Every three years, Foundation Health Partners (FHP), along with our healthcare partners, conducts a Community Health Needs Assessment (CHNA) to evaluate our community health needs and develop plans to address the highest priority issues. In 2022 FHP collaborated with Interior Community Health Center and the Frontier Region of Alaska’s Division of Public Health to create a joint assessment that identified 4 priorities that will guide the Community Health Improvement Plan (CHIP) for 2023 – 2025. These priorities, adopted by the Greater Fairbanks Community Hospital Foundation, include (1) Alcohol use. (2) Social Isolation (3) Care of Elders/Seniors (4) Pediatric behavioral health.

Social isolation is a silent but serious issue that affects the health and well-being of many individuals living in Interior Alaska. In this article, I’ll discuss what constitutes social isolation; some common causes; how it impacts daily life; and finally, consider strategies that could lend to individual and community connectedness.

Understanding Social Isolation

Feeling isolated is an intense lack of connection and meaningful relationships. Feeling lonely and disconnected is an emotion that accompanies social isolation. Social isolation is a bit tricky and is not defined by being apart from others; we know the paradox of feeling lonely relationships and we know it can feel satisfying to be apart from others isolated. Those who feel isolated become so disconnected that they enter self-preservation mode, and their sense of aloneness deepens. The causes and circumstances are varied. Isolation is sometimes the outcome of changes in functional status such as an injury or chronic illness, geographic or socio-economic barriers, age-related factors like retirement, transportation changes, and language or cultural barriers. The effects of social isolation can be particularly damaging to elders and individuals living with mental health issues. Social isolation is also a risk factor for those across all age groups in abusive relationships - where the harm escalates in a vacuum of connection to helpers.

Isolation in Interior Alaska

A variety of factors can cause social isolation, but remote locations, especially where people live apart from family or cultural connections, are known to have some of the highest rates. Interior Alaska’s geographical location and extreme climate can create an environment that further promotes feelings of exclusion and alienation. Many Fairbanks area residents consider themselves “transplanted” here due to military, school, or work. Building connection to the community has extra challenges of the long-cold-dark winter, transportation, and real or perceived limits to opportunity to connect with others. Even among those who have lived here many years, changes in circumstance can compound loneliness. Changes such as family and friends moving away, retirement, divorce, traumas, and health complications redefine social circles that once provided the sense of connection and purpose. Isolation sometimes sneaks up and sometimes it hits like an avalanche.

The Impact of Social Isolation on Health

For decades, researchers have pointed out the connection between having a healthy sense of a support system and resilience and recovery. Those with strong sense of connectedness and purpose tend to fair better with acute and chronic health issues. More recently, research has helped define the causal relationship of social isolation and an increase in inflammation, cortisol levels, anxiety, depression, sleep disturbance, substance abuse, and other serious physiological and psychological problems that escalate as isolation progresses unresolved. These conditions lend to chronic and life-changing conditions such as hypertension, obesity, weakened immune system, cognitive decline, and exacerbation of dementia symptoms. For children and adolescents, social isolation contributes to academic and emotional decline. For young adults especially, isolation contributes to suicide risk. For people across all ages in abusive relationships, isolation contributes to the heightened risk of violence and death. Social isolation is self-perpetuating, like digging a hole in wet sand. Their condition worsens as the challenge of maintaining social circles becomes ever more discouraging.

The COVID 19 Pandemic added a dimension to social isolation, on a global level, that we will be striving to understand for decades. While in a state of alarm, over a long period of time, we were called upon to arrange our lives around preventing contact with one another – because contact was a threat. At the same time, we were acutely aware of the need to remain connected for emotional and practical purposes and because it is our nature – to be connected. Consequently, the pandemic lit a fire under developers of computer technology for solutions to work and social connection. Use and access to this technology spread to demographics that might never have otherwise used it. The work-from-home capabilities are a permanent shift in our workforce. This presents yet another paradox. For some this means increased time and opportunity for meaningful relationships beyond work; while for others, it has eliminated or significantly decreased the opportunity for workplace connection.

Benefits of Connectedness

It is crucial that we stay connected with friends, family, and community to have the support we need to lead a healthy life. Connectedness is the foundation of the sense of belonging. Belonging is an essential component of greater community cohesion, improved relationships, access to support networks, higher self-confidence, and decreased social anxiety and feelings of loneliness. The sense of purpose and belonging is also a source of strength that defines resilience; helping us cope with stressors and even crisis and trauma.

Solutions for Social Isolation and Support for Connectedness

Solutions to isolation take the form of individual and community interventions. Individual solutions are as varied as the cause and circumstance surrounding an individual’s experience with feeling disconnected. There is no common fix but there are some guidelines. Because isolation is so varied, solutions begin with introspection and take the first few steps on a path toward connecting with others. Make incremental changes by building on small enjoyable habit shifts. Add a social component to something that is part of your daily life. If you enjoy activities such as knitting, reading, video games, or taking walks - add a social opportunity to that interest. For example, knit at the yarn-store social hour, try a book club meeting in-person or on-line, take a class, go to a gaming event, or walk with a friend or hiking group. Shift some common phone habits such as making a call instead of texting or looking around and listening while in public rather than focusing on your phone. Simply listening to surroundings and joining in social settings builds a sense of connection. Try having a conversation with a trusted person about the experience of isolation; sharing can build support and inspire solutions. Ask your healthcare provider to suggest support groups for physical and mental health support.

As a community, we have capacity to be more inclusive, create opportunity to connect, and share awareness of a need for meaningful relationships. We can develop more safe and accessible public space and host events that draw people together. We can support systems for volunteerism, which has a two-fold benefit; it creates a sense of belonging for the volunteer and it delivers meaningful services. The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community, Our Epidemic of Loneliness and Isolation was published on the U.S. Department of Health and Human Services website in May and defines guidelines for the National Strategy to Advance Social Connection.

The Community Health Improvement Plan for Social Isolation

Community health and social service leaders have pieced together the components of a shared plan for reducing social isolation in Fairbanks. This is a priority because social isolation is a powerful contributing factor to serious physical and mental health outcomes and with collaboration, we can effectively change this. The Community Health Improvement Plan (CHIP) defines the goals for reducing isolation, the immediate strategies, and the measures for improvement over the next three years. The CHIP was adopted by the Foundation Health Partners governing board in May and can be found here for public input.

Carol Anthony came to Fairbanks with a student exchange program to the University of Alaska Fairbanks more than 40 years ago. The friendliness, fascinating people, and meaningful work associated with life in this community have all contributed to her knowing that even in this far-flung place, a transplanted person can feel like they belong and have purpose. Carol is the Community Partnerships Manager at Foundation Health Partners, where she has worked for 35 years.