Not to be confused with solitude, health practitioners define loneliness as the perception of social isolation—a perception that has reached epidemic proportions in the U.S. In a six-year study published in 2012, 43 percent of Americans over the age of 60 reported being lonely, according to the study’s author Carla Perissinotto, MD., assistant professor in UCSF’s Division of Geriatrics.
But that number becomes even more profound when considering its impact on health: loneliness is a proven social determinant for serious health problems, including shortened lifespan.
“The lonely half of Americans have a 45 percent increased mortality at six years compared to the other half, and a 60 percent increased rate of disability, or rate of losing your activities in daily living,” says Dr. Paul Tang, vice president and chief innovation and technology officer at the Palo Alto Medical Foundation.
While the U.S. spends about 18 percent of its Gross Domestic Product on medical intervention, we continue to score among the unhealthiest of OCED (Organization for Economic Co-operation and Development) countries.
“We have this real disparity between what we get versus what we pay for,” says Tang. “And one of the other factors is that all of the other countries but the U.S. spend more on social service than on medical service, and I think that’s a big part of it.”
“Only 10 percent of health and well-being is attributed to medical intervention,” says John S. Williams, marketing communications specialist at PAMF’s innovation center. The rest of health and well-being can be attributed to genetics, behavior, and the social and community aspects of a person’s life.
While the desolate, empty feeling of loneliness is not something typically addressed in a doctor’s visit, PAMF’s innovation center identified it as a recurring theme while interviewing the elderly population. As one woman described it to Tang, “Your world dies before you do.”
In an effort to combat loneliness as a root cause for illness, PAMF developed a program called linkAges, a multigenerational time-bank-like service-exchange program. Formed in Mountain View in 2010 under the direction of Tang, the program brings together individuals in the community who probably wouldn’t have otherwise interacted.
“In American culture, which is a young culture compared to Asia or Europe, we value professional work, autonomy and mobility, and all of the things that make America great. But it also leaves us less supported as we age out of the workforce,” says Tang. “You view yourself in the context of what you contribute in a professional vein, and when you retire, that sort of recognition goes away. You don’t think as highly of yourself, and often feel like you’re a burden to everybody, including your family, and that leads to a downward spiral.”
LinkAges expanded to the Bay Area in 2013, and just a few months ago took root in Santa Cruz, with partners including the Live Oak Senior Center, Cabrillo College, Santa Cruz Libraries, and Museum of Art & History, which has pledged to open up space for artistic collaborations between linkAges members. It is free and open to anyone 18 or older who passes a criminal background check. (See tagline at the end of this article for a membership code.)
“Once people join the system, they are able to post a request or offer services on the website platform,” says Williams. “Somebody might say ‘I need a ride to my doctor’s appointment, I don’t have a car,’ and it takes them two hours round trip. That gets recorded, and then [the driver] uses that time later, likely with someone different, to play chess or learn photoshop, or any number of things.”
Since its inception, more than 3,000 hours have been exchanged among linkAges’ 760 members, and its potential impact in the Santa Cruz community is greatly anticipated—with 26 local members already signed up.
Patsy Gardner, a linkAges member who recently moved to Santa Cruz, looks forward to offering knitting, fiber arts and babysitting as a service to other local linkAges members. She recently attended a Tech Day at the Live Oak Senior Center. “I learned how to take pictures on my iPhone and it helped me with my tablet a little bit, too” says Gardner. “I think most of us get all these ‘toys,’ and we know the basics, but I can’t do everything that they do.”
Tang agrees with Jennifer Acher of the Stanford Business School that the three major components of happiness are meaning, connectedness, and being part of something bigger— and linkAges interactions often touch on all three, says Tang.
The largest category of exchanges seen in linkAges are in what Tang calls the enrichment group, where members are sharing something they know, from ukelele playing to knitting or cooking. “One of the things as you get older is you have experiences to pass on,” says Tang. For example, there was the 84-year-old retired professor’s Scrabble game with a 28-year-old woman, and the woman living in a retirement home who threw her arms up in happiness when she met a dog owner at the park, fulfilling her wish to just walk a dog again.
“Based on our initial experience with time bank and the stories we get back, there is a lasting effect of just feeling like you are valued or contributing. And I think as we age, the importance of that just elevates,” says Tang. “American health care of course is reimbursed for doing things to people, and this is not one of those things, but under the Affordable Care Act, we’re moving to a world where you get compensated to improve the health of the communities that you serve, so this fits in really well with that.”
 

MEETING AND MOVING

But there’s more for Santa Cruz to look forward to: Under the umbrella of linkAges is the Meet and Move program, a support network that links family caregivers of all kinds with other caregivers to simply walk and talk—and for every hour used in the Meet and Move program, members are given one hour of time to use in the linkAges program.
With an orientation at 11 a.m.-noon on Feb. 11 at the Senior Network Services Building in Soquel, Meet and Move is also free and open to anyone who passes a background check. “Anyone can come as long as they are a caregiver who is not being paid,” says Cyndi Mariner, project coordinator for Meet and Move. “People come, and they can talk if they want or just walk, they can laugh, cry, scream, and it’s all fine. Whatever you gotta do, we’re all about supporting each other on this journey.”
Mariner, who joined the program while caring for her 84-year-old mother, says that Meet and Move changed her life, giving her an outlet for support and a small block of time to exercise. Caregivers are often under a lot of stress, often forget to take care of themselves, and can also suffer from social isolation, Mariner explains.
“As a family caregiver, your time gets eaten up so quickly,” says Mariner, “and suddenly you’ve got weeds growing over the backyard and you need help weeding the garden, or you need someone to run out and get groceries for you. The linkAges platform gives that help right to you.”

To sign up for the linkAges timebank, visit linkages.org, click “sign up” and use the membership code ‘goodtimes.’ The next linkAges orientation is 2-3 p.m., Thursday, Feb. 18, from 2-3 pm at the Museum of Art & History. Register by emailing ti******@******es.org. For more information on Meet and Move, visit linkages.org/meetandmove.