John Fredell, 72, said he hardly knows anyone on his street in South Minneapolis, but he remembers a time when he knew the entire population of his hometown of Center City, Minnesota.

A retired physician and 1977 University of Minnesota graduate, Fredell said it is easier to feel connected to others in rural areas. 

“I would say the rural area is more close-knit … if you have kids and there are other kids in the neighborhood that are the same age, kids get to know each other and they get the parents together,” Fredell said. 

A recent study from the University Rural Health Research Center compared multiple measures of social isolation experiences for elderly adults living in rural and urban environments. The study found that some rural elders feel more lonely despite having larger social networks, but urban elders feel more socially isolated overall.

“In the study, we found objectively rural residents have more people in their lives, but subjectively some of those residents still feel lonelier than urban residents,” said lead researcher Carrie Henning-Smith. “We’ve known for a long time that rural residents have bigger families than urban, but I think that people’s social needs and health needs are not taken care of because of that.” 

State-level initiatives aiming to improve rural health services emphasize mental health and education for health literacy. Mark Jones, executive director of the Minnesota Rural Health Association, said he has hopes for the future of rural health despite current concerns.  

“I think the rural areas are very motivated to innovate and to make things work for their people,” said Jones, who resides in rural northwestern Minnesota. “We live without Target, we’re good with that, but it’s hard to live without health care.”

Henning-Smith echoed confidence in rural health systems, and said isolation and sense of belonging are key pieces of mental health.

“We heard people say that because there’s an increasing awareness of the health impacts of being lonely or isolated, there’s more attention being paid to it,” she said.

Rural populations are older than urban groups overall, so loneliness has been discussed for years in those areas. Henning-Smith said she hopes the recent study will drive future solutions specific to rural health. 

“It has important implications both for how people are connected with one another socially and how we can make everyone feel like an important and valuable member of the community across ages and other demographic characteristics,” she said.

The changing access to resources for rural health are also emphasized by the changing of the communities they serve. Henning-Smith noted that although the survey had a small sample size, diversity in rural communities was a factor in the variety of responses. 

“Not all rural areas and not all rural people look the same and have the same access to opportunities,” Henning-Smith said. “I think we need to understand not only rural and urban differences, but differences between rural residents in … looking at social isolation.”