Imagine what it’s like to live on a block where elderly neighbors are bolted behind their front doors for fear of venturing out. Where parents worry daily about safety, so they resist letting children play in the neighborhood. Where more than half of the houses lie empty.
These images are not consequences of life under a pandemic. This was life pre-COVID-19 for the Baltimore neighborhood where I grew up and now work as a nurse researcher.
For the past year, my research team at the University of Maryland, the Black Mental Health Alliance, the PATIENTS program, and B’more for Healthy Babies at Promise Heights, with support from the Robert Wood Johnson Foundation, has been listening to residents of two disadvantaged neighborhoods in West Baltimore. Residents told us they were “self-isolating” from family, neighbors and the community to cope with living in a neighborhood where they don’t feel supported, safe, or connected.
As one resident put it: “A lot of things scare us...it makes us not want to allow our kids to go to the recs that open because we fear that a drive by [shooting] or...standing in the doorway you can get shot.”
Another told us: “I fear standing at the bus stop or going to the subway stations [because] I’ll be caught up in somebody else’s mess.”
Physical distancing during COVID-19 is intended to keep us safe at home and limit the spread of the virus. In much the same way, these families are self-isolating to protect themselves from the dangerous situation or environment in which they live. They fear being swept up by violence or toxic social groups so they avoid playing basketball on their neighborhood courts and don’t participate in community life. We coined the term “situational isolation” to describe this self-isolating behavior which is driven not by choice but by circumstances in the social setting and built environment that make it difficult to get out and about or develop friendships.
But these anxieties and isolating behaviors have serious consequences. When families weaken their social networks by isolating themselves, they are cut off from support and opportunities that affect health and well-being. Studies show that poor family support and limited involvement in community-life is associated with increased illness and premature death. One study found that social isolation is as damaging to one’s health as smoking 15 cigarettes a day.
These behaviors take on sharper meaning today given the disproportionate impact that the coronavirus is having on communities of color. In Maryland, blacks comprise about half of COVID-related deaths even though they make up 30 percent of the population.
We are formed, deformed, and transformed by our social relationships. While individuals and families in West Baltimore endure further social isolation during COVID-19, I’m moved by the kindness radiating across our community.
Physical distancing in the COVID-19 pandemic has forced many to look for creative and generous ways to strengthen connectedness for families and communities. We have reached a critical moment of deep understanding that if all of our neighbors have access to what they need to survive and thrive, we too have a better chance in life.
We are formed, deformed, and transformed by our social relationships.
In Baltimore, food, housing, and electricity are considered basic needs and are being urgently addressed for many. The digital divide that has been a barrier to equitable education is narrowing slightly through gifting of electronic devices and free internet services to the most vulnerable. The state has halted prosecutions for drug, prostitution and some other offenses to protect vulnerable citizens in prisons. Baltimore ministers have created virtual “freedom schools” and are delivering free food to community members. The city’s schools have served over 50,000 meals to children and their families in need.
Others in the community are working and providing essential services, including health professionals, grocery workers, truck drivers, and hospital environmental health service workers. Caregivers, mothers and fathers, like those in my study, are reporting through social media that for the first time they can spend quality time with their children, serving as teachers and health promoters. They are making collages of the best moments of their lives, having dance parties, and building relationships with family and neighbors in new ways.
This crisis has helped us realize the importance of social connections to our health and well-being. While observing physical distancing recommendations, I urge you to stay connected to your family, friends, and neighbors. Do not underestimate the impact of a 30-second smile or a simple wave. Look out for essential workers in your community and show appreciation while at the grocery store or a health care visit.
Physical distancing does not have to exacerbate the underlying social isolation in disadvantaged communities like Baltimore. When the pandemic is over (and it will end), we should strengthen these meaningful social connections we’re creating so they are sustained.
Crises have a way of bringing people closer together. I am reminded of the mantra for the African philosophy of Ubuntu: “I Am Because, We Are.” The one lesson I hope we’ve learned from standing together with family, friends, and community is how feeling connected can help all of us to not only survive but thrive.
Yolanda Ogbolu, PhD, CRNP, FNAP, FAAN, is an assistant professor, neonatal nurse practitioner, and director of the Office of Global Health at the University of Maryland School of Nursing.
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