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Mortality Risk Higher for Nursing Home Residents in Socially-Isolated Neighborhoods

January 27, 2021

Nursing home residents in US neighborhoods with the highest proportions of older adults living alone appeared to have increased risk of death compared with nursing home residents in communities with fewer older adults living alone. Researchers published their findings in Preventive Medicine Reports. 

“Studies have found living alone to be an important risk factor for mortality. Yet little is known about possible spillover health effects of living in a community where many elderly residents live alone,” wrote researchers from Northeastern University. “Even less is known about whether these risks persist after entering nursing homes.” 

Investigators explored the association between the county-level percentage of adults age 65 and older living alone and 730,524 older adults admitted to US nursing homes in 2011. 

After controlling for county-, nursing home facility-, and individual-level factors, researchers found an 8% higher risk of dying among nursing home residents in counties in the highest quartile of older adult single-occupancy households compared with counties in the lowest quartile. 

We also found evidence of a linear trend: as the proportion of elderly single-occupancy households within a county increased, the risk of mortality was higher,” the study stated.

The findings, if confirmed as causal in future studies, could suggest the health effects of community living arrangements carry over into nursing home residence, researchers wrote. Consequently, older adult house-sharing programs or other interventions to modify community living arrangements may help. 

“In one home-sharing program in the US state of Vermont, surveys found that more than 80% of participants reported feeling happier and less alone,” researchers wrote. “Over the long term, such programs may contribute to more favorable health trajectories among Americans who are increasingly aging in place and at growing risk of entering nursing home facilities.” 

Jolynn Tumolo


Kim D, Park C, Briesacher BA. Socially-isolated neighborhoods and the risk of all-cause mortality among nursing home residents in the United States: A multilevel study. Prev Med Rep. 2020;21:101285. Published 2020 Dec 13. doi:10.1016/j.pmedr.2020.101285

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