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Human beings are ultimately a social species, and we depend on each other for comfort, care and survival. Our social networks or ‘tribes’ can have a significantly positive effect on our lives, outcomes and overall health and wellbeing. Anyone of any age can experience social isolation and loneliness, but older adults are at an increased risk, with almost half (49%) of adults aged seventy-five and above currently living alone. An Age UK study in 2011 reported that one million older adults in the UK are alone at Christmas and 3.9 million indicated that the television was their main company on a daily basis. This in itself is an issue when we think that the recent rises in television license fees may mean that the TV is no longer financially viable for some.
For many people, the world is a lonely place, and this can have a significant impact on their health. A report in 2017 stated that loneliness is as harmful as smoking 15 cigarettes every day, and social isolation is associated with an increased risk of mortality and co-morbidities. This is not a new issue, but the very nature of modern society places more and more people at risk, and there is a need for significant action today.
What does it mean?
Whilst the terms social isolation and loneliness are often used interchangeably and are certainly related, they do not mean the same thing. Isolation is defined as being the absence of social contact regularly. This may be staying within the home for longer periods of time, not accessing services, lack of involvement in the community, a lack of communication with existing friends or family, or a combination of multiple factors. Whereas, loneliness is ultimately a subjective experience. An abstract feeling that cannot be determined by others but almost refers to the perceived quality of the relationships we form.
It is important to note that it is not about a measuring a quantifiable number of family or friends. Some people may choose to have fewer contacts, whereas others may require a more robust social network to thrive. A person can be lonely surrounded by people and an individual can be socially isolated without feeling lonely.
Who is at risk?
Social isolation and loneliness are known to particularly affect the older generation, and those over the age of 70 are at an increased risk. Over the last fifty or so years, increases in the rates of divorce and lower rates of fertility have meant that more adults are living on their own in their later years, with less family support. Poor health, decreased mobility, retirement, and bereavement may also place older adults at risk.
However, both loneliness and social isolation are ultimately equal opportunity afflictions, and anyone can be affected. There are many different factors which can result in isolation, including age, education level, socioeconomic status, and living in rural or deprived communities. Furthermore, research from Carers UK stated that 8 in 10 (81%) of unpaid carers described themselves as lonely or socially isolated. People with poor health or disabilities are more likely to be isolated, and more and more young adults, aged between 16 and 24, are reporting that they feel lonely often or always.
What are the effects of social isolation and loneliness?
Helping people to build and maintain positive relationships to combat loneliness has been seen as increasingly important amongst public services and the third sector, and it is acknowledged that the relationship between social isolation, loneliness, and health is complex.
This is not simply a moral issue but one that has a significant cost to the individual, community and the wider society. Social isolation and loneliness are comparable to obesity and smoking and can increase the likelihood of mortality by up to 25%. Loneliness is associated with a plethora of health conditions including mental health issues, cardiovascular issues, and an increased risk of coronary heart diseases and high blood pressure. As well as physical health impacts, some studies have highlighted a 64% increased risk of developing dementia and evidence to suggest that people are more likely to commit suicide or be diagnosed with depression. Economically, a report by the London School of Economics estimated that care and support for each older adult who is currently experiencing social isolation will cost the care system £6000 over the next ten years.
Addressing the Issue
Technology: Technology has transformed the world, and there is evidence to suggest that addressing the digital divide can improve social isolation. Although the internet can create an illusion of sociability and go some way to addressing loneliness, it remains that the digital divide means that this may not be accessible for the most at-risk population. Free internet training schemes are available in most communities yet engagement continues to be minimal. Evidence indicates that the biggest factor within the digital divide is related to attitudes about the use of tech, and some have highlighted that individuals may not be technologically minded and that on-line communication should never be seen as a substitute for face to face social contact.
Attitudes: There is also a stigma surrounding the idea of loneliness, and some have suggested that individuals may not want to reach out as this could appear as vulnerability. This is particularly apparent amongst the older generation who may distrust public services due to a fear of losing their independence. Moreover, an older adult living alone may not want to place pressure on their families or they may consider loneliness to be a by-product of ageing.
Community: Since the latter half of the twentieth century, society has transformed quite dramatically, and we do not have the same community values that were apparent years ago. From 1987-1994, participation in community activities fell by 45% and it could be argued that to address the increase of loneliness and isolation across the country; we need to examine the loss of community. Furthermore, identifying those at risk of loneliness can be a challenge if the individual is not already engaged with services.
Befriending: Befriending services are becoming more and more popular and these are an excellent way of addressing social isolation and loneliness amongst older adults. This is where the individual is matched up with a worker or volunteer who visits or telephones on a regular basis. However, there are still challenges to encouraging participation and it remains that the success of any such service will ultimately depend on whether everyone affected by the issue is able to participate.
Personalisation: Every single person is unique and the way in which their needs are met should be personalised. There is not a one size fits all approach and a personalised response is essential to ensure that their individual’s needs are met and barriers to access overcome.
In recent years there has been a wealth of academic research into the cause and effects of loneliness, but there has been little effect. There is a distinct need for everyone to do more, and to recognise that anyone can be affected. The vast majority of services discussed are aimed at adults at risk, yet isolation and loneliness are affecting more and more people each year, and the situation is only worsening.