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Loneliness and isolation: Social relationships are key to good health

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The John Lewis Christmas ad has become synonymous with the start of the festive season, along with Black Friday sales and twinkly lights along local high streets.

This year the company partnered up with Age UK for its Man on the Moon advert, supporting the charity’s campaign to highlight the one million older people in the UK who will be alone this Christmas.

Age UK reminds us that one million older people in the UK can go for a whole month without speaking to a friend, neighbour or family member.

Here at PHE, we also know that loneliness and social isolation can affect people of all ages, including children, and can have a significant impact on health and wellbeing.

The wider effects of social isolation
It’s important to understand the distinction between loneliness and isolation. Age UK defines ‘isolation’ as separation from social or familial contact, community involvement, or access to services, while ‘loneliness’ can be understood as an individual’s personal, subjective sense of lacking these things. It is therefore possible to be isolated without being lonely, and to be lonely without being isolated.

As part of a wider programme of work to support local action on health inequalities, PHE commissioned the UCL Institute of Health Equity to produce a series of practice resources  on issues where opportunities exist to reduce inequalities – including reducing social isolation across the life-course.

The document on social isolation, published earlier this year, explains how the quality and quantity of social relationships can affect people’s physical and mental health.

For example, social isolation is associated with increased risk of coronary heart disease, in part, because social isolation and feelings of loneliness can be a physical or psychosocial stressor resulting in behaviour that is damaging to health, such as smoking.

The practice resource demonstrates that positive social relationships and networks can promote health for people at any age through, for example:

  • providing individuals with a sense of belonging and identity
  • sharing knowledge on how to access health and other public information and services
  • influencing behaviour, for example through support from family or friends to quit smoking, reduce alcohol intake, or to access health care when needed
  • providing social support to cope with challenges such as pressures at school or work, or life changes such as becoming a new parent, redundancy, or retirement for example

Which groups are at higher risk of social isolation?
The quality of our relationships and the size of our social networks can impact positively and negatively on our health, so it’s important to understand which groups in society are particularly vulnerable to becoming socially isolated.

The new resource on reducing social isolation highlights several groups at increased risk of this issue, including new mothers, children and young people experiencing bullying, people with long-term conditions and disability, unemployed adults, carers and retired people.

Many of the risk factors associated with social isolation are more prevalent among socially disadvantaged groups and accumulate throughout life; for example, social isolation in childhood is associated with isolation in adolescence and adulthood.

Intervention: a joined up approach
The relationship between social isolation and health is complex, and no one sector can tackle the issue by working alone.

In the practice resource, the Institute of Health Equity and PHE advocate for a joined-up approach where health professionals link with other government departments and local organisations such as schools, housing services, the justice system and voluntary organisations to reduce social isolation for people of all ages.

PHE also published guidance earlier this year that outlines a range of evidence-based community-centred approaches to improve health and involve those at risk of social exclusion in designing and delivering solutions that address health inequalities.

They include volunteering, peer support and social network approaches such as ‘timebanking’ – building social networks of people who give and receive support through contributing skills and practical help.

We are already seeing some great examples across England, such as the LinkAge programme in Bristol, which facilitates a range of activities for older people to improve physical health and allow people to connect socially.

An evaluation in one particular area found that for every £1 invested there was a social return on investment of £1.20; cost-savings for the NHS also come through early intervention that avoids later stage, more expensive treatments.

Social isolation is common amongst older men, particularly those who live alone. This may be one of the factors behind higher rates of death by suicide among men over 75, so interventions to reduce social isolation can also contribute to wider work by local authorities on suicide prevention.

A good example is Men’s Sheds – an innovative community-based scheme to help bring older men together in a familiar environment where they can work on projects and share tools and skills, or just have a cup of tea with others.

We know that experiencing poor health, including conditions that result in a lack of mobility, or the loss of sight or hearing, can result in social isolation and feelings of loneliness. Therefore, alongside specific interventions for a health issue, it’s important to remember that social activities such as lunch clubs, allotment groups and exercise classes can also make a significant contribution to a patient’s health and wellbeing.

The PHE practice resource on reducing social isolation and our guidance to community-centred approaches provide information and guidance to support local authorities, clinical commissioning groups and other stakeholders to develop effective strategies to prevent and reduce social isolation. This is an important challenge that we must address to improve population health and reduce health inequalities.

As you enjoy spending time with friends and family this Christmas, why not take the opportunity to reach out to someone who might be feeling lonely in your community, such as an elderly neighbour or someone you know who lives alone? A small gesture really can make a big difference.

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  1. Comment by Robert Edmonds posted on

    A timely reminder from PHE of the need for collaboration to address the multi-layered health issue of loneliness. And good to see this recognised as an inequalities issue that cuts across the generations. Here at Community Network we are discussing with local health and social care commissioners how they can add value to contracts by enabling providers to devise and deliver peer support groups involving individuals at risk of loneliness. We offer training and consultancy in setting up groups via the phone - and run groups that target those multiple health conditions, carers and others. Talking Communities is the name we have given to these groups and they have been shown to impact positively on the self-worth, identity and mental wellbeing of participants.

  2. Comment by Julie Gildie posted on

    I am currently researching this topic for my undergraduate dissertation, focussing on the town of Church Stretton in Shropshire. Thank you for shariang this article.

    • Replies to Julie Gildie>

      Comment by Alex Gatehouse posted on

      Hi Julie,
      Great to hear that you have been researching this important area.
      I would be interested to read your dissertation as I am seeking research into the impacts of loneliness. Please do drop me an email so we can continue discussion
      Many thanks,