In the basement of a Methodist church, I met a sprightly woman named Marie who’s there every weekday to spend time at Allentown’s senior center. I asked her what brought her there. 

“My old lady friends!” she replied, gesturing to the other three women at the table, all of them laughing. 

They complemented each other in the way you’d expect long-time friends to and nodded in agreement when Marie described the way that they had “become like family.” The joy in these connections was palpable and a part of why I want to celebrate these centers for helping people thrive in later life. 

This summer, as part of my medical training, I set out to learn about the role of social spaces in health and wellness, especially in the lives of older folks. Over the month of July, I visited four Pittsburgh-area senior centers – in Mount Washington, Allentown, the Hill District and Penn Hills. 

I imagined senior centers as quiet places for older people to spend their days when they had little else to do. Instead, I found thriving hubs of activity and community, where seniors connect with friends, make art, participate in high-energy exercise classes, sports and much more. 

Each had its own charms, with variations in funding and resources, but the social atmospheres were similar. The staff knew their patrons well. It was apparent that there’s no way to work at a senior center without really getting to know the people who show up every day.

Cynthia McMahan in the Oakland branch of the Carnegie Library of Pittsburgh on October 5, 2023. For McMahan, the library represents the importance of accessible social spaces in reducing inequality and isolation. (Photo by Amaya Lobato Rivas/PublicSource).

I heard passing check-ins about children, grandchildren and travels that demonstrated a connection much deeper than surface-level. 

At one center, a kindly, dedicated woman named Michelle coordinates and attends weekly dinner outings at a curated rotation of well-loved restaurants. Just prior to my visit, a group of 19 seniors joined her at Hofbräuhaus and several spoke fondly of the food and togetherness they experienced there. One woman told me, “I would never be going to these places on my own.”

I mainly talked with patrons in the large room where they ate lunch. Overwhelmingly, their reason for visiting the center was to socialize. During my visits, I saw seniors connect with each other over heated card games, group exercise classes, pottery painting and simple conversation.

Apart from the opportunity to chat with friends, senior centers offer resources for health maintenance, including monthly blood pressure screenings and informational visits about relevant clinical trials. They’re also a reliable place to eat nutritious and affordable meals, which can be difficult to find for seniors on a budget. Herb-roasted salmon with scalloped potatoes, roasted Brussel sprouts and chocolate pudding are hard to turn down especially for the suggested donation of $0.50. 

Isolation is as harmful as smoking

While I was learning from people, like Marie, who are well-connected socially and have developed a network of friends through their senior centers, I thought about the seniors that I didn’t get a chance to talk to, who aren’t able to access the centers. I’ve met many older hospital patients in this category who, due to health problems, have trouble getting around on their own and as a result, have very little contact with peers. 

A commonly cited psychology study found that social isolation has the same effect on longevity as smoking 15 cigarettes per day. Retired seniors, having lost their connection to a workplace, are especially vulnerable to isolation. Many older folks are also unable to drive and are more likely to use mobility aids like canes, walkers or wheelchairs.

Cynthia McMahan sits in the Oakland branch of the Carnegie Library of Pittsburgh on October 5, 2023. She often goes to the library, a “Palace for the People,” to study with friends. (Photo by Amaya Lobato Rivas/PublicSource).

When I asked about what changes people wanted to see in their communities, I heard requests for more benches and level paths in parks, closer grocery stores and sidewalk repairs. It’s clear that quality public transportation and accessible spaces can help older people to stay engaged and healthy. 

As a medical student at the University of Pittsburgh, I’ve developed a deep interest in how our environments shape our health. During our orientation week, we were told that 80% of our health outcomes are determined not by healthcare, but by “social determinants of health” – what our neighborhoods, homes, schools and work environments look like. 

These factors are apparent to physicians when they treat patients affected by environmental pollution, poor transportation access and food insecurity, but they have only recently become a valued part of medical education. I’m thankful for the discussions we’re having because it’s empowering to know that my role as a physician can (and should) address both individual patients and broader societal problems. 

While I’ve been learning about physiology and disease, I’ve also been thinking about how we can improve people’s health upstream of clinics and hospitals.

Maintaining social infrastructure

After seeing the benefits of senior centers first-hand, I’ve become interested in advocating for equitable access to “social infrastructure,” which includes senior centers, but also other community centers, parks, places of worship and libraries. 

I first heard the term “social infrastructure” from sociologist Eric Klinenberg’s book “Palaces for the People,” which emphasizes the importance of accessible social spaces in reducing inequality and isolation. The title is borrowed from Pittsburgh’s Andrew Carnegie, who sought to create beautiful, opulent libraries all over the country, open for the public to use to read, meet and learn – free of charge. 

Cynthia McMahan in the Oakland branch of the Carnegie Library of Pittsburgh on October 5, 2023. (Photo by Amaya Lobato Rivas/PublicSource).

I love walking into the Oakland branch of the Carnegie Library of Pittsburgh [CLP] to study with friends, and I regularly reap the benefits of the many parks in the surrounding area. But I know that not all Pittsburgh residents have equal access to these kinds of spaces, evidenced by the fact that it took more than 100 years after the first CLP was established for the predominantly Black Hill District to receive its own branch. 

Klinenberg writes about a powerful relationship between social infrastructure and public health, for people of all ages, not just seniors. In one example, he describes how neighborhoods with well-developed social infrastructure fared better in a record Chicago heat wave, regardless of race or income status. By creating the conditions where social support systems can be built, social infrastructure makes our communities healthier and more resilient. 

In a time when social divides have deepened and health disparities persist, our society benefits when we maintain and develop shared social spaces. As I continue learning about medicine from as many angles as I can, the lessons I learned from Pittsburgh seniors this summer will stay with me, spurring me to advocate for policies that promote health both in and outside the hospital. 

Cynthia McMahan is a 2nd-year medical student at the University of Pittsburgh, interested in community-partnered research, health policy and advocacy. She can be reached at cynthia.mcmahan98@gmail.com. 

The Jewish Healthcare Foundation has contributed funding to PublicSource’s healthcare reporting.

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