Why we need to take action
It is normal to experience loneliness from time to time but severe or chronic loneliness can start to affect your quality of life and your health. Loneliness is a subjective negative feeling associated with a perceived lack of a wider social network (social loneliness) or absence of a specific desired companion (emotional loneliness). Factors potentially driving loneliness include living alone, unemployment, loss of friendships and lack of belonging.
In this blog I focus on older adults (60 years or older) living in London, partly because London is one of the loneliest cities in the world. There are an estimated one million, one hundred thousand older people who are chronically lonely in the UK with 200,000 older adults in London feel lonely.
There is significant evidence on how loneliness affects quality of life and wellbeing. Loneliness can be as harmful for our health as smoking 15 cigarettes a day. Being lonely is associated with increased all-cause mortality and anxiety. Furthermore, loneliness amongst older people is associated with experiencing depression, and older people with a high degree of loneliness are twice as likely to develop Alzheimer’s disease as those with a low degree of loneliness.
Inequalities in loneliness among older adults
The risk of loneliness among older adults in London is not evenly distributed. Certain groups, such as those affected by income deprivation and living in economically disadvantaged areas like Tower Hamlets, Hackney, Newham, and Islington, face a higher risk. Other factors that contribute to this risk include living alone, lacking a sense of neighbourhood belonging, and residing in unsafe areas.
Age UK reports that older people are:
Current efforts to combat loneliness
The UK has implemented various strategies, campaigns, and initiatives to address loneliness among older adults. In 2018 the English government launched a Loneliness Strategy and appointed a minister for loneliness, focusing on combating loneliness through a range of approaches including social prescribing, digital technology and urban design. The Loneliness Strategy described the government as having three overarching goals guiding its work on loneliness i.e.
- A commitment to help improve the evidence base so we better understand what causes loneliness, its impacts and what works to tackle it.
- To embed loneliness as a consideration across government policy.
- To build a national conversation on loneliness, to raise awareness of its impacts and to help tackle stigma.
Meanwhile the Welsh government launched Connected Communities, its own loneliness strategy. It also saw potential in intergenerational initiatives. The Scottish government too launched its loneliness strategy, A Connected Scotland using this as a call to action by individuals, communities, local authorities, health boards and other community planning partners, third sector and social enterprise, and business – to play their part in reducing social isolation and loneliness.
These governmental strategies complemented existing initiatives by charities and voluntary organisations, including befriending schemes, group interventions, and campaigns like the Campaign to End Loneliness. Charities such as Age UK have made specific contributions to working to combat loneliness. For example, as well as Befriending, Age UK also provides social activities, transport, day centres, lunch clubs and IT training.
It should be noted that much has happened since the English government launched its Loneliness Strategy during Theresa May’s premiership. The UK has had three different Prime Ministers since then, a COVID pandemic, the impact of the war in Ukraine and a cost-of-living crisis. These mean that loneliness may not have remained the priority it was intended to be. Some of the changes, including the COVID lockdowns, may also have accelerated the use of digital responses to loneliness.
A further issue is the fragmentation of efforts. There are many charities in the UK, as well as local communities, local authorities and national government all working to tackle loneliness. The government’s Loneliness Strategy recognised the need for a more joined-up approach but it has remained difficult to achieve this in practice, perhaps partly due to the COVID and partly due to no clear mechanism of coordination between these disparate bodies.
Additionally, there are insufficient volunteers and challenges in ensuring sustainability, as well as difficulties in reaching those who need help the most. There is a need for cost-effectiveness and evaluation of the effectiveness of these interventions. Sometimes multiple interventions are implemented simultaneously, making it challenging to evaluate what works. Moreover, there needs to be more emphasis on tackling inequalities related to loneliness and involving people from underserved communities in the design of these interventions.
- Address specific risk factors: to consider which action is most effective in relation to living alone, unemployment, loss of friendships, lack of belonging and living in a deprived area (including for instance the respective merits of befriending and intergenerational programmes, and of volunteering and other initiatives which recognise older adults as a potential resource rather than simply passive recipients of support).
- Evaluate current interventions across the UK: to provide robust evidence to understand what works, to inform future strategies. Additionally, when implementing multiple initiatives, establish mechanisms for effectively measuring and assessing their impact to determine which specific interventions are working effectively.
- Unification of effort: develop clear mechanisms to coordinate the activities of the different organizations working to combat loneliness, led by local authorities or other relevant entities (including Metro Mayors).
- Strengthen community engagement and address the diverse needs of underserved communities:
- Tailored Interventions: Recognize that a one-size-fits-all approach is not effective in addressing loneliness.
- Empower poor communities.
- Identify what resources are required and how these can be sourced.
- Aim to ensure sustainability and long term impact.
Maysa Elsayedkarar June 2023