! Social vulnerability is also related to frailty and pain! All these things decrease the quality of life of that person, and as I said in my last post, “it is not just about the length of life lived, but the quality of life lived.”

Social health is often overlooked and overshadowed by other domains of health, such as physical health. But it is time to start paying attention to this silent killer that many people discredit. Think of how you feel when you move to a new town or start a new job. You feel alone, isolated, anxious. Maybe your heart rate quickens, or you start to sweat. You have physical reactions to your social and emotional states! This is what causes disease and death! We need to give attention to social vulnerability, so our communities can thrive. We need to care. We need to reach out our hands to our neighbors and ensure everyone has support, has a network, and has engagement. After all, nobody wants to die alone.

By Eleanor Pineau


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