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Make the Social Choice the Easy Choice

By Risa Wilkerson on November 30th, 2020

Earlier this month, in “Mending Divided Communities with the Thread of Social Trust,” I wrote that “No matter what we’re working on—racial justice, poverty, COVID relief, or any other issue that affects community health—the only way to solve those problems is through collaboration.” We know that collaborative, community-led, place-based initiatives often build trusting relationships between people working in different sectors and living in different neighborhoods.

It takes these types of meaningful social connections to address complex problems and create healthier places to live. As it turns out, even just connecting with others is good for health. A growing body of evidence shows that a strong social network can boost longevity by 50 percent. And social isolation—the lack of significant social connections—negatively impacts our health. In fact, social isolation is linked to increased risk of death from all causes.

Even before the COVID-19 pandemic, social isolation had spiked in recent years, impacting people of all ages. It is especially prevalent among those who are marginalized because of their race, income, location, sexual orientation, and gender identity. Social isolation is also exacerbated by experiences such as long-term illness or disability, domestic violence, loss of a loved one, becoming a caregiver, having a baby, moving to a new place, and more. In other words, it’s widespread.

This year, Healthy Places by Design partnered with the Robert Wood Johnson Foundation to facilitate a learning network of six grantees focused on social isolation and its connection to public health. During our learning exchanges, many themes emerged. Among them is the need to reframe the conversation around social isolation. Currently, it is being defined, discussed, and addressed primarily through an individual lens rather than a systemic one.

This is reminiscent of how physical activity and healthy eating were viewed in the early 2000s. Back then, Healthy Places by Design worked at the forefront of a paradigm shift for public health: together with foundations and national partners, we shifted the conversation away from an individual focus to one that recognizes how the places where we live affect our health. Instead of telling people to “Eat more fruits and vegetables and exercise 30 minutes a day,” we encouraged multi-sectoral and neighborhood leaders to “Make the healthy choice the easy choice” through community-level policy, systems, and built environment (PSE) changes. It’s time for another paradigm shift.

We need to realize that the rise of social isolation is not a personal choice or individual problem, but one that is rooted in societal norms and community design.

In Solutions for Social Isolation: What We Can Learn from the World, the Robert Wood Johnson Foundation describes lessons learned after reviewing 200 applications from around the globe and shares future opportunities for addressing social isolation. Many of the key strategies and opportunities listed are well aligned with community-level work already taking place to improve health through PSE changes. That means we can leverage existing efforts to improve social connectivity.

For example, the report notes how people are adapting the built environment to create more public spaces for social connections—including open streets, parks, and intergenerational housing to combine  quality child care and healthy aging services. Building inclusive, healthy places requires co-creating public spaces with the diverse community members who live there. This not only increases social connections for those involved, but the resulting designs also create greater ongoing social connections among those who frequent these places.

The report also recognizes the need to elevate inequity as a root cause of social isolation, noting, “People who experience inequities and are isolated from opportunity because of where they live, how much money they make or the color of their skin more often experience social isolation. Addressing inequities should be at the front and center of all efforts to strengthen social connectedness.”

A good solution solves many problems. We don’t have to build independent strategies to improve this public health issue. We can strengthen the social fabric of our communities—and our country—by integrating this priority into other strategies. Dr. Julianne Holt-Lunstad, Director of the Social Connections and Health Research Laboratory at Brigham Young University, writes, “Social well-being is influenced by all sectors of society, including health, transportation, housing employment, education, food and nutrition, and environment.” She suggests a framework of Social in All Policies to guide diverse sectors in their work.1

Organizing educational and social events, although helpful, is not sufficient. We must recognize how current structures and practices of exclusion and isolation exist. And together, we must improve policies, systems, and environments to make the social choice the easy choice for everyone.

Risa Wilkerson

Executive Director

Action-driven optimist, abundance thinker, and simplicity seeker.