South Jersey residents who feel socially isolated are twice as likely to experience heart disease as those who are more connected to their community, three times more likely to report mental health issues and four times more likely to misuse drugs, according to new research from Rutgers University in Camden.
The findings are part of a report by the university’s Senator Walter Rand Institute for Public Affairs, which highlights how personal connections to people and place affect an individual’s physical and mental health.
While academics have traditionally focused on social isolation among the elderly, the Rand study found that in South Jersey, it’s young people who are more likely to be lonely. According to its findings, millennial residents are 50% more likely to say they feel alone than their elders, and twice as likely to report they face mental and physical health challenges.
“Our study revealed a strong and surprising relationship between age and social isolation,” the authors wrote, noting that interviews with college students led to some surprising findings. “Interestingly, these students blamed social media for this difficulty. Because social media makes superficial relationships easier, they said, it prevents the development of meaningful connections.”
In addition, while other research has shown childhood trauma — or adverse childhood experiences (ACEs), which impact an estimated 40% of the state’s youth — increase the chances of chronic health concerns down the road, Rand found these early incidents also could predict isolation later in life. Those who endured abuse or violence as youngsters were 3.6 times more likely to be unable to develop connections with others as adults, when compared to those who did not encounter ACEs, researchers discovered.
A region that doesn’t always get close attention
The report, provided to NJ Spotlight in advance of its scheduled release today, is based on nearly 2,400 personal surveys from residents living or working in five counties in the southwestern corner of the state — Burlington, Camden, Cumberland, Gloucester and Salem — plus health-related data from public agencies and health care providers. It is part of a larger effort to better understand the health needs of a rural region with a limited population that doesn’t always get close attention in statewide studies, Rand said.
The research also explored the impact of neighborhood quality and access to transportation on residents’ well-being; public transit is severely limited in the region and four in 10 people surveyed said poor transportation presents a barrier to accessing health care.
The Rand Institute was established to focus on public policy issues within New Jersey’s eight southern counties; the report covers the five served by the institute’s hospital partners: Cooper University Health Care, Jefferson Health, Lourdes Health System, Inspira Health Network and Virtua Health.
Darren Spielman, executive director of the institute, said the team was surprised by several things they discovered through the research, which involved a collaboration with the five regional hospital systems that share patient data.
“We thought there would be a connection (between social isolation and health), but we didn’t know it would be like this,” Spielman said, noting that the association between loneliness and poor well-being was stronger than they had anticipated. Other unexpected findings were the social isolation and poor health reported by millennials — as well as the suspected cause, social media — and the connection between ACEs and isolation, he said.
(The study was not done to compare the health of South Jersey residents to those elsewhere in the state or nation, but Spielman said that, in general, many counties in north Jersey report better public health outcomes.)
Big effect of social conditions
The report notes that health care outcomes are driven in large part by underlying social conditions, like education and poverty, or — as defined by the World Health Organization — the “landscape” in which an individual is born, grows, lives, works and ages. To truly impact health, policy must address the larger landscape in addition to treating the patient directly, the study said.
The Rand researchers chose to focus on human connection, which experts consider a key social determinant of health. Forming these bonds by cooperating with those who are not blood relatives is also an important human trait, they said, and while it has been studied for years it is only recently being linked to health outcomes.
Overall, nearly half the study participants (across all age groups) reported being in “good or excellent” physical health — and slightly more assessed their mental health that way — while around 16% said they were in “fair or poor” health of mind or body. These numbers did vary somewhat by county, ranging from 21% of Cumberland County residents listing their health as “fair or poor” to 13% of those in Gloucester County.
Generally, the respondents felt fairly positive about their connections with the people in their communities and the places they live, Rand noted. Three-quarters of respondents said they rarely felt socially isolated, while fewer than one in 10 said they often did.
But those who do struggle to maintain meaningful connections reported a number of negative health conditions. Rand used a point system to compare responses and found residents who felt isolated were 50% more at risk for obesity, asthma and diabetes — and 2.5 times more likely to abuse alcohol then their less lonely neighbors.
The communities in which people live also played a role in their health and well-being, the study found; an unrelated report released in January suggested that public investment in Camden has improved the health of its citizens.
Majority said their neighborhoods were ‘good or excellent’
Roughly six in 10 respondents in the Rand study said they lived in a “good or excellent” neighborhood, with healthy food options and safe places to play and walk, but only 42% said these areas were set up to bolster social connections. Those who reported their community as “poor or fair” were 3.5 times more likely to have health issues and 2.7 times more likely to face mental health challenges.
When it came to getting to the doctor or accessing other health-related services in South Jersey, the car is king, Rand confirmed. (The institute has done other studies documenting the region’s limited public transit options.) Nearly nine out of 10 people drove to their own appointments; those with high health care needs, housing troubles, poverty and other social challenges were far more likely to rely on public transit or on others with a car for a ride.
Sarah Allred, facility director at Rand who led the research, said the report grew out of the institute’s work with the five hospital systems to create meaningful assessments of community health needs, a process the federal government requires every few years for nonprofit facilities. The decision to focus on social connections — and to consider the impact of age, neighborhood, transportation and early trauma — was driven by what they learned from residents, she said.
“It was truly a bottom-up process,” Allred explained, adding, “This was really a great collaboration. It’s rare that you see these kinds of stakeholders coming together this way.”
Rand worked with hundreds of community-based organizations to distribute the 60-question survey, which was completed by residents in more than half the towns in the five counties, Allred explained. Researchers also conducted three dozen focus groups, interviewed key stakeholders, and collected data from county and local health offices.
The Rand team hopes to continue exploring several of the connections it discovered, including the isolation and health concerns reported by young people and the link to social media. They also want to dig into the ACEs impact to know what is really driving the social isolation some victims of childhood trauma reported later in life.
“It would be great to study that a little further so we could confirm that trend,” Spielman said, and see “if there might be things that could be done about” social isolation among young folks.
In addition, Rand hopes to collect the same kind of information from residents in the other three counties they study, Atlantic, Cape May and Ocean.