The Secret of Long Life in Places Like Okinawa and Sardinia

In a recent post, I investigated why loneliness is as deadly as smoking. Conversely, communities where loneliness is rare foster exceptionally long lives. These communities enjoy great longevity and benefit from health-promoting practices that minimize loneliness.

1. Don't go to a retirement home

Centenarians tend to be highly active people, physically as well as socially. This source of vitality is associated with being part of a local community.

Conversely, when the aged move to an institutional setting, their life expectancy shrinks dramatically. In Ireland, when aged people moved to nursing homes, one in five died within three months of admission. One in three were dead within a year, and slightly more than half had died within two years. In a New Hampshire study, being admitted to a home for the aged cut four years (47 months) off a person's life expectancy. When the person's health status at admission was statistically controlled, the loss in life expectancy declined to 41 months.

However one slices the data, moving to a nursing home is a virtual death sentence. Why is the impact so severe? Part of the answer seems to be that the aged are cut off from normal-life connections in these settings. They succumb to the feelings of helplessness that overcome inmates in other institutional settings. When retirees are taken care of by an institution and get corralled into its daily routines, they lose a sense of control over their own lives.

It is much better for the elderly to remain active in the community, where they sustain strong ties with friends, neighbors, and relatives and interact with people of all ages.

2. Live modestly

Some communities of aging are comparatively low-income. This is intriguing because people in the wealthiest zip codes in the U.S. may live over a decade longer than those in the poorest ones.

This apparent contradiction may be resolved by the realization that although objectively poor, these people do not feel poor. They are happy with what they have and do not strive to buy a luxury car or move to a bigger home.

There is an interesting corollary to this argument. This is that people living in the U.S., and most other developed countries, need to be extremely wealthy to approach the life satisfaction of much poorer people in communities of aging like Okinawa, Nicoya, Costa Rica, or Sardinia. (Two communities of aging, Singapore and Loma Linda, CA, are urban).

3. Have a reason to get up in the morning

Retirement has two distinct meanings: (a) moving out of town to a quiet place and (b) giving up work. Both are bad for longevity.

Country living is all very well for peace and quiet, but many retirees soon tire of the dullness of a rural existence because there is little with which to fill their day. It is different for farmers, foresters, and others who make their living from the land. Some of the centenarians in communities of aging are farmers or gardeners who feel a deep connection with their crops, livestock, and land.

This raises the second meaning, namely, giving up work. An occupation is the biggest reason that most people get up in the morning, and if you give up work, you lose a key source of motivation and a reason for being engaged with the wider community,

4. Work hard and help others

Some jobs are dangerous and depressing, but most forms of employment are beneficial for physical health and psychological well-being. Delaying retirement by a year was associated with a significant reduction in mortality in the U.S.

Employed people are more cognitively engaged and more socially active, both of which are associated with improved health. Busy people tend to be happy people, consistent with Aristotle's maxim that happiness is an activity.

Even if they do not remain in the workforce, people who age well lead active lives that involve constructive activities, such as playing music, being engaged in arts and crafts, and volunteering for the good of the community. These activities generally have a social component that is important for maintaining social stimulation.

5. Interact with people of all ages

Communities of aging are good at promoting communication between people of all ages. This happens naturally in rural communities where everyone knows everyone else, and it is easy to strike up a conversation.

In urban societies, more effort is needed, and this is illustrated by the efforts of Singapore's government to help families live near aged relatives. Here, as in other places that promote longevity, older people are a valued part of their extended families and maintain close relationships with children. Such efforts have borne fruit. Since 1950, longevity in Singapore increased from 58 to 84.