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October 8, 2015

Reducing social isolation across the lifecourse

By Jim Garside, Time to Shine Administration Officer

The first part of this article (Reducing social isolation across the lifecourse) is a summary with a link to the full report. The second part (The lifecourse approach) is background on the lifecourse approach but the ‘key messages’ section the second part is taken directly from the report.

Public Health England has commissioned a report to help local authorities and health bodies to develop programmes that prevent and reduce health inequalities and social isolation.

‘Local action on health inequalities: Reducing social isolation across the lifecourse’ looks at social isolation as a public health issue, identifies the people most at risk of social isolation, and provides examples of interventions to support people at different stages of life.

This practice resource, written by Dan Durcan and Dr Ruth Bell for the Institute of Health Equity, highlights the work projects such as Time to Shine do to improve the lives of older people:

“Big Lottery funding is supporting interventions to reduce social isolation among older people through its £82m Fulfilling Lives, Ageing Better programme in 16 local areas across England. Evaluations of these interventions will provide information to inform work in other local areas to reduce social isolation.”

The report notes that whilst anyone can experience social isolation and loneliness some individuals and groups are more vulnerable than others.

Social isolation, when experienced at older ages, increases the risk of mortality but this can be mitigated by the strength and quality of people’s previous social connections:

“A meta-analysis of 148 studies covering over 300,000 study participants who were on average 63.9 years old at the beginning of the studies, reported that having adequate social relations is associated with a 50% greater likelihood of survival over seven-and-a-half years of follow-up compared with those without adequate social relations. Furthermore, authors of this research reported that the size of the effect of social isolation on survival was comparable to the effect of giving up smoking and greater than the effect of obesity and physical inactivity.”

Although retirement can be a positive time of life, retired and older people that have lost touch with colleagues, fallen ill or suffered bereavement are especially vulnerable.

“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.”

The report provides a broad overview of research evidence that supports the need to create and maintain social networks to promote the health and wellbeing of people throughout their life.

Findings include the impact of social isolation on older men compared to older women, older people belonging to ethnic minority groups, and older people with dementia.

The report concludes that the key to preventing social isolation is to create and maintain good quality social relationships, and supportive social networks, and that local organisations are well-placed to work with individuals and communities to do so.

Read the full report

The lifecourse approach looks at the effect of social and economic conditions on people’s health throughout their lives.

The report examines the experience of social isolation at different stages of life, from pregnancy and early years to later life and retirement, as people can experience social isolation at any time of life.

Younger people are most likely to experience social isolation in their formative years owing to other people’s response to their gender, ethnicity, sexuality or physical appearance.

As people age contributing factors to social isolation have a cumulative effect but sudden changes to personal circumstances, such as unemployment or bereavement, can make matters worse.

The report stresses the need for strong social networks to promote health and wellbeing by giving people a sense of belonging, influencing behaviour, and as a source of support and information.

The quality and quantity of social relationships affect health behaviours, physical and mental health, and risk of mortality.

Anyone can experience social isolation and loneliness. While social isolation is more commonly considered in later life, it can occur at all stages of the lifecourse. Particular individuals or groups may be more vulnerable than others, depending on factors like physical and mental health, level of education, employment status, wealth, income, ethnicity, gender and age or life-stage.

There are links between health and social inequality and social isolation; many factors associated with social isolation are unequally distributed in society.

Factors that influence social isolation and loneliness operate at the individual level, the level of the community or local area and at the wider societal level. Individual and community level factors that impact on social isolation are nested in the wider social, economic, political and cultural context.

A range of services provided by the public sector, private sector, third sector and community and voluntary services may have the potential to impact on social isolation, even if this is not their primary aim. For example, aspects of the built and natural environment and transport infrastructure can help or hinder efforts to enhance social connections.

Learning from specific interventions already in place in local areas can be used to inform work in other local areas to reduce social isolation. Although the context of social isolation across local areas may differ, a recurrent theme is the importance of involving communities in the design of interventions and the way they are managed and implemented.

Many community based interventions intended to reduce social isolation will not be identified as such within the community they serve. Instead, they will be focused on activities that can be shared; bringing people together naturally in a way that is appropriate to their particular needs.
Successful interventions to tackle social isolation reduce the burden on health and social care services. As such they are typically cost-effective.