“Gains in life expectancy don’t mean living more years disease-free,” says Brown, noting that many now spend old age managing chronic diseases like dementia, cancer and heart conditions. Beyond not having kin to help, loneliness in itself is a threat: Stronger social relationships reduce the risk of mortality by 50 percent, research shows.

Black Americans face more lifetime stress than White Americans because of racial inequality, discrimination and segregation — stress that also strains relationships, says Debra Umberson, co-director of the Aging and Longevity Center at the University of Texas, Austin. They’re more likely to prematurely lose close family members, including children, Umberson notes. “Stress, family disruption, grief and loss, and incarceration can create new economic strains and interfere with one’s ability to work.”

Physicians must be made aware that older adults could lack people at home to monitor their health, experts say. Another solution could involve facilitating tailored one-on-one care that doesn’t require unpaid family caregivers or exorbitant costs — almost like a wedding planner, says Verdery. But half of older adults living alone had incomes below the “Elder Index” — a measure of the income required by those who are 65 or older to continue living independently — in 2019, according to AARP research.

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