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Interesting, innovative new models are emerging nationwide for measuring the degree to which community members are connected or disconnected from one another. That was the takeaway from a late-July Healthy Places by Design gathering of more than 90 local leaders who share interest in reducing social isolation, a public health crisis with adverse impacts equivalent to those of chronic smoking or alcohol consumption.

Healthy Places by Design is focused on social isolation because it is a place-based problem linked to depression, poor sleep, accelerated cognitive decline, and weakened immunity. It causes a greater risk of stroke, coronary heart disease, and premature death. People who feel disconnected are less inclined to act in healthy ways or work with others to promote well-being for all. The monthly gathering is a key element of our work in this burgeoning area.

Here are some highlights from the discussion with three guest speakers, two of whom were local practitioners who shared stories about how they are learning to measure this place-based problem:

Focus on Youth in Maine

In Maine, measurement work is focused on youth because by emphasizing youths’ needs, it is likely to have a lasting effect on the greater community. That is according to Kina-Ana Tinkman, Executive Director of the Maine Resilience Building Network, one of the gathering’s three speakers. Youth who feel connected at school and at home are 66% less likely to experience health risk behaviors in adulthood.ⁱ

The need is pressing. Forty-three percent of Maine youth feel like they don’t matter in their community when they leave their home or school. Only 37% of LGBTQ+ youth in Maine feel they matter compared to 56% of their hetero, binary peers.

Specifically, Maine’s measurement work is focused on mattering – “the sense of being significant and valued by other people,” as defined by Gordon Flett, author of The Psychology of Mattering: Understanding the Human Need to be Significant.

Maine is working in three domains: home, work/school, and the community. The Network released Cultivating Mattering for Maine Youth, which highlights the research on building positive relationships and connections for youth.

Tinkman explained, “Without the data we are collecting, the Network would be blindly developing and implementing strategies based on assumptions. Now we are confidently identifying strategies and addressing the most pressing issues.” This includes developing tools for youth, the greater community, and businesses to help change the culture and engage more youth to where they are thriving where they live.

A byproduct of the work includes new funding opportunities for some of the local communities in Maine, like a $50,000 grant from the United Way to improve mattering scores, and a rural community was awarded a CDC Social Determinants of Health Accelerator Plan grant that focuses on increasing food security and social connectedness. As Tinkham says, “We’re measuring it to better address it.”

Focus on Social Cohesion in Brown County, WI

In Brown County, Wisconsin, which includes Green Bay, Beyond Health, a steering committee of local health-focused entities facilitated by Brown County Public Health, has identified social cohesion as one of three priority suggestions in the county’s community health assessment (CHA). That is according to Andrea Kressin, Community Engagement Manager at Brown County Public Health in Wisconsin. Social cohesion is framed as “helping people connect with each other and their community in healthy ways.” Brown County uncovered three key indicators to measure social cohesion based on a standardized tool:

• Percent of respondents who see themselves as members of the community;
• Percent of respondents who rate “good” or “excellent” for living together as neighbors;
• Percent of respondents who are “satisfied” or “very satisfied” with their personal relationships.

Public Health is finding ways to work smarter not harder by connecting with local partners. A local nonprofit, Wello, is conducting well-being surveys every two years that align with the measurements needed (for bullets 1 and 3) in the CHA. The other is measured through a local collaborative study, The Leading Indicators for Excellence (LIFE) Study, that assesses and reports on residents’ quality of life.

Kressin explained that they plan to disseminate data with grassroots leaders and are taking an intentional approach to include historically underserved groups. They want the data to be used by those in decision making roles to inform future policies. Brown County, like others in Wisconsin and across the country, are naming and addressing racism and equity in their CHAs and facilitating difficult conversations that are long overdue.

Kressin shared how the information from these key stakeholder conversations also help to inform the three-year Community Heath Improvement Plan. She said, “We brought topics [to the stakeholders], asked questions, and wove the responses into the final product.” Consider the progress that could be made if all community health assessments included social connectedness as a priority area.

Available Measurement Tools and Frameworks

Abigail Barth, Research and Innovation Program Manager at the Foundation for Social Connection, shared additional tools that are available to measure social connectedness and loneliness. While “loneliness” and “social connectedness” are closely related, Barth explained, they require different measurement tools. It is important to know which one you are trying to measure as the implications and strategies are different.

Two common tools are the UCLA Loneliness Scale and the Berkman-Syme Social Network Index, which some participants have used. Other tools with subsets of questions that measure loneliness and/or social connectedness include the County Health Rankings, Behavioral Risk Factors Surveillance System (BRFSS), and the National Health Interview Survey (NHIS).

One participant shared how they originally used the UCLA Loneliness Scale but switched to the Campaign to End Loneliness tool, as they felt the latter used more positively framed language.

Barth said that in her experience, administering these tools may be challenging for respondents as the questions can create discomfort, as loneliness and social isolation can be sensitive experiences to discuss. Giving these types of surveys can create discomfort or other unintended consequences for some respondents. The purpose and intent can help inform which tool is best.

With so many tools, it is important to notice that some scales may take a narrower scope to measuring loneliness and connectedness exclusively with in-person relationships in mind (some measurement tools were created before the internet) while others can address online and in-person connections.

Think With Us / Join Us

Healthy Places by Design is especially interested in what organizations and communities from across the country are doing to measure social connections at the community-level. If you have an example to share with us, or you want to learn more about what others are doing, email us today. And plan to join us for Healthy Places by Design’s next Local Leaders for Socially Connected Communities convening.

The network, now 290-people strong and growing, is vital to creating healthier and more inclusive communities.

For more information on upcoming topics and schedules, or to join the next Local Leaders call, please email Gabriella Peterson at gabriellap@healthyplacesbydesign.org.

Resources for this session are now available including a recording and presentation slides.

Photo: “It Has to be From Here: Forgotten but Unshaken.” A mural in North Philadelphia by Betsy Casañas. Casañas is connected to North Philly, and her art represents the community’s strength and resilience.

[i] https://www.cdc.gov/healthyyouth/protective/youth-connectedness-important-protective-factor-for-health-well-being.htm#:~:text=Recent%20CDC%20findings%20published%20in,and%20mental%20health%20in%20adulthood.