Only the lonely

13 Feb 2020 Nick Garbutt    Last updated: 13 Feb 2020

In most respects our health is better than our ancestors and we can thank technology for that. But in one important health indicator, loneliness, it is not.  

Theresa May’s premiership will always be remembered for the its catastrophic paralysis in the face of Brexit. Yet picking through the rubble of her disastrous administration there are one or two important social policy initiatives we should, in time, be grateful for.

One of these is the Loneliness Strategy. Currently this applies only to England and Wales, but with the return of the Executive and Assembly there is much in it that could be swiftly adapted for Northern Ireland to help tackle this hidden and growing health crisis.

In this context the publication last week by NISRA of its latest survey of loneliness in Northern Ireland. The findings are alarming.

In 2018/2019 one in 20 of us felt lonely “always or often”; two fifths of respondents over the age of 75 said they were “more often lonely” and 62% of those who were in poor health were lonely.

Other risk factors which came out clearly in the report are bereavement, unemployment and not having access to a car. Women are more likely to experience loneliness than men.

Perhaps surprisingly people in urban areas experience more loneliness than those in rural areas, with Belfast having the highest levels. In Belfast 44.6% of people reported being more often lonely. The figure for Fermanagh and Omagh is just 28.6%.

Wealth is also a factor with the highest levels of loneliness occurring in areas of multiple deprivation.

The Jo Cox Commission defined loneliness as: “a subjective, unwelcome feeling of lack or loss of companionship. It happens when we have a mismatch between the quantity and quality of social relationships that we have, and those that we want.”

At first glance this looks like an individual matter for the person concerned and not one for government. However there are two really important reasons that should not be the case.  

First it is now well established that loneliness and isolation are major drivers for poor mental and physical ill health.

Studies show that acute loneliness and social isolation can impact gravely on wellbeing and quality of life. It has a significant and lasting negative effect on blood pressure; is associated with depression and higher rates of mortality.

Recent research shows that the overall negative effects are comparable to well-established risks such as smoking and alcohol usage. Clearly, as the population ages, so too will loneliness and it is therefore an important public health issue which doctors cannot tackle alone.

Older people, especially those with chronic health conditions who are bereaved and have no access to transport are most at risk. And as the population continues to grow this can only get worse. But they are not the only ones to suffer.

It can also strike at other key moments in life, affected people of all ages: after divorce, moving jobs, moving home, becoming a parent, children leaving home, retirement, bereavement, becoming a carer. There are many moments in peoples’ lives when they can become vulnerable to loneliness.

Loneliness also costs us a lot of money. The Eden Project published a piece of research three years ago which assessed the financial impact of loneliness in terms of increased public service usage by elderly people, putting the cost at £12,000 per person over a 15-year period.

It also cited American research suggesting that involvement in community activity, such as church and sports groups reduces mortality – so that the more people participate in such activities in a community, so does the death rate fall.

It also identified potential savings in less visits to the GP and decreased use of social care services for people who are better nurtured in their community. The projected health savings of more than £5 billion  across the UK and £267 million for Northern Ireland were based on the reduction in GP and nurse visits that a healthier population would require.

But there is a broader imperative too. The promotion of societal wellbeing is at heart of Northern Ireland’s Programme for Government and the widespread and growing loneliness we are experiencing demonstrates a breakdown in social relationships and our social support networks.

Government might not have a direct role in improving our social lives but it can help others, especially voluntary sector organisations to tackle loneliness and help people build their social networks.

Theresa May did not share Margaret Thatcher’s repudiation of the notion of society. Quite the contrary. Her strategy provides a partnership model to help tackle loneliness and puts a responsibility on every government department at Whitehall to spell out what proactive measures they are taking to contribute to the strategy.

It states: “To tackle loneliness and support people’s social connections, we all need to take action. This includes government, local authorities, businesses and the voluntary sector, where there is an opportunity to embed loneliness as a consideration across their work. Alongside this, it is also the responsibility of communities, families and the individual. By working together, we can help to create a more socially connected society.”

Specifically this means local authorities embedding tackling loneliness into their strategic planning, working with local communities and the voluntary sector on utilising community space and transport, for example. It wants to see more sharing of best practice between health bodies and wider adoption of social prescribing.

It has specific ideas on how employers can promote social wellbeing, helping employees build stronger relationships both with colleagues and outside the workplace and tackling bullying.

On the voluntary and community sector it states: “The voluntary sector already plays a vital role in tackling loneliness and bringing people together. It can create strong, integrated communities and challenge obstacles that isolate people or groups. In its delivery of services and projects, it can equip people and communities with the knowledge and skills to recognise loneliness and tackle it. The most effective answer to the challenge of loneliness is the simple decision of families, friends, faith groups and communities to include each other and to be open to new social connections.”

Northern Ireland may not have its own loneliness strategy just yet. But the English strategy is a great model which could swiftly be adapted to our circumstances to the benefit of all. There's plenty of work being done already, not least by the British Red Cross which Scope has previously analysed. 

We may have made much progress in so many areas over the past few decades. But it has come at a price. There is so much to gain from promoting stronger, more resilient and welcoming communities where nobody need feel alone.

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