Thursday 3 May 2018
Professor Roger O’Sullivan is Interim Chief Executive of the Institute of Public Health in Ireland (IPH). He is also Director of the Ageing Research and Development Division within IPH. In 2016 he was made visiting Professor at Ulster University. Between 2007 – 2015 Roger was Director of The Centre for Ageing Research and Development in Ireland.
As a society, we have never had more opportunities to connect with people, yet the fear of loneliness is capturing the public’s imagination.
While the history and experience of loneliness may be as old as civilisation – featuring in classics such as Bronte’s Jayne Eyre, Shelley’s Frankenstein and Steinbeck’s Of Mice or Men – nonetheless our understanding is still limited and often stereotypical.
In its simplest terms, loneliness is explained as the difference between desired and actual contact. It is a subjective feeling, in that some people with lots of friends can still feel lonely, and those who live alone may not! Loneliness has been described as an unwanted solitude.
Increasing social contact is often considered the “cure” for loneliness. While increasing social contact may be valuable for some people with few friends or family, it does not help all those experiencing loneliness. Likewise, advising people who report loneliness to get a pet when they want human contact is unlikely to change the feelings of loneliness.
The term loneliness is often used in an interchangeable way with the term social isolation; however, they are different and require different actions to address, as illustrated below:
(Henderson, 2013 cited in Harvey and Walsh, 2016)
Loneliness is a condition that is often associated with older people, but it is a mistake to think of all older people as lonely. Loneliness can occur from time to time, at a particular stage in life or can be associated with specific events such as widowhood or retirement. For those who experience it, we need to ensure that it is recognised as emotionally painful, distressing, and – importantly – individualistic.
Loneliness has been described as following a U-trajectory – generally higher in teenage years, low during family formation and working age and rising again in older age. Of course, anyone can have a temporary feeling of being lonely, but chronic loneliness is a sustained feeling of loneliness and affects about 10% of older people (Victor, 2011).
Impact of Loneliness
Although chronic loneliness can affect health and quality of life, it is not clear whether loneliness causes these, or indeed whether poor health and a declining quality of life are triggers for loneliness. However, what is known is that older people who are chronically lonely are more likely to have poor health, are at higher risk of developing dementia, and are more likely to visit their local doctor or A&E department (Lawlor, 2016).
Loneliness has been linked to a wide variety of mental and physical health outcomes, such as depression, nursing home admission, and overall decline in quality of life for older people:
- Lonely people have higher cortisol (stress hormone) levels;
- Loneliness can increase the risk of heart disease and impede recovery rates from stroke;
- Lonely people have more disrupted sleep;
- Loneliness has been associated with a broad range of adverse psychological conditions including anxiety, depression, substance abuse, social deviance, lower social skills, a more critical view of self, and perfectionism (Harvey and Walsh, 2016, Lawlor 2016)
There are both individual and wider societal factors that have implications for one’s risk of loneliness. Individual risk factors include: age, gender, childlessness, poverty, education, income, personality (anxiety), widowhood, and migration as part of retirement. Environmental risk factors include such aspects as low population density in rural locations and/or location in an impoverished neighbourhood (IPH, 2016).
In terms of groups at particular risk of loneliness, they include:
- Individuals with a physical disability/mobility issues;
- Individuals with an intellectual disability;
- Individuals who are caring for a family member or friend;
- Members of the LGBTQ+ community;
- Individuals living with dementia or cognitive impairment;
- Individuals from ethnic minority/minority communities (Harvey and Walsh, 2016).
Although loneliness is a very personal experience, addressing loneliness is not simply a matter for individuals but is also an issue for public health and society as a whole.
What we know about what works for tacking loneliness is still developing but in terms of preventing loneliness we know that people who have a more positive view of later life report less loneliness. Those who are more socially active and engaged with networks are more likely to be protected from loneliness.
Positive healthy relationships matter. As children, we make friends quickly, but it is actually a skill that we could all benefit from across the life-cycle. Likewise, building our social support, and our physical and psychological resources are key, but that is not forgetting that loneliness can have a social and economic dimension.
The important message is that loneliness can be transient, and when we need help through difficult times associated with loneliness and depression or bereavement, it is important to ask for it.
This article is based on a research paper by Brian Harvey and Kathy Walsh that was published by the Institute of Public Health in Ireland (IPH). The purpose of the paper research was to examine the concept of loneliness and to identify the most effective policy and service interventions to address loneliness amongst older people in Ireland, North and South. You can find this paper and more information on the work of IPH on www.publichealth.ie
CARDI. (2012). Focus on Loneliness and physical health. Centre for Ageing Research and Development in Ireland.
Harvey, B and Walsh, K. (2016) Loneliness and Ageing: Ireland, North and South. Institute of Public Health in Ireland.
IPH. (2016). Loneliness and Ageing: Ireland, North and South. Institute of Public Health in Ireland.
Lawlor, B. (2016). Loneliness or isolation: is there a difference to health? Presenation at Loneliness & Ageing: A Public Health Issue – Seminar, Belfast 6 December 2016.
Victor, C. (2011). Loneliness in old age: the UK perspective. Safeguarding the Convoy: a call to action from the Campaign to End Loneliness. Age UK Oxfordshire: Oxford.
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