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Group of people in a circle - pinkLoneliness and social isolation

The issues of loneliness and social isolation are receiving increasing attention nationally due to their negative impacts on individual health and wellbeing. While the terms ‘loneliness’ and ‘isolation’ are sometimes used as if they were synonymous, they refer to two different concepts. Isolation refers to separation from social or familial contact, community involvement, or access to services. Loneliness, by contrast, can be understood as an individual’s personal, subjective sense of lacking these things to the extent that they are wanted or needed. It is therefore possible to be isolated without being lonely, and to be lonely without being isolated. For instance, an older person can be physically isolated (living on one’s own, not seeing many other people etc.) without feeling lonely. For some, physical separation is even a result of choice. Similarly, one can feel lonely in the midst of other people. However, evidence suggests that one of the most effective ways of combating loneliness is to combat isolation (Public Health England, 2015).

This page summarises some of the key issues relating to loneliness and social isolation in Southampton. However, more detailed information is available in the Southampton loneliness and social isolation briefing available to download in the resources section of this page.

Why is tackling social isolation important?

The links between loneliness and poor health are well established. Being lonely can have a significant effect on individuals’ health; it can have physically and emotionally damaging effects resulting in higher blood pressure, depression, poor nutrition, decreased immunity, anxiety, fatigue and social stigma. It is also associated with higher rates of mortality; comparable to well-established risks such as smoking and alcohol consumption. Weak social connections carry a health risk that is more harmful than not exercising, twice as harmful as obesity, and is comparable to smoking 15 cigarettes a day or being an alcoholic. Indeed, the Marmot Review into health inequalities found that “individuals who are socially isolated are between two and five times more likely than those who have strong social ties to die prematurely.” It is also linked to higher incidence of dementia, with one study reporting a doubled risk of Alzheimer’s disease in lonely people compared with those who were not lonely.

As a result of these health impacts, lonely individuals tend to make more use of health and social care services, and are more likely to have early admission to residential or nursing care. Tackling loneliness is, therefore, relevant to a number of important agendas for local authorities, in particular public health (LGA, 2016).

Tackling loneliness not only alleviates the suffering, and improves the quality of life, of individuals, but it also brings wider benefits to local communities. For example tackling loneliness can reduce the demand for costly health, care and other interventions and, by reconnecting individuals to their communities, it can give renewed access to older people’s economic and social capital. Whilst hard cost benefit analysis of loneliness is still scarce, existing data indicates good returns on investment. Given the high cost of the health, social care and other services required by lonely individuals if their circumstances are not addressed, there is a strong case for investment in this area, particularly given the relatively low cost of many effective interventions.

Who is at risk of social isolation?

In September 2015, Public Health England produced a report looking at reducing social isolation across the life course arguing that while social isolation is more commonly considered to occur in later life, it can occur at all stages of life. The report outlines four key life stages where social isolation can occur:

  • Pregnancy and early years; one in five mothers lack support networks to help them through pregnancy and are unaware of the services available to help with depression. Among mothers in low income households, the proportion is greater, at one in three. There are also links between social disadvantage, social isolation and poor self-rated health among new mothers.
  • Children and young people; children who are socially isolated in school may have low perceived social efficacy (a lack of belief in their ability to control events in their life) and experience anxiety and social withdrawal. Children who experience social isolation in childhood tend to have lower educational outcomes and lower adult social class (based on occupation), and higher likelihoods of smoking, obesity and psychological distress in adulthood. Adverse childhood experiences such as domestic abuse, sexual abuse, parental absence, being in care and parental divorce are also associated with social isolation later in life and poorer mental health outcomes. Other at risk groups include young carers, teenage pregnancies, obese children, children with a disability and those not in education, employment or training (NEET).
  • Working-age adults; experiences and life transitions can occur at any point in life that lead to social isolation. Significant risk factors include unemployment (particularly long-term unemployed), divorce, ethnic minority groups (numerous barriers to social inclusion), and those with an addiction (rooted in and a cause of social isolation). Addiction can also bring extreme forms of social isolation such as homelessness and criminality.
  • Retirement and later life; in particular, three life events are associated with social isolation among older people: retirement and losing connection with colleagues; falling ill and becoming less mobile; a spouse dying or going into care. Given that social isolation relates to network size and diversity, and frequency of contact, it is easy to see how retirement and older age increase the risk of social isolation. Social networks shrink with retirement and loss of working colleagues, friends and relations, and the reduction of income associated with retirement may limit social activities, especially for those on lower incomes. Social networks become less accessible with decreased mobility: it becomes more difficult to participate. When some or all of these events happen and result in social isolation, the consequences can include unmet healthcare needs and premature death.

Levels of social isolation in Southampton

Recent estimates place the number of people aged over 65 who are often or always lonely at over one million. The population that is socially isolated, and therefore at risk of loneliness, is considerable. A report from the LGA (2016) summarising recent research estimated that:

  • Over 1 million older people say they are always or often feel lonely
  • 12 per cent of older people feel trapped in their own home
  • 6 per cent of older people leave their house once a week or less
  • 17 per cent of older people are in contact with family, friends and neighbours less than once a week, and 11 per cent are in contact less than once a month
  • Over half (51 per cent) of all people aged 75 and over live alone

Nationally loneliness is measured in the ONS Opinions and Lifestyle Survey, whilst local data for Southampton was collected as part of the 2016 City Survey, which asked residents questions about social isolation including the extent to which they felt lonely in their daily life. Due to the similar methodology used in the two surveys, the results are comparable and show that loneliness in Southampton is slightly lower than the national average. Overall, 1 in 7 (14.6%) of residents aged 16+ in Southampton reported feeling lonely in their daily life (compared to 15.4% for England), whilst 6 in 10 (59.2%) reported not feeling lonely at all. The prevalence increases for the over 65’s to nearly 16% in Southampton, with national data suggesting that this dramatically increases amongst those aged over 80 (29.2%). Based on the City Survey findings there are an estimated 30,000 residents in Southampton (aged 16+) who feel lonely in their daily lives, with approximately 5,200 of those aged over 65.

The Southampton City Survey provides some insight into the demographic differences of loneliness, with higher levels of loneliness seen amongst BME communities (22%), those who are not working (24%), those who have a disability (20%), people for whom English is not their first language (24%), and residents that are in poor health (35%). Due to the relatively small sample size, the city survey does not provide the comprehensive low-level geographical data that is needed to provide targeted interventions and it does not provide information on those who are considered at risk, or cover children and young people.

Social Isolation Index for Southampton (SIIS)

As a result of these limitations and a local demand for increased intelligence on social isolation, a local Social Isolation Index for Southampton (SIIS) has been developed in an attempt to provide some further insight into areas at increased risk in the city. The SIIS considers social isolation over the different life stages in Southampton, rather than just focusing on older people. Several different methodologies were reviewed, and data used in these models assessed along with other known datasets available measuring some additional risk factors identified in the literature for each stage of the life course.

Datasets were drawn together at lower super output area level in order to assess differences between neighbourhoods in the city. These were then combined into an index for each life stage and mapped to show areas, which may have an increased risk of social isolation in the city. These maps along with further information on the methodology and data used can be found in the Southampton loneliness and social isolation briefing and are available to download in the resources section of this page.

Resources

Resources relating to loneliness and social isolation can be downloaded below

Southampton Loneliness Social Isolation Intelligence Briefing

Southampton Loneliness Social Isolation Intelligence Briefing
Report
pdf | 7MB | 01.04.17

Social Isolation Index for Southampton (SIIS) published data

Social Isolation Index for Southampton (SIIS) published data
Dataset
xlsx | 54KB | 01.04.17

Social Isolation Index for Southampton (SIIS) maps

Social Isolation Index for Southampton (SIIS) – Young People
Visualisation
jpg | 4MB | 24.04.17
Social Isolation Index for Southampton (SIIS) – Working Age
Visualisation
jpg | 4MB | 24.04.17
Social Isolation Index for Southampton (SIIS) – Older People
Visualisation
jpg | 4MB | 24.04.17
Social Isolation Index for Southampton (SIIS) – Overall Index
Visualisation
jpg | 4MB | 24.04.17

Last updated: 03 April 2017