Jennie Brown lives alone, but she isn't lonely -- most of the time, that is.
"The only time I get lonely is on a real pretty Sunday, and I see people going out and walking around," she says. "But I have a lot of company."
And that, doctors increasingly believe, may be part of what's kept people like the Highlandtown woman alive. Mrs. Brown turns 91 today, having outlived her husband, two world wars and any number of illnesses that might have overwhelmed someone with fewer family connections and social networks than this mother of three and grand- and great-grandmother of 40-plus.
At a time when more Americans than ever are home alone -- U.S. Census figures show that 22.6 million people were living alone, ,, an all-time high of one out of four households -- medical research is indicating that going solo may be hazardous to your health.
Two studies published by the Journal of the American Medical Association earlier this year, for example, found that persons with heart problems were more likely to have another heart attack or die within five years if they were without spouses or close friends and family.
"If you take patients without a spouse or without a friend they could confide in, 50 percent of them were dead in five years. In contrast, those who had a spouse or a friend who they confided in -- only 18 percent were dead in five years," said Dr. Redford B. Williams, a Duke University Medical Center researcher whose study, published in January in JAMA, followed some 1,400 patients with coronary artery disease for an average of nine years.
Dr. Williams said studies like his show it's not so much living alone that poses a health risk, it's the lack of social contact.
"The bad news is living alone could be a health factor, but the good news is if you have friends to talk to, that's enough -- whether it's regular participation in organized religious activities or clubs or just one friend you go out with every Thursday to play pinochle," he said. "Our data show if you simply have a confidant, it provided all the same protection as a spouse."
The connection between loneliness and health is something that has long intrigued researchers. Studies such as a massive one in Finland involving 95,000 people found death rates among widows and widowers jumped after the death of their spouses -- suicide and fatal accidents went up, as did fatal heart attacks and other coronary-related death.
It's "the pain and toll of loneliness," said Dr. James Lynch, a Baltimore psychologist and author of "The Broken Heart: The Medical Consequences of Loneliness."
"Loneliness, if it's chronic, leads to depression, which alters the immune system and changes the blood pressure," said Dr. Lynch, who has spent some 25 years studying the phenomenon. "The lonely also operate in self-destructive ways."
Dr. Williams agreed. "You may not take your pills on time, or eat a low-fat diet or watch your sodium intake. You may not exercise as much without a friend who says, 'Let's get out and walk today,' " he said. "You're less likely to follow medical advice."
Indeed, researchers have found that people who live alone, primarily elderly men and women, were more likely than married couples to eat nutritionally deficient meals.
Additionally, companionship offers "a buffer" against the stresses of daily life, Dr. Williams said. "People who have someone to confide in have an effective means of reducing stress levels," he said.
Dr. Thomas Finucane, a geriatrician at Francis Scott Key Medical Center, said living alone, by itself, is not automatically a health risk for someone who is independent and relatively strong. Others may need someone around, simply for physical reasons: to call for help, for example, in an emergency or just to help with day-to-day living.
"I think that if a patient is in robust good health, living alone can be a good choice," Dr. Finucane said. "But for a patient at the other end of the scale, who is more dependent and frail, it may not be."
Most of the research about the effect of living alone deals with the elderly -- they're more likely to have existing, life-threatening conditions that are easier to quantify than, say, a younger person who may suffer minor ailments as a result of living alone, doctors said.
Yet loneliness may take its toll on even younger persons.
"The evidence in general, for all levels, all ages, is that being socially isolated is bad for your health. It's just easier to study older people because they have more chronic diseases," Dr. Williams said.
"I've found that losing your mate at 40, may be worse than losing your mate at 60 because you're totally unprepared for it," Dr. Lynch said. "This cuts across all levels of society -- all ages, both sexes."
While the St. Ambrose Housing Aid Center in Baltimore started its home-sharing program five years ago for economic and social reasons, it is glad to find it may be contributing to its participants' health as well. The program matches people with room to spare in their homes -- and hearts -- with those looking for more communal housing than a traditional rental offers.
"Sometimes for an older person to remain independent in her home, she could use the extra income or the companionship. Sometimes, people just get tired of eating breakfast alone," said Mark Benson, coordinator of the home-sharing program. Mr. Benson, 32, practices what he preaches: He's always lived in a group home, first for economic reasons and now for the companionship, and also participates in a dinner club in his Lauraville neighborhood.
"It's just nice, when you have some anxiety, to have someone to just vent to," he said. "There's always someone to share with."
One of Mr. Benson's clients, Frances Jackson, has already had two successful matches since she first joined the program -- she's opened her Northwood home first to a single mother and her daughter and more recently to a young man.
Now 56, Mrs. Jackson was something of an empty nester -- her husband had died in 1985 and her son, though disabled and living at home, was attending college most of the day.
"I was lonely," Mrs. Jackson said. "On Sundays, I liked to make a big dinner -- that's what I was used to doing when my husband was home."
Her first live-ins stayed for 1 1/2 years, moving out only when the young woman was transferred to Florida. Then the program linked her with a man in his 20s who has became "like a second son to me," she said. He stayed 2 1/2 years and moved out when he got married this summer -- although he's joked that if his wife doesn't treat him well, he'll be back "home," Mrs. Jackson said with a tinge of motherly pride.
"I don't know who cried more when he left, him or me," said Mrs. Jackson.
Since he moved out, she's gained 20 pounds, which contributed to high blood pressure problems for the first time in her life, she said.
"I began eating more because I was nervous," said Mrs. Jackson, who has her blood pressure under control and is about to start a diet. "I used to feel safe because I wasn't home alone. I would just fall asleep and forget about it. It just makes the home alive. It makes you feel like a family is back together again. I've already started my new application to St. Ambrose."
Doctors say women may have less problem with loneliness despite the fact they're more likely to be widowed. They're more likely, for example, to admit that they're lonely and reach out for friendships, researchers said.
Mrs. Brown enjoys her big family -- her three children live in the area, and her grandchildren and great-grandchildren are occasional visitors as well. One relative, a journalist, wants to write a book about her and has taped her speaking about her memories during some of her visits.
"Everybody loves Jennie, She's like a magnet," said June Biggerman, a home nurse who continues to visit even though she's since moved into administrative work. "She's got a wonderful family. Many of our patients don't have the support system she has. That's definitely in her favor."
Mrs. Brown is enrolled in a house-call program run by Francis Scott Key that sends medical professionals out to her home regularly now that her mobility is limited. She has her dog Trixie for some companionship.
Mrs. Brown's daughter, Mildred Oldewurtel said her mother is very independent and refuses to leave her home of 67 years even as her health diminishes.
"She does her own cooking and her own washing," said Mrs. Oldewurtel, who lives nearby in Dundalk. "She'll hide her wash, so no one else will do it. I've stayed here with her when she's sick, but they made me leave -- they said I was making an invalid out of her because I did too much for her."
"I don't want to be a burden. And I'm comfortable here," Mrs. Brown says of her home, remembering the family she's raised here and the boarders she used to take in after retiring as a waitress and cook. "I used to have seven beds going here."
She gets out every once in awhile -- her family gave her a big 90th birthday party last year and, and her photo album shows her amid crowds and crowds of family and friends.
"I thought it was just going to be a crab feast," she said fondly. "But I thought I better dress up a little anyway, in case there was going to be one of those male strippers."
Home alone tips
The irony of living alone is that you have plenty of company: Nearly 23 million other Americans are in the same boat. Here's some advice on how to ward off loneliness and keep it from threatening your health:
* Pursue interests that put you in contact with other like-minded people. Consider religious groups, civic clubs, neighborhood activities, classes or exercise groups -- even if all you do is walk, you might join a group that walks in malls before the stores open.
* If you're homebound, inquire about home-visiting programs. Volunteers for some social services agencies and civic organizations visit those who can't come out.
* Cultivate relationships with family and friends. Don't be shy and wait by the phone -- call, visit or write when you think of them. They might be lonely too.
* Consider roommate or home-sharing possibilities. But make sure you check their references and be clear on how much privacy/companionship each of you desires.
* If you like animals, consider pets.
* Stay as active as possible. If you enjoy gardening, do it even if all you can manage is some plants on the windowsill.
* Don't let your diet lapse if you're eating alone. Make sure meals are nutritionally balanced and enjoyable. Buy smaller, single-serving sizes or make big batches of your favorite foods and freeze the leftovers.