Community and Social Supports
Feeling connected and belonging to a community is vital for well-being. It satisfies a basic human need that helps individuals and communities thrive.
In contrast, social isolation and loneliness are harmful to health in a similar way as obesity or smoking.[1] Isolation is linked to a higher prevalence of mental health disorders, self-harm, suicide, and poor physical health.
Several factors, including immigration status, veteran status, and aging, can impact social isolation or connection.
[1] International journal of environmental research and public health
Here’s what you’ll learn:
How Social and Community Context Impacts Olivia
Meet Olivia—a young artist who has found community through volunteering, joining LGBTQ+ support groups, and sharing her experiences with homelessness on a youth advisory board. After law enforcement encounters and overcoming addiction, Olivia is working on building deeper connections with others and embracing her identity within her chosen family.
Get to Know OliviaHow Social and Community Context Impacts The Jackson Family
Meet Nichelle—a devoted wife and mother who balances caregiving for her mom with her own family responsibilities. Living near a Haitian community helps Nichelle feel connected to her culture. With her sister far away, she leans on her best friend and creative hobbies to find joy in daily life.
Get to Know The Jackson FamilyHow Social and Community Context Impacts The Garcia Family
Meet Elena—certified nurse assistant, National Guard veteran, and single mom. Living far from her support network, she is navigating grief, PTSD, and an invisible disability while raising her two children. Elena is trying to build community and find her way again.
Get to Know The Garcia FamilyHow Social and Community Context Impacts Chris
Meet Chris, a teacher who is blind and who has built a strong community through friends, family, and shared interests. Between hosting karaoke nights, playing Dungeons & Dragons, and spending time with his girlfriend’s family, Chris works to overcome stereotypes while nurturing his social connections.
Get to Know Chris
Terms to Know
Limited English proficiency (LEP) refers to individuals having difficulty reading, speaking, writing, or understanding English because it is not their primary language.[1] U.S. federally assisted or conducted programs provide LEP individuals with reasonable access to the same services as English speakers.[2]
[1] Economic Research Service U.S. Department of Agriculture
An immigrant is a person lawfully in the United States who is not a U.S. citizen, U.S. national, or person admitted under a nonimmigrant category.[1] The unauthorized immigrant population includes “all foreign-born non-citizens who are not legal residents, including naturalized citizens, persons granted lawful permanent residence, persons granted asylum, persons admitted as refugees, and persons admitted as resident nonimmigrants (i.e., students and temporary workers, as opposed to tourists) who have unexpired authorized periods of admission. Most unauthorized immigrants either entered the United States without inspection or were admitted temporarily and remained past the date they were required to depart.”[2]
Everyone has an immigration status in the United States. Common types include:[1]
- Born or naturalized citizen
- Legal permanent resident/Green Card holder
- Conditional permanent resident
- Refugee or asylum-seeker
- Nonimmigrants (those with visas for temporary stays, which includes students or temporary workers)
- Person with temporary protected status
- Undocumented person (those who overstayed their visas or entered without papers)
Social isolation describes a person with a limited social network who lacks social interactions, meaningful relationships, and connections with neighbors and society.[1] Social isolation can be measured by an individual’s social network and the characteristics of the individuals and institutions providing support.
[1] Institute of Medicine (US) Division of Health Promotion and Disease Prevention
A refugee is someone who has left their home country and cannot return because of persecution due to race, religion, nationality, membership in a social group, or political beliefs.[1]
A veteran is an individual who served in the active military, naval, or air service.[1] They were released or discharged under conditions other than dishonorable.
Community and Belonging
Strong communities work together to solve problems. Being part of a community improves confidence and a sense of identity and fights off feelings of loneliness.[1]
Ways people feel connected:
- Membership: Feeling belonging and safety within the community
- Influence: Knowing they can make a difference in the community and receive benefit from it
- Integration and fulfillment of needs: The community meets the individual’s needs, and in turn, the individual feels more commitment to contributing to the community
- Shared emotional connections: These are built through common experiences and history with community members
[1] Relationship between sense of community belonging and self-rated health across life stages.
Key
Facts
- 6.1% of the Indiana population is of foreign-born individuals
- 43% of the foreign-born Indiana population were born in Latin America
- 19% of the U.S. civilian labor force is foreign-born individuals
- 40+ languages are spoken in Indiana
- 75% of immigrants in Indiana report English proficiency
- 28,000 refugees resettled in Indiana as of 2021
- 76% of the total refugees in Indiana from 2009 to 2019 were Burmese
- Indiana is one of the largest enclaves of Burmese people in the U.S.
Immigration Status
Immigration status, like gender or race, can be a source of everyday inequality.[1] Immigration can result from social issues and be a social issue itself. The way people think about why people migrate shapes how immigrants are treated in a new place, which impacts their health.
Refugees who often leave their countries due to danger or conflict face unique challenges. They have higher rates of mental health problems due to past trauma and are at increased risk of additional trauma after resettling.[2]
[1] National Library of Medicine
[2] Recognizing and Breaking the Cycle of Trauma and Violence Among Resettled Refugees.
For example, in Indiana, where Burmese refugees make up over 80% of arrivals since 2007, language barriers are a significant obstacle.[1] Not knowing English affects all areas of their resettlement, and while agencies offer language classes, many refugees can’t attend due to work and other responsibilities.
Social determinants of health that impact immigrants and refugees include:
- Living and working conditions
- Income inequality and poverty
- Access to health care
- Immigration policies and enforcement
- Inequalities pertaining to gender, race, and ethnicity
Immigrants who experience discrimination often have worse mental and physical health.[1] However, having friends, family, or community support can lessen the negative effects and improve mental and physical health.
When immigrants first arrive in the U.S., they are generally healthier than U.S. natives. However, their health tends to worsen over time. Discrimination, such as employers ignoring work authorization, can further impact their well-being.
[1] The Effects of Perceived Discrimination on Immigrant and Refugee Physical and Mental Health.
Key
Facts
- 407,000 Hoosiers are veterans
- 2 out of 3 U.S. veterans have trouble transitioning to civilian life
- 12% of Hoosiers who experienced homelessness in Indianapolis in January 2024 were veterans
- 150 Hoosier veterans died by suicide in 2020, higher than the national rate for this population
Veteran Status
Veterans face many challenges when reintegrating into civilian life. These include finding and keeping jobs, strained relationships with family and friends, adjusting to civilian schedules, and legal problems.
About 64% of surveyed veterans said their transition from military to civilian life was difficult, with 69% saying finding a job was their greatest challenge. They might lack a strong support network, making it hard to find jobs and housing. Health challenges and homelessness can create a harmful cycle that worsens over time.
Veterans share many risk factors for homelessness with other adults, including substance abuse, severe mental illness, and low income. Military misconduct and discharge for that misconduct may indicate other risk factors for homelessness, such as difficult deployment experiences, mental health issues, alcohol and substance abuse, financial instability after deployment, and unemployment.
Health Care
Many veterans struggle with navigating Veterans Affairs health care because of not understanding their benefits or difficulties navigating the complex health care system. They experience long wait times and poor access to VA facilities in rural areas.
Veterans with mental and physical disabilities might avoid seeking necessary help due to a sense of pride in their identity and conditioning to be mentally tough. Less than half of the veterans who need mental health services get treatment, and of those, only a third receive evidence-based care.[1] Past failures in treating veterans often stem from focusing too much on PTSD, overshadowing other important transition issues.[2] Research shows many veterans struggle with or without PTSD.
Veterans are more likely to have comorbid chronic conditions, which are linked to greater mortality rates, increased health care spending, and lowered quality of life.[3]
[2] Beyond war and PTSD: The crucial role of transition stress in the lives of military veterans
Barriers to successful reintegration
- Finding quality employment and affordable housing
- Navigating the health care system
- Using health care services
- Prevalence of chronic health conditions
- Behavioral health and PTSD stigma
- Increased risk of criminal justice involvement for veterans with PTSD
- Social isolation or lack of social support network
- Substance use disorder, usually from untreated mental illness
- Discharge from service due to misconduct
Key
Facts
- 1 out of 3 U.S. adults aged 45 or older feel lonely
- 1 out of 4 U.S. adults age 65 or older are socially isolated
- Social isolation is linked with a 50% increase in dementia for adults over age 50
- The risk of dementia increases by 50% for socially isolated adults over age 50
Aging Population
Indiana is experiencing a significant population shift due to the aging Baby Boomer generation. By 2025, nearly 19% of Hoosiers will be 65 or older. Improving the social determinants of health for people of all ages and backgrounds can lead to better health later in life.[1] Public health groups, health care providers, policymakers, and public and private partners all have a role in making this happen.
As people age, they are more likely to get chronic diseases such as diabetes, hypertension, cancer, arthritis, and heart conditions. This is especially true if they have additional risk factors like age-related changes in their bodies, exposure to harmful environments, unhealthy habits, genetic factors, and social conditions.
About 88% of elderly adults have at least one chronic condition, and 60% have at least two.[2] This leads to more doctor visits, more chronic diseases, higher health care costs, and complex medication routines.
Seniors living on a fixed income depend on limited funds from Social Security, pensions, and savings. About 40% of older Americans rely solely on Social Security, and about 8% of Hoosiers aged 60 or older live below the federal poverty level. [3] [4]
Economic instability, like high inflation, makes it even harder for people whose costs increase but whose income remains the same. For seniors on a tight budget, unexpected expenses like medical emergencies or home repairs can lead to serious financial problems.
[1] U.S Department of Health and Human Services
[2] Healthcare on the brink: navigating the challenges of an aging society in the United States.
Key
Takeaways
- Immigration status can impact a person’s health and well-being, with worse impacts among those who experience discrimination.
- Veterans often struggle to switch to civilian life due to a lack of social support. They might have challenges finding employment and securing affordable housing.
- The population in Indiana is shifting older as Baby Boomers age, increasing the need for caregivers and social supports designed to meet their needs.
- People who are socially isolated or lonely are more likely to have mental and physical health problems.
Other Social & Community Topics
Criminal Justice Involvement
Addressing education, economic stability, and community support reduces crime and improves outcomes for those who have interacted with the criminal justice system.
Social Identity
Social identities like race, disability, and age shape experiences in daily life. Marginalized groups often face discrimination that contributes to poorer health outcomes.
Trauma
Understanding adverse childhood experiences and intimate partner violence helps us prevent trauma and support healing.
Housing stability: U.S. veterans are at greater risk for experiencing homelessness. Some veterans have increased risk factors, including substance use disorders and mental illness, income-related factors, social isolation, adverse childhood experiences, and past incarceration.[1]
Food insecurity: Being a non-U.S. citizen is a risk factor for food insecurity, particularly due to income instability during economic uncertainty.[2]
Income and employment: 60% of caregivers work full-time, and 20% of U.S. caregivers report moderate to extreme financial strain. Overworked caregivers may be more likely to make a mistake with care or may have impacts on their paid employment due to unforeseen caregiving needs.[3]
[1] Risk factors for homelessness among US veterans.
[2] University of Utah Health
[3] MeetCaregivers, Inc.
Access: By 2050, over one-third of students will be immigrants or have immigrant parents, but many schools are not equipped to support their unique needs, including bilingual learning.[1]
Attainment: Working-age adults with limited English proficiency earn 25-40% less than people with proficient English.[2]
[1] Harvard Graduate School of Education
[2] The Brookings Institution
Substance use disorder (SUD): Older adults are at greater risk for mood disorders, memory issues, and lung and heart problems. Substance use can worsen these conditions and contribute to dangerous effects such as impaired judgment, loss of coordination, and delayed reaction time, which can result in falls and accidents.[1]
Behavioral health: Veterans who are transitioning to civilian life might not seek PTSD treatment due to stigma or believing they do not meet the criteria.[2]
Health literacy: Only 45% of veterans receiving health care at VA facilities have adequate health literacy skills.[3]
[1] NIDA
[2] Clinical Psychology Review.
[3] U.S. Department of Veteran Affairs
Walkability: Accessible neighborhoods and a built environment with convenient access to grocery stores and safe places to stay active are increasingly important for people whose mobility decreases with age.[1]
[1] U.S Department of Health and Human Services
Trauma: Past exposure to trauma and violence among refugees is linked to a higher rate of mental health disorders.[1]
Criminal justice involvement: 5% to 38% of veterans have PTSD. The risk of criminal justice involvement is 61% greater for veterans with PTSD compared to those without, and the chance of arrest for violent offenses is 59% greater.[2]
[1] Recognizing and Breaking the Cycle of Trauma and Violence Among Resettled Refugees
[2] Council on Criminal Justice