tag:theconversation.com,2011:/uk/topics/health-effects-of-loneliness-37845/articlesHealth effects of loneliness – The Conversation2023-11-14T18:06:28Ztag:theconversation.com,2011:article/2164712023-11-14T18:06:28Z2023-11-14T18:06:28ZAutistic people experience loneliness far more acutely than neurotypical people – new research<figure><img src="https://images.theconversation.com/files/558608/original/file-20231109-21-q7xuk9.jpg?ixlib=rb-1.1.0&rect=53%2C0%2C5972%2C3593&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">New research debunks the stereotype that autistic people lack the motivation to form meaningful social connections.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-man-suffering-depression-social-anxiety-2252053059">KieferPix/Shutterstock</a></span></figcaption></figure><p>Autistic people are up to four times more likely to experience <a href="https://www.autism.org.uk/advice-and-guidance/topics/loneliness#:%7E:text=Autistic%20people%20are%20more%20likely,rewarding%20relationships%20in%20your%20life.">loneliness</a> than non-autistic people. </p>
<p>Despite enduring <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329932/">stereotypes</a> that autistic people lack the desire for meaningful social connections, <a href="https://www.liebertpub.com/doi/10.1089/aut.2022.0062">new research</a> from my colleagues and I unveils the profound distress they experience due to loneliness. It also shows the unexpected role that differences in the ways individuals receive and interpret different stimuli through their senses – their “sensory processing” – may play in this phenomenon. </p>
<p>We combined two complementary studies that investigated autistic and non-autistic people’s experiences of loneliness, using different methods.</p>
<p>In the first study, autistic and non-autistic participants completed questionnaires measuring loneliness, anxiety, depression and sensory differences. We felt that the usual standardised loneliness questionnaires do not fully capture the important distinction between chosen solitude and distress caused by loneliness. </p>
<p>To address this, we added the additional question “How much does this upset you?” to each factor on the questionnaire to assess the level of distress caused by loneliness. Statistical analysis revealed how these factors related to each other and differed between the two groups. </p>
<p>In the second study, autistic participants discussed their experiences of loneliness in short, recorded conversations. We then identified common themes. </p>
<h2>Sensory differences and distress</h2>
<p>The results from the first study demonstrated a direct link between sensory processing differences and increased loneliness and poorer mental health in both autistic and non-autistic adults. </p>
<p>This association was particularly pronounced among autistic participants due to the differences in sensory processing and how they experience the environment around them. This was surprising, as the link between sensory processing differences and loneliness hasn’t been made before. </p>
<p>What’s more, autistic adults reported experiencing not only greater levels of loneliness but also more intense distress associated with it. This suggests that autistic individuals suffer more acutely from loneliness. This is on top of being more likely to experience it in the first place.</p>
<p>In the second study, autistic participants spoke about the intense pain of feeling lonely and socially isolated, while also needing to retreat into solitude to recover from over-stimulation. They expressed a deep desire for meaningful relationships with other people. </p>
<p>But they also described the barriers they faced in achieving this. These obstacles included difficulty connecting with non-autistic people, finding friends with shared interests, and feeling misunderstood and unaccepted by society.</p>
<p>One autistic participant described the difficulties she had faced in making friends as an adult: “I’m trying to reach out, I’m trying to find my people, but it all still feels a bit hopeless.”</p>
<p>Many autistic participants also described feeling overwhelmed in high-intensity social situations, such as being in large groups, around unfamiliar people, or in busy office environments. They needed time alone to recover afterwards. </p>
<p>However, they had a more positive experience of this type of chosen solitude compared with being forced to be alone. Additionally, having more access to quieter environments with less stimulation could reduce the amount of recovery time needed.</p>
<h2>Societal and environmental barriers</h2>
<p>In addition to the emotional distress of loneliness, many autistic people also cited practical barriers to social connection. These included financial constraints, a lack of affordable and accessible community spaces, and the difficulty of navigating busy and noisy urban environments.</p>
<p>Autistic people may be at heightened risk of financial hardship during the cost-of-living crisis, as they often face <a href="https://theconversation.com/dehumanising-policies-leave-autistic-people-struggling-to-access-health-education-and-housing-new-review-202997">barriers</a> to employment and benefits. They are also more likely to experience <a href="https://sensorystreet.uk/">sensory overload</a>, as they process sensory information differently. </p>
<p>For example, one autistic woman in her sixties described how she could see her aunt’s house from her living room window, but could not safely cross the busy road that separated them to visit her.</p>
<figure class="align-center ">
<img alt="A woman sitting down looks into the middle distance." src="https://images.theconversation.com/files/558644/original/file-20231109-24-wbjilb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/558644/original/file-20231109-24-wbjilb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/558644/original/file-20231109-24-wbjilb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/558644/original/file-20231109-24-wbjilb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/558644/original/file-20231109-24-wbjilb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/558644/original/file-20231109-24-wbjilb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/558644/original/file-20231109-24-wbjilb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Many autistic people cited practical barriers to social connection.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/serious-older-50s-woman-looks-out-2146877297">fizkes/Shutterstock</a></span>
</figcaption>
</figure>
<h2>Doing things differently</h2>
<p>Our findings debunk the outdated stereotype that autistic people lack the motivation to form meaningful social connections. Instead, social environments often exclude people with higher levels of sensory differences. This can limit the opportunities for autistic people to socialise and form meaningful relationships. </p>
<p>Our research highlights the need to create <a href="https://www.ribaj.com/intelligence/sensory-impact-buildings-and-neurodiversity">more welcoming sensory environments</a> to reduce these barriers. Small adjustments to lighting, acoustics, décor and wayfinding, among other sensory factors, can significantly reduce the burden on people with sensory processing differences and open up more social spaces to them. </p>
<p>Concerted efforts from society as a whole – including town planners, employers, educators and owners of public social spaces – are needed to create spaces that consider the sensory needs of all neurotypes.</p><img src="https://counter.theconversation.com/content/216471/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gemma L. Williams does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Autistic people are not only more likely to feel lonely but are also more likely to experience it more acutely than non-autistic people according to new research.Gemma L. Williams, Research Officer in Public Health, Swansea UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2111262023-09-04T04:21:07Z2023-09-04T04:21:07ZFeeling lonely? Too many of us are. Here’s what our supermarkets can do to help<figure><img src="https://images.theconversation.com/files/544734/original/file-20230825-19-dja0ah.jpg?ixlib=rb-1.1.0&rect=1517%2C0%2C4191%2C2674&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Even <a href="https://endingloneliness.com.au/wp-content/uploads/2020/11/Ending-Loneliness-Together-in-Australia_Nov20.pdf">before COVID-19</a>, <a href="https://aifs.gov.au/resources/resource-sheets/understanding-and-defining-loneliness-and-social-isolation">social isolation and loneliness</a> were all too common across the community. Living among millions of other people is no comfort for people in cities, where the pace of life is often hectic, and technology and digitisation often limit, rather than help with, social interaction. </p>
<p>The pandemic <a href="https://www.apa.org/pubs/journals/releases/amp-amp0001005.pdf">amplified these problems</a>. In its wake, more of us report we’re lonely.</p>
<p>For some, a weekly shopping trip may be the only chance to interact with others. A supermarket chain in the Netherlands is helping to combat loneliness with so-called “slow” checkouts where chatting is encouraged. Could a similar approach work here?</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-loneliness-is-both-an-individual-thing-and-a-shared-result-of-the-cities-we-create-198069">Why loneliness is both an individual thing and a shared result of the cities we create</a>
</strong>
</em>
</p>
<hr>
<h2>We’re getting lonelier</h2>
<p>Around a third of Australians report feeling lonely. <a href="https://lonelinessawarenessweek.com.au/download/512/">One in six</a> experience severe loneliness.</p>
<p>According to the annual Household, Income and Labour Dynamics in Australia (<a href="https://melbourneinstitute.unimelb.edu.au/hilda/publications/hilda-statistical-reports">HILDA</a>) Survey, people <a href="https://www.abc.net.au/news/2023-07-17/social-media-work-hours-cost-of-living-rising-loneliness/102563666">aged 15 to 24</a> report the greatest increase in social isolation over the past 20 years and the highest rates of loneliness. Another <a href="https://www.abc.net.au/news/2023-07-14/middle-aged-men-experiencing-high-level-loneliness/102563492">Australian survey</a> found men aged 35 to 49 had the highest levels of loneliness.</p>
<p>Loneliness and social isolation are <a href="https://www.abc.net.au/news/2023-07-17/social-media-work-hours-cost-of-living-rising-loneliness/102563666">not the same</a>. Social isolation is a matter of how often we have contact with friends, family and others, which can be measured.</p>
<p>Loneliness is more subjective. It describes how we feel about the “quality” of our interactions with others. </p>
<p>Technology is <a href="https://www.psychologytoday.com/au/blog/live-long-and-prosper/202210/technology-use-loneliness-and-isolation#:%7E:text=Technology%20compulsion%20might%20lead%20to,disconnection%20and%20reduce%20well%2Dbeing.">contributing</a> to <a href="https://www.abc.net.au/news/2023-07-17/social-media-work-hours-cost-of-living-rising-loneliness/102563666">high rates of loneliness</a>. Instead of meaningful face-to-face interactions, many of us now rely on social media, phone apps and video calls to socialise. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-the-digitalisation-of-everything-is-making-us-more-lonely-90870">How the digitalisation of everything is making us more lonely</a>
</strong>
</em>
</p>
<hr>
<p>We’re also working longer hours, often at home. And due to the cost of living, many of us are choosing to stay home and save money, rather than eat out or go to “the local”. </p>
<p>It isn’t only in Australia where this is happening. In the UK, around <a href="https://www.lonelinessawarenessweek.org/statistics">3.9 million older people</a> say television is their main company. Half a million may go five or six days a week without seeing anyone.</p>
<p>The World Health Organisation <a href="https://www.who.int/teams/social-determinants-of-health/demographic-change-and-healthy-ageing/social-isolation-and-loneliness">recognises</a> loneliness and social isolation as public health issues and priorities for policymakers. These issues seriously affect people’s mental and physical health as well as longevity. The impacts are comparable with other <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15967-3">risk factors</a> such as smoking, alcohol consumption, obesity and not being physically active.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/loneliness-is-making-us-physically-sick-but-social-prescribing-can-treat-it-podcast-199939">Loneliness is making us physically sick, but social prescribing can treat it – podcast</a>
</strong>
</em>
</p>
<hr>
<h2>Could slow, ‘chatty’ checkouts be part of the solution?</h2>
<p>For many, a visit to the supermarket may be the only time they interact with others. Sadly, increased use of technology, including self-serve checkouts, and cashiers tasked with speedily processing customers can make it challenging to have a conversation.</p>
<iframe width="100%" height="750" src="https://www.youtube.com/embed/TpALSOvw4LU" title="The FASTEST checkout cashier ever😮 TikTok: rogerlopez7511" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" allowfullscreen=""></iframe>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/more-than-milk-and-bread-corner-store-revival-can-rebuild-neighbourhood-ties-121244">More than milk and bread: corner store revival can rebuild neighbourhood ties</a>
</strong>
</em>
</p>
<hr>
<p>Four years ago, the Netherlands’ second-largest supermarket chain, <a href="https://jumbo.com">Jumbo</a>, introduced <em>Kletskassa</em> or “chat checkout”. It’s for shoppers who want to chat and aren’t in a hurry. Recognising loneliness was an issue for many, the idea was to increase social interaction between customers and staff by slowing things down and encouraging conversation. </p>
<p>Jumbo’s chief commercial officer, Colette Cloosterman-van Eerd, <a href="https://www.dutchnews.nl/2021/09/jumbo-opens-chat-checkouts-to-combat-loneliness-among-the-elderly/">explained</a>:</p>
<blockquote>
<p>Many people, especially the elderly, sometimes feel lonely. As a family business and supermarket chain, we are at the heart of society. Our shops are an important meeting place for many people, and we want to play a role in identifying and reducing loneliness.</p>
</blockquote>
<p>The first <em>Kletskassa</em>, in Vlijmen in Brabant, was so successful the family-owned company started rolling out slow checkouts in <a href="https://www.dutchnews.nl/2021/09/jumbo-opens-chat-checkouts-to-combat-loneliness-among-the-elderly/">200 of its stores</a>. Not only were customers responding positively, the concept also appealed to Jumbo’s employees. They are trained to recognise signs of loneliness and come up with local initiatives to combat social isolation.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/i-tell-everyone-i-love-being-on-my-own-but-i-hate-it-what-older-australians-want-you-to-know-about-loneliness-166109">'I tell everyone I love being on my own, but I hate it': what older Australians want you to know about loneliness</a>
</strong>
</em>
</p>
<hr>
<p>Cloosterman-Van Eerd said: </p>
<blockquote>
<p>We are proud our staff want to work the chat checkout. They really want to help people and make contact with them. It’s a small gesture but it’s a valuable one, particularly in a world that is becoming more digital and faster.</p>
</blockquote>
<p>The original focus of Jumbo’s initiative was older shoppers. However, the trial showed people of all ages were keen to use the <em>Kletskassa</em>. The desire for human interaction didn’t change across age groups.</p>
<p>So, these “chatty” checkouts are open to anyone who will benefit from social connection. Some Jumbo stores also have an <a href="https://www.brightvibes.com/dutch-supermarket-introduces-a-unique-chat-checkout-to-help-fight-loneliness/">All Together Coffee Corner</a>, where locals can enjoy a coffee and chat with neighbours and volunteers who also <a href="https://scoop.upworthy.com/dutch-supermarket-introduces-a-unique-slow-checkout-lane-to-help-fight-loneliness-595693-595693">help out</a> with shopping and gardening.</p>
<p>The Netherlands’ government is partnering a range of organisations, local government and companies to come up with solutions to combat loneliness across the country. Some 50% of the 1.3 million people over 75 report they regularly feel lonely. Jumbo’s initiatives are part of the Health Ministry’s <a href="https://www.globalwellnesssummit.com/blog/governments-ramp-up-the-war-on-loneliness/">One Against Loneliness</a> campaign.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/11SY0wG6Zc8?wmode=transparent&start=10" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Jumbo supermarket’s innovation of slow chat checkouts has been extended to 200 of its stores.</span></figcaption>
</figure>
<h2>Supermarkets as ‘third places’ to combat loneliness</h2>
<p>In the 1980s, sociologist Ray Oldenberg coined the term <a href="https://link.springer.com/article/10.1007/BF00986754">“third place”</a> – a place that’s not home (the “first place”) and not work (the “second place”). Third places are familiar public spaces where people can connect over a shared interest or activity. </p>
<p>Libraries, coffee shops, book stores, community gardens, churches, gyms and clubs are examples of third places. They all provide the opportunity for close proximity, interaction and often serendipitous conversations with other people we might not usually meet. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/many-people-feel-lonely-in-the-city-but-perhaps-third-places-can-help-with-that-92847">Many people feel lonely in the city, but perhaps 'third places' can help with that</a>
</strong>
</em>
</p>
<hr>
<p><em>Kletkassa</em> have helped thousands of people, of all ages and backgrounds, by providing a few minutes of kindness and conversation. Imagine what could be achieved if our supermarkets offered their own version of the “slow checkout” for anyone who’s in need of a chat to brighten their day. </p>
<p>The first chain to introduce this sort of initiative in Australia would have a solid advantage over competitors through differentiation and prioritising customers. At the same time, it would make a small but meaningful contribution to improving social wellbeing. </p>
<p>Challenge extended!</p><img src="https://counter.theconversation.com/content/211126/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Louise Grimmer does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>For people who feel lonely, a trip to the supermarket could help – if only the store provided opportunities to chat at the checkout. A Dutch chain has done just that, and customers and staff love it.Louise Grimmer, Senior Lecturer in Retail Marketing, University of TasmaniaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1980692023-01-24T19:18:51Z2023-01-24T19:18:51ZWhy loneliness is both an individual thing and a shared result of the cities we create<figure><img src="https://images.theconversation.com/files/505296/original/file-20230119-26-3pzdvg.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C8674%2C5787&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>If you’re feeling lonely, you’re not alone. Loneliness is an <a href="https://www.ipsos.com/en/loneliness-increase-worldwide-increase-local-community-support">increasingly common experience</a>, and it can have severe consequences. People who feel lonely are at <a href="https://doi.org/10.1007/s12160-010-9210-8">higher risk of serious health issues</a>, including heart disease, immune deficiency and depression.</p>
<p>Traditionally, loneliness has been viewed as an individual problem requiring individual solutions, such as psychological therapy or medication. Yet loneliness is caused by feeling disconnected from society. It therefore makes sense that treatments for loneliness should focus on the things that help us make these broader connections. </p>
<p>The places where we live, work and play, for example, can promote meaningful social interactions and help us build a sense of connection. Careful planning and management of these places can create <a href="https://www.gov.uk/government/publications/loneliness-annual-report-the-third-year/tackling-loneliness-annual-report-february-2022-the-third-year">population-wide improvements in loneliness</a>.</p>
<p>Our research team is investigating how the way we design and plan our cities impacts loneliness. We have just published a <a href="https://authors.elsevier.com/c/1gNq14pqpjtIuw">systematic review</a> of research from around the world. Overall, we found many aspects of the built environment affect loneliness. </p>
<p>However, no single design attribute can protect everyone against loneliness. Places can provide opportunities for social interactions, or present barriers to them. Yet every individual responds differently to these opportunities and barriers.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/4-ways-we-can-recover-from-the-loneliness-of-the-covid-pandemic-187856">4 ways we can recover from the loneliness of the COVID pandemic</a>
</strong>
</em>
</p>
<hr>
<h2>What did the review look at?</h2>
<p>Our review involved screening over 7,000 published studies covering fields such as psychology, public health and urban planning. We included 57 studies that directly examined the relationship between loneliness and the built environment. These studies covered wide-ranging aspects from neighbourhood design, housing conditions and public spaces to transport infrastructure and natural spaces.</p>
<p>The research shows built environments can present people with options to do the things we know help reduce loneliness. Examples include chatting to the people in your street or neighbourhood or attending a community event. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1612065166132400129"}"></div></p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/many-people-feel-lonely-in-the-city-but-perhaps-third-places-can-help-with-that-92847">Many people feel lonely in the city, but perhaps 'third places' can help with that</a>
</strong>
</em>
</p>
<hr>
<p>However, the link between the built environment and loneliness is complex. Our review found possibilities for social interaction depend on both structural and individual factors. In other words, individual outcomes depend on what the design of a space enables a person to do as well as on whether, and how, that person takes advantage of that design.</p>
<p>Specifically, we identified some key aspects of the built environment that can help people make connections. These include housing design, transport systems and the distribution and design of open and natural spaces.</p>
<h2>So what sort of situations are we talking about?</h2>
<p>Living in small apartments, for example can increase loneliness. <a href="https://link.springer.com/article/10.1007/s10901-020-09816-7">For some people</a>, this is because the smaller space reduces their ability to have people over for dinner. Others who live in <a href="https://doi.org/10.1017/S0144686X15000112">poorly maintained housing</a> report similar experiences.</p>
<p>More universally, living in areas with good access to <a href="https://doi.org/10.1017/S0144686X19001569">community centres</a> and <a href="https://doi.org/10.1093/ije/dyab089">natural spaces</a> helps people make social connections. These spaces allow for both planned and unexpected social interactions. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/1-in-4-australians-is-lonely-quality-green-spaces-in-our-cities-offer-a-solution-188007">1 in 4 Australians is lonely. Quality green spaces in our cities offer a solution</a>
</strong>
</em>
</p>
<hr>
<p>Living in environments with good access to destinations and transport options also protects against loneliness. In particular, it benefits individuals who are able to use <a href="https://doi.org/10.1093/gerona/glu069">active transport (walking and cycling) and high-quality public transport</a>. </p>
<p>This finding should make sense to anyone who walks or takes the bus. We are then more likely to interact in some way with those around us than when locked away in the privacy of a car.</p>
<p>Similarly, built environments <a href="https://doi.org/10.1002/jcop.21711">designed to be safe</a> — from crime, traffic and pollution — also enable people to explore their neighbourhoods easily on foot. Once again, that gives them more opportunities for social interactions that can, potentially, reduce loneliness.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/505295/original/file-20230119-16-3pzdvg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/505295/original/file-20230119-16-3pzdvg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=428&fit=crop&dpr=1 600w, https://images.theconversation.com/files/505295/original/file-20230119-16-3pzdvg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=428&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/505295/original/file-20230119-16-3pzdvg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=428&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/505295/original/file-20230119-16-3pzdvg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=538&fit=crop&dpr=1 754w, https://images.theconversation.com/files/505295/original/file-20230119-16-3pzdvg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=538&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/505295/original/file-20230119-16-3pzdvg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=538&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Neighbourhoods that make it easier to get around without a car also promote social interactions.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>Environments where people are able to express themselves were also found to protect against loneliness. For example, residents of housing they could personalise and “make home” reported feeling less lonely. So too did those who felt able to “<a href="https://doi.org/10.7870/cjcmh-2002-0010">fit in</a>”, or identify with the people living close by.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/designing-cities-to-counter-loneliness-lets-explore-the-possibilities-104853">Designing cities to counter loneliness? Let's explore the possibilities</a>
</strong>
</em>
</p>
<hr>
<h2>Other important factors are less obvious</h2>
<p>These factors are fairly well defined, but we also found less tangible conditions could be significant. For example, studies consistently showed the importance of socio-economic status. The interplay between economic inequalities and the built environment can deny many the right to live a life without loneliness.</p>
<p>For example, <a href="https://doi.org/10.1080/19491247.2021.1940686">housing tenure</a> can be important because people who rent are less able to personalise their homes. People with lower incomes can’t always afford to <a href="https://doi.org/10.1177/1440783320960527">live close to friends</a> or in a neighbourhood where they feel accepted. Lower-income areas are also notoriously under-serviced with <a href="https://doi.org/10.1016/j.jtrangeo.2020.102869">reliable public transport</a>, <a href="https://link.springer.com/article/10.1186/1471-2458-14-292">well-maintained natural spaces</a> and <a href="https://doi.org/10.1016/j.healthplace.2007.11.002">well-designed public spaces</a>. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1605150887269335046"}"></div></p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/i-really-have-thought-this-cant-go-on-loneliness-looms-for-rising-numbers-of-older-private-renters-118046">'I really have thought this can’t go on': loneliness looms for rising numbers of older private renters</a>
</strong>
</em>
</p>
<hr>
<p>Our review reveals several aspects of the built environment that can enhance social interactions and minimise loneliness. Our key finding, though, is that there is no single built environment that is universally “good” or “bad” for loneliness. </p>
<p>Yes, we can plan and build our cities to help us meet our innate need for social connection. But context matters, and different individuals will interpret built environments differently.</p><img src="https://counter.theconversation.com/content/198069/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennifer Kent receives funding from the Australian Research Council.</span></em></p><p class="fine-print"><em><span>Marlee Bower receives funding from the BHP Foundation. She is affiliated with Australia's Mental Health Think Tank.</span></em></p><p class="fine-print"><em><span>Emily J. Rugel does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A systematic review of thousands of studies around the world has found many aspects of our cities affect loneliness. But people’s relationship with their environment is complex and highly individual.Jennifer L. Kent, Senior Research Fellow in Urbanism, University of SydneyEmily J. Rugel, Honorary Adjunct Lecturer, Sydney Medical School, University of SydneyMarlee Bower, Research Fellow, Matilda Centre for Research in Mental Health and Substance Use, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1880072022-08-16T20:04:28Z2022-08-16T20:04:28Z1 in 4 Australians is lonely. Quality green spaces in our cities offer a solution<figure><img src="https://images.theconversation.com/files/477162/original/file-20220802-22-th7gyq.jpg?ixlib=rb-1.1.0&rect=69%2C2%2C1404%2C932&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Photo by Xiaoqi Feng</span>, <span class="license">Author provided</span></span></figcaption></figure><p><a href="https://journals.sagepub.com/doi/full/10.1177/00048674211031489">One in four</a> Australian adults feel lonely, and the impacts can be dire. Loneliness increases our risks of <a href="https://doi.org/10.1177/0020764018776349">depression</a>, <a href="https://link.springer.com/article/10.1007/s00125-020-05258-6">diabetes</a>, <a href="https://www.sciencedirect.com/science/article/pii/S1568163718302472">dementia</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/30789112/">self-harm</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/29563886/">suicide</a>. But <a href="https://theconversation.com/loneliness-is-a-social-cancer-every-bit-as-alarming-as-cancer-itself-126741">likening it to a disease</a> and <a href="https://www.theguardian.com/us-news/2019/jan/26/pill-for-loneliness-psychology-science-medicine">proposals to treat it with a pill</a> miss the point: we’ve been building for loneliness over many decades and decision-makers have been asleep at the wheel.</p>
<p>Having studied the issue, we view loneliness as largely a product of our environment – what we call a “lonelygenic environment” – not a disease or a problem with any particular individual. So what is this “lonelygenic environment”? </p>
<p>Over decades, our cities have become sprawling low-density agglomerations. Many places are too far to walk from home. Short errands are routinely done by car, erasing opportunities to stop and chat with locals. </p>
<p>Large-scale felling of street trees has not only obliterated natural shade, but severed our connection with the “more than human” world. Car traffic dominates residential roads, which are also clogged with parked cars. </p>
<p>We have lost the people-friendly streets that we once used for regularly gathering, playing and celebrating with neighbours. No wonder we now <a href="https://www.abc.net.au/news/2021-05-29/older-australians-more-likely-know-their-neighbours-by-name/100156872?utm_campaign=abc_news_web&utm_content=link&utm_medium=content_shared&utm_source=abc_news_web">know so few by name</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/japans-old-enough-and-australias-bluey-remind-us-our-kids-are-no-longer-free-range-but-we-can-remake-our-neighbourhoods-187698">Japan's Old Enough and Australia's Bluey remind us our kids are no longer ‘free range’ – but we can remake our neighbourhoods</a>
</strong>
</em>
</p>
<hr>
<p>If the determinants of loneliness are largely environmental, so too must be the solutions. Yet we hear so little about this. </p>
<h2>How much difference can green space make?</h2>
<p>In a previous <a href="https://theconversation.com/peoples-odds-of-loneliness-could-fall-by-up-to-half-if-cities-hit-30-green-space-targets-161989">Conversation article</a>, we suggested investing in public green space is part of the solution to the epidemic of loneliness. The article was based on our <a href="https://academic.oup.com/ije/article/51/1/99/6289969">longitudinal study</a> that reported a greening target of 30% local landcover could cut the odds of becoming lonely by a quarter. Among people living alone, who tend to be more vulnerable to loneliness, green space cut those odds by up to a half.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1402817312185405445"}"></div></p>
<p>But how can green space reduce loneliness? That’s the focus of our new <a href="https://www.sciencedirect.com/science/article/pii/S0048969722046198">review</a> of studies from around the world. Two-thirds of the studies found green space potentially protected people against loneliness. </p>
<p>Our review identified multiple pathways for reducing loneliness. These included:</p>
<ol>
<li>building capacities for connection with community</li>
<li>restoring our sense of belonging and connection with nature</li>
<li>reducing harms, such as <a href="https://www.pnas.org/doi/abs/10.1073/pnas.1718503115">violence</a>, that may otherwise lead to loneliness.</li>
</ol>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/479284/original/file-20220816-22-7kvf9o.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/479284/original/file-20220816-22-7kvf9o.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/479284/original/file-20220816-22-7kvf9o.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=275&fit=crop&dpr=1 600w, https://images.theconversation.com/files/479284/original/file-20220816-22-7kvf9o.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=275&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/479284/original/file-20220816-22-7kvf9o.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=275&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/479284/original/file-20220816-22-7kvf9o.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=345&fit=crop&dpr=1 754w, https://images.theconversation.com/files/479284/original/file-20220816-22-7kvf9o.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=345&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/479284/original/file-20220816-22-7kvf9o.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=345&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Domains of pathways linking contact with green space to the risk of loneliness.</span>
<span class="attribution"><a class="source" href="https://www.sciencedirect.com/science/article/pii/S0048969722046198?via%3Dihub">Excerpt from Figure 2 in Astell-Burt et al (2022)</a>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<h2>The quality of the green space matters</h2>
<p>During the COVID-19 pandemic we undertook a nationally representative <a href="https://www.mdpi.com/1660-4601/18/21/11028">survey</a> and found the odds of connecting with neighbours were five times higher for people who visited high-quality green space than for those who didn’t or couldn’t. </p>
<p>Related benefits were also much stronger if green spaces were higher quality. For example, exercise and relief from stress were both more commonly reported by people visiting higher-quality green spaces. </p>
<p><audio preload="metadata" controls="controls" data-duration="2043" data-image="" data-title="Callan Park – the green asylum, featuring an interview with Xiaoqi Feng (23:50-28:46 & 31:54-33:16)" data-size="49039822" data-source="Source: Inner West Icons" data-source-url="https://www.innerwesticons.com/episodes/callanpark" data-license="" data-license-url="">
<source src="https://cdn.theconversation.com/audio/2571/callan-20park-20final-20mix-20update-converted.mp3" type="audio/mpeg">
</audio>
<div class="audio-player-caption">
Callan Park – the green asylum, featuring an interview with Xiaoqi Feng (23:50-28:46 & 31:54-33:16)
<span class="attribution"><a class="source" rel="nofollow" href="https://www.innerwesticons.com/episodes/callanpark">Source: Inner West Icons</a><span class="download"><span>46.8 MB</span> <a target="_blank" href="https://cdn.theconversation.com/audio/2571/callan-20park-20final-20mix-20update-converted.mp3">(download)</a></span></span>
</div></p>
<p>Quality was defined by participants’ views on things such as access, aesthetics, facilities, incivilities (e.g. litter, disrepair) and safety. Perceptions are important because the qualities of a green space need to resonate for people to visit them. </p>
<p>Regular visits to green spaces foster attachment and belonging. These spaces permit quiet contemplation in solitude, but also bring people together and connect people with nature. They become revered as settings for gatherings, bonding, cheering and shared memory-making.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-do-we-find-making-new-friends-so-hard-as-adults-171740">Why do we find making new friends so hard as adults?</a>
</strong>
</em>
</p>
<hr>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/uH0WZZjHMBA?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">World Urban Parks Congress presentations on NSW government investments in green space (by Dr Caroline Butler-Bowdon) and associated health and community benefits (by Professor Thomas Astell-Burt)</span></figcaption>
</figure>
<p>By encouraging relaxation and playfulness – which can be frowned upon in other settings – green spaces may also enable connection for people who otherwise find it difficult, such as those with highly introverted <a href="https://www.sciencedirect.com/science/article/pii/S0013935121018922">personalities</a>. </p>
<p>The psychologically restorative benefits of green space are now <a href="https://landscapeaustralia.com/articles/evidencing-the-benefits-of-green-space/">well-documented</a>. Green spaces such as <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)69920-0/fulltext">healing gardens</a> can serve as therapeutic landscapes, offering refuge and respite for those experiencing loneliness, which can stem from some form of trauma. While usually provided for patients, these settings might also offer sanctuaries for health professionals experiencing <a href="https://journals.sagepub.com/doi/full/10.1177/1039856220965045">burnout</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/4-ways-we-can-recover-from-the-loneliness-of-the-covid-pandemic-187856">4 ways we can recover from the loneliness of the COVID pandemic</a>
</strong>
</em>
</p>
<hr>
<p>The bottom line is that higher-quality green space maximises opportunities for both social connection and health. While our previous <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-292">research</a> and other studies highlight inequities in access to green space, we must pay even more attention to inequities in the quality of green space. </p>
<h2>Consult communities to get it right</h2>
<p>This may all sound like we think the impacts of green space are universally positive; we don’t. For instance, many studies in countries such as <a href="https://www.sjdr.se/articles/10.16993/sjdr.50/">Denmark</a>, <a href="https://www.mdpi.com/1660-4601/19/4/2018">Poland</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/33440760/">New Zealand</a> report that some people with disabilities, who are already vulnerable to loneliness, face significant barriers to visiting green spaces and may feel “out of place” within them. </p>
<p>Other research indicates that the creation or regeneration of green spaces in communities may be associated with <a href="https://journals.sagepub.com/doi/abs/10.1177/0309132518803799?journalCode=phgb">disempowerment and dispossession</a>, by making nearby housing less affordable.</p>
<p>In other words, a nearby green space that is highly attractive and a source of joy for some people may for others be a symbol of processes that aggravate loneliness and perpetuate misery. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/In6JMOx47DE?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">PBS News Hour: How ‘green gentrification’ is pricing out longtime East Boston residents.</span></figcaption>
</figure>
<p>That is why community views on the design of green space really matter. Consultation is key to ensure everyone feels meaningfully engaged in the process. </p>
<p>Our <a href="https://www.powerlab.site/">program of work</a>, and our new <a href="https://www.sciencedirect.com/science/article/pii/S0048969722046198">review</a> in particular, shows green space qualities depend on the context, preferences and needs of local residents. It is clear we need local networks of green spaces that provide something of value for everyone.</p>
<p>Finally, the process of urban greening itself can help counter loneliness by empowering communities to actively participate in creating and maintaining local green spaces. This has been done successfully over decades by the Royal Botanic Garden Sydney’s <a href="https://www.rbgsyd.nsw.gov.au/learn/community-greening">Community Greening program</a>. By bringing people together to create green spaces, the garden has been quietly showing us the solution to our lonelygenic environment all along.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/V-feCm1FDF8?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Community greening activities at the Royal Botanic Garden Sydney.</span></figcaption>
</figure><img src="https://counter.theconversation.com/content/188007/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Xiaoqi Feng works for the University of New South Wales and has received research funding from the National Health and Medical Research Council (NHMRC), the National Heart Foundation of Australia, and Hort Innovation Ltd.</span></em></p><p class="fine-print"><em><span>Thomas Astell-Burt works for the University of Wollongong and has received research funding from the National Health and Medical Research Council (NHMRC), the National Heart Foundation of Australia, and Hort Innovation Ltd.</span></em></p>When the pandemic hit, green space was there for us at a time when others weren’t or couldn’t be. Urban greening might be the solution to the ‘lonelygenic environment’ that our cities have created.Xiaoqi Feng, Associate Professor in Urban Health and Environment; NHMRC Career Development Fellow, UNSW SydneyThomas Astell-Burt, Professor of Population Health and Environmental Data Science, NHMRC Boosting Dementia Research Leadership Fellow, University of WollongongLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1878562022-08-03T20:04:47Z2022-08-03T20:04:47Z4 ways we can recover from the loneliness of the COVID pandemic<p>Loneliness has been a huge concern since the start of the COVID <a href="https://www.phrp.com.au/issues/june-2020-volume-30-issue-2/how-the-covid-19-pandemic-is-focusing-attention-on-loneliness-and-social-isolation/">pandemic</a>. One <a href="https://www.apa.org/pubs/journals/releases/amp-amp0001005.pdf">review</a> published in May, which looked at loneliness studies across many countries, found loneliness was more common since the start of pandemic.</p>
<p>The pandemic is far from over and our social routines and decisions continue to modify and adapt based on the health crisis. </p>
<p>So what can we do to reconnect and recover?</p>
<p>National health and community leaders have identified four actions to combat loneliness. These are detailed in a <a href="https://endingloneliness.com.au/ending-loneliness-together-white-paper-social-connection-to-accelerate-social-recovery">white paper</a> launched today at Parliament House.</p>
<h2>Loneliness has increased since COVID</h2>
<p>Loneliness was already <a href="https://pubmed.ncbi.nlm.nih.gov/35140066/">a growing problem</a> before COVID. <a href="https://www.psychweek.org.au/wp/wp-content/uploads/2018/11/Psychology-Week-2018-Australian-Loneliness-Report.pdf">One in four Australians</a> reported problematic levels of loneliness before the pandemic began – an estimated <a href="https://endingloneliness.com.au/wp-content/uploads/2020/11/Ending-Loneliness-Together-in-Australia_Nov20.pdf">5 million</a> Australians at any given time. </p>
<p>Since COVID began, this has only worsened. One <a href="https://www.mdpi.com/1660-4601/18/19/9982/htm">study</a> that covered 101 countries found at least 21% of people reported severe loneliness, compared with only 6% who reported the same levels before the public health crisis.</p>
<p>Even after social restrictions were eased in Australia, the United Kingdom and the United States, a study I led found people continued to experience high levels of social anxiety, which we know adds to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8995965/">loneliness</a>. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1293860173719547905"}"></div></p>
<h2>The costs of loneliness</h2>
<p>Loneliness isn’t unusual given it’s a natural human emotion. But when ignored or not effectively addressed, it can lead to poorer physical health.</p>
<p>Loneliness increases the risk of <a href="https://academic.oup.com/abm/article/55/3/203/5899648">heart disease, stroke, diabetes</a>, cognitive <a href="https://jnnp.bmj.com/content/85/2/135">decline</a> and poorer <a href="https://www.nature.com/articles/npp2016141">immunity</a>.</p>
<p>It’s also associated with negative impacts on our <a href="https://www.ncbi.nlm.nih.gov/pubmed/27124713">mental health</a>, including increasing depression, social anxiety and paranoia. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/loneliness-is-a-health-issue-and-needs-targeted-solutions-96262">Loneliness is a health issue, and needs targeted solutions</a>
</strong>
</em>
</p>
<hr>
<p>Persistent loneliness is associated with an 83% higher <a href="https://www.cambridge.org/core/journals/international-psychogeriatrics/article/abs/situational-versus-chronic-loneliness-as-risk-factors-for-allcause-mortality/9A0B94A0548C9D1CF29A051494394927">likelihood</a> of an earlier death in adults aged over 50, compared with 56% for situational loneliness (loneliness that occurs because of a specific situation and is more brief). </p>
<p>Due to the adverse impacts on our health, loneliness also has a negative effect on our economy. A 2021 <a href="https://bcec.edu.au/assets/2021/11/139532_BCEC-Stronger-Together-report_WEB.pdf">report</a> from Bankwest Curtin Economics Centre estimated the cost of loneliness at A$2.7 billion each year to the Australian economy, an equivalent annual cost of $1,565 for each person who becomes lonely.</p>
<h2>Improving our knowledge for effective action</h2>
<p>As a community, we have to understand what loneliness actually is. If we can understand what it is (and what it’s not), then we can take the right action. </p>
<p>People often confuse social isolation with loneliness, but they are distinct. Many solutions thought to be a cure for loneliness can increase social contact, and therefore reduce social isolation, but that doesn’t mean this reduces loneliness. Loneliness is subjective, so we won’t clearly know the true impact of these solutions on loneliness unless we ask people or better measure it. </p>
<p>We have different social needs and also different levels of access to resources. This means what can work for one person may not work for <a href="https://link.springer.com/article/10.1007/s00127-020-01889-7">another</a>.</p>
<p>For some people, their loneliness cannot be resolved easily because there are many things contributing to it that aren’t within the person’s control. Examples include having a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4636039/">chronic health condition</a>, or living in more socially deprived <a href="https://pubmed.ncbi.nlm.nih.gov/32456626/">neigbourhoods</a>. </p>
<p>A broad approach to addressing loneliness is therefore needed because once loneliness is triggered, it can be maintained through systemic barriers and policies that govern the way we live, work and play. This may require us, for example, to educate young people how to manage the dynamic nature of friendships as they transition from high school to further education and employment, or to ensure safe places and opportunities for co-workers to come together to form meaningful social connection.</p>
<p>This also builds the case for prevention and early intervention. Addressing loneliness earlier can mitigate the risk of developing more enduring forms of loneliness. </p>
<p>Australia is at risk of falling behind on addressing loneliness. There’s growing recognition around the world that addressing loneliness needs government support and policy changes. For example, the UK and Japan have appointed <a href="https://www.gov.uk/government/news/joint-message-from-the-uk-and-japanese-loneliness-ministers">government ministers</a> to address loneliness.</p>
<h2>4 actions to address loneliness</h2>
<p>Earlier this year, national health and community leaders gathered to develop Australia’s National Strategy to Address Loneliness and Social Isolation. This puts forward four key actions as a start, which are detailed in the <a href="https://endingloneliness.com.au/ending-loneliness-together-white-paper-social-connection-to-accelerate-social-recovery">white paper</a> launched today.</p>
<p>These four actions were developed to ensure all sectors of society are united in their understanding of loneliness. This will ensure evidence-based and cost-effective plans can be implemented to help people who feel lonely, and enable those around them to assist.</p>
<p><strong>Action 1: develop a strategic framework for social connection</strong></p>
<p>This involves all sectors from health, workplaces and communities coming together to develop a comprehensive evidence-based framework that can promote social connection, and address loneliness and social isolation. </p>
<p><strong>Action 2: strengthen our workforce capacity across all sectors</strong></p>
<p>This involves our workforce being supported to deliver evidence-based education, training, resources and practical solutions to people at risk of distressing or persistent loneliness. It involves up-skilling front-line practitioners from the health and community sectors, and people who work in our schools and workplaces, to identify and help people who are lonely.</p>
<p><strong>Action 3: empower our communities to help each other</strong></p>
<p>This involves increasing community awareness of the issue to ensure Australians of all ages, cultural backgrounds and many socially vulnerable groups feel able to ask for the help they need and to empower them to help others. </p>
<p><strong>Action 4: invest in Australian-based scientific research</strong></p>
<p>This involves significant government and industry investment in Australian-based scientific research to specifically target loneliness and to rapidly translate the evidence into practice and policy.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/i-tell-everyone-i-love-being-on-my-own-but-i-hate-it-what-older-australians-want-you-to-know-about-loneliness-166109">'I tell everyone I love being on my own, but I hate it': what older Australians want you to know about loneliness</a>
</strong>
</em>
</p>
<hr>
<p>These actions are only the tip of the iceberg in terms of what we can do. But taking them is the first step towards addressing the rising rates of loneliness in this country.</p>
<p>Inaction will be costly, especially as we attempt to recover from the COVID pandemic.</p><img src="https://counter.theconversation.com/content/187856/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle H Lim is the Chair and Scientific Chair of Ending Loneliness Together, a not-for-profit focused on combatting chronic loneliness in Australia. Dr Lim has been the recipient of the Barbara Dicker Brain Sciences Foundation grant, NHMRC Special Initiative in Mental Health. Dr Lim is also the co-director of the Global Initiative on Loneliness and Connection. </span></em></p>A white paper launched today reveals four actions governments, researchers and policymakers can take to combat loneliness.Michelle H Lim, Senior Lecturer and Clinical Psychologist, Swinburne University of TechnologyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1619892021-06-09T20:02:33Z2021-06-09T20:02:33ZPeople’s odds of loneliness could fall by up to half if cities hit 30% green space targets<figure><img src="https://images.theconversation.com/files/404651/original/file-20210606-10178-i06jfw.png?ixlib=rb-1.1.0&rect=0%2C0%2C1378%2C1031&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Photo: Thomas Astell-Burt </span>, <span class="license">Author provided</span></span></figcaption></figure><p><a href="https://psychweek.org.au/wp/wp-content/uploads/2018/11/Psychology-Week-2018-Australian-Loneliness-Report.pdf">One in four</a> Australians feel lonely on three or more days a week. Our <a href="https://doi.org/10.1093/ije/dyab089">longitudinal study</a>, just published in the International Journal of Epidemiology, finds adults in neighbourhoods where at least 30% of nearby land was parks, reserves and woodlands had 26% lower odds of becoming lonely compared to their peers in areas with less than 10% green space. For people living on their own, the associations were even greater – in areas with 30% or more green space the odds of becoming lonely halved.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/405273/original/file-20210609-13-tg29sv.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Chart showing decreasing odds of becoming lonely with increasing green space" src="https://images.theconversation.com/files/405273/original/file-20210609-13-tg29sv.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/405273/original/file-20210609-13-tg29sv.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=147&fit=crop&dpr=1 600w, https://images.theconversation.com/files/405273/original/file-20210609-13-tg29sv.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=147&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/405273/original/file-20210609-13-tg29sv.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=147&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/405273/original/file-20210609-13-tg29sv.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=185&fit=crop&dpr=1 754w, https://images.theconversation.com/files/405273/original/file-20210609-13-tg29sv.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=185&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/405273/original/file-20210609-13-tg29sv.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=185&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><a class="source" href="https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyab089/6289969">Chart: The Conversation. Data: Astell-Burt et al 2021</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>This is good news for cities around the world – including <a href="https://www.c40knowledgehub.org/s/article/Trees-for-Life-Master-Plan-for-Barcelona-s-Trees-2017-2037?language=en_US">Barcelona</a>, <a href="https://www.environment.act.gov.au/__data/assets/pdf_file/0005/1413770/Canberras-Living-Infrastructure-Plan.pdf">Canberra</a>, <a href="https://www.seattle.gov/trees/management/canopy-cover">Seattle</a> and <a href="https://vancouver.ca/news-calendar/park-board-achieves-target-to-plant-150000-trees-by-2020.aspx">Vancouver</a> – that have set targets of 30% green cover. It’s even better news for the <a href="https://www.medianet.com.au/releases/198075/">City of Sydney</a> and the <a href="https://www.melbourne.vic.gov.au/community/greening-the-city/urban-forest/Pages/urban-forest-strategy.aspx">City of Melbourne</a>, which have targets of 40% green cover by 2050 and 2040 respectively.</p>
<p>Our study used <a href="https://melbourneinstitute.unimelb.edu.au/hilda">data from the HILDA Survey</a> on 6,766 adults in cities across Australia who were not lonely in 2013. We assessed association between urban green space availability within 1.6km of home (a commonly used “walkable” distance in public health and urban planning) at the start and the cumulative incidence of loneliness reported four years later, which was about 12% overall. We took into account competing explanations for loneliness, such as differences in age, income, employment and disability. </p>
<p>We focused on publicly accessible green space categorised as parkland by the Australian Bureau of Statistics. This <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/1270.0.55.001%7EJuly%202016%7EMain%20Features%7EMesh%20Blocks%20(MB)%7E10012">green space data</a> focuses on discrete green spaces where gatherings and chance encounters with neighbours might occur. This meant the analysis excluded private gardens, which offer alternative spaces where people might gather but are not always available (e.g. for people living in apartments).</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/lonely-in-lockdown-youre-not-alone-1-in-2-australians-feel-more-lonely-since-coronavirus-142724">Lonely in lockdown? You're not alone. 1 in 2 Australians feel more lonely since coronavirus</a>
</strong>
</em>
</p>
<hr>
<h2>Benefits are even stronger for people living alone</h2>
<p>Loneliness can affect anyone – it’s the state of <em>feeling</em> alone, not simply <em>being</em> alone. You can feel perfectly content and connected while in solitude. You can also feel lonely in a crowded room.</p>
<p>That said, our study did find the odds of becoming lonely doubled among adults living alone compared with those in a couple. Lone-person households have become <a href="https://www.tandfonline.com/doi/full/10.1080/03071022.2017.1256093">more common</a> in many countries. One in four Australian homes were <a href="https://www.aihw.gov.au/reports/australias-welfare/social-isolation-and-loneliness">lone-person households</a> in the 2016 Census.</p>
<p>It is good news, then, that our study also found the odds of becoming lonely went down 52% among adults living alone in areas with more than 30% green space compared with those in areas with less than 10%. In other words, meeting urban greening targets could be especially important for the large numbers of people who live alone.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/405275/original/file-20210609-6177-ij1guh.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Chart showing decreases in odds of loneliness among adults living alone compared to areas with less than 10% green space" src="https://images.theconversation.com/files/405275/original/file-20210609-6177-ij1guh.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/405275/original/file-20210609-6177-ij1guh.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=147&fit=crop&dpr=1 600w, https://images.theconversation.com/files/405275/original/file-20210609-6177-ij1guh.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=147&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/405275/original/file-20210609-6177-ij1guh.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=147&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/405275/original/file-20210609-6177-ij1guh.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=185&fit=crop&dpr=1 754w, https://images.theconversation.com/files/405275/original/file-20210609-6177-ij1guh.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=185&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/405275/original/file-20210609-6177-ij1guh.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=185&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption"></span>
<span class="attribution"><a class="source" href="https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyab089/6289969">Chart: The Conversation. Data: Astell-Burt et al 2021</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/i-really-have-thought-this-cant-go-on-loneliness-looms-for-rising-numbers-of-older-private-renters-118046">'I really have thought this can’t go on': loneliness looms for rising numbers of older private renters</a>
</strong>
</em>
</p>
<hr>
<h2>Why reducing loneliness matters</h2>
<p>Reducing loneliness has many potential impacts on health. Increasing evidence links feeling lonely with increased risks of <a href="https://pubmed.ncbi.nlm.nih.gov/29792097/">depression</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/27091846/">heart disease</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/32092313/">inflammation</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/30914351/">dementia</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/25910392/">death</a>. </p>
<p><a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-8251-6">Research</a> indicates there is no one-size-fits-all treatment for loneliness. Some have called for a “<a href="https://agmr.hapres.com/htmls/AGMR_1255_Detail.html">precision health</a>” approach using machine learning of biomarker data to afford new understandings of loneliness. </p>
<p>However, we need to be careful <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30577-4/fulltext">not to “medicalise’” loneliness</a>, as if it were a disease that could be simply <a href="https://clinicaltrials.gov/ct2/show/NCT02826577">treated with medication</a>. </p>
<p>Better evidence is needed to develop effective and scalable public policies focused on prevention. Some of our best options might actually come from outside the health sector.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/designing-cities-to-counter-loneliness-lets-explore-the-possibilities-104853">Designing cities to counter loneliness? Let's explore the possibilities</a>
</strong>
</em>
</p>
<hr>
<h2>Does more green space equal more social contact?</h2>
<p>International evidence affirms the importance of protecting nature for supporting <a href="https://science.sciencemag.org/content/352/6288/938.full">population health</a> and for <a href="https://science.sciencemag.org/content/365/6448/76">minimising climate change</a>. Evidence in Australia indicates urban greening – and urban reforestation in particular – could also help to reduce risks of <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2739050">psychological distress</a>, <a href="https://www.sciencedirect.com/science/article/pii/S2352827319301703?via%3Dihub">lack of sleep</a>, <a href="https://academic.oup.com/ije/article/49/3/926/5625172">cardiometabolic diseases</a>, <a href="https://www.sciencedirect.com/science/article/pii/S1353829219303557">subjective memory complaints</a> and maybe even <a href="https://www.sciencedirect.com/science/article/pii/S0160412020320572?via%3Dihub">dementia</a>. Reducing loneliness might be an important way in which contact with green space produces these potential benefits.</p>
<p>A possible mechanism to explain the link between green space and loneliness is the sharing of familiar natural settings that help to <a href="https://www.tandfonline.com/doi/abs/10.1080/17439760.2014.994224">enhance mood</a> and <a href="https://www.pnas.org/content/112/28/8567">interrupt rumination</a>. This is thought to provide collective relief from social anxieties and enable people of all ages to play and connect with each other in meaningful, life-affirming ways. </p>
<p>These opportunities can be much rarer in less restorative environments, such as parts of cities with few trees and sparsely vegetated areas. Our research indicates that this is more often the case in socioeconomically disadvantaged communities in <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-292">Australian cities</a>. Urban greening strategies must address this disparity to help reduce population health inequities.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/spending-time-in-nature-has-always-been-important-but-now-its-an-essential-part-of-coping-with-the-pandemic-153073">Spending time in nature has always been important, but now it's an essential part of coping with the pandemic</a>
</strong>
</em>
</p>
<hr>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/404654/original/file-20210606-28372-w18ani.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/404654/original/file-20210606-28372-w18ani.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/404654/original/file-20210606-28372-w18ani.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/404654/original/file-20210606-28372-w18ani.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/404654/original/file-20210606-28372-w18ani.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/404654/original/file-20210606-28372-w18ani.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/404654/original/file-20210606-28372-w18ani.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Green spaces provide natural settings where everyone can play and connect.</span>
<span class="attribution"><span class="source">Photo: Thomas Astell-Burt</span></span>
</figcaption>
</figure>
<p><a href="https://www.theguardian.com/lifeandstyle/2020/apr/20/the-coronavirus-has-made-me-so-grateful-for-city-parks-we-should-fight-for-them">Anecdotal</a> and survey evidence in <a href="https://www.mdpi.com/1660-4601/18/5/2757/htm">Australia</a> and the <a href="https://bmjopen.bmj.com/content/11/3/e044067">UK</a> indicates how important our local green spaces are for connecting and coping with COVID-19 lockdowns. Despite this, evidence actually remains limited on the extent to which green space may reduce loneliness and how.</p>
<p>Another possible mechanism is that some people may prefer to “lean on green”. This refers to seeking contact with nature, in the absence of other people, for what many feel is more dependable, <a href="https://www.sciencedirect.com/science/article/pii/S135382921931158X">non-judgmental support</a>.</p>
<p>However, a surprising finding from our study was that more green space <em>did not</em> provide relief from loneliness among the 1,282 adults in our sample who were lonely in 2013. We hypothesise, but were unable to test, that this was due to decreased visits to green space. Urban greening might help to reduce the odds of <em>becoming</em> lonely, but those who <em>are</em> already lonely might need more support. </p>
<figure class="align-center ">
<img alt="Woman sits alone on a bench next to lake and trees in a park" src="https://images.theconversation.com/files/404655/original/file-20210606-28218-1plz0ze.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/404655/original/file-20210606-28218-1plz0ze.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=403&fit=crop&dpr=1 600w, https://images.theconversation.com/files/404655/original/file-20210606-28218-1plz0ze.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=403&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/404655/original/file-20210606-28218-1plz0ze.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=403&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/404655/original/file-20210606-28218-1plz0ze.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=506&fit=crop&dpr=1 754w, https://images.theconversation.com/files/404655/original/file-20210606-28218-1plz0ze.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=506&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/404655/original/file-20210606-28218-1plz0ze.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=506&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Some people may seek solitude in nature for non-judgmental support.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/cjrULwnJKhI">Josephine Baran/Unsplash</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/green-prescriptions-should-your-doctor-send-you-for-a-walk-in-the-park-143231">Green prescriptions: should your doctor send you for a walk in the park?</a>
</strong>
</em>
</p>
<hr>
<h2>Should we be ‘prescribing’ nature?</h2>
<p>This support may come in the form of providing regular social activities in green space, such as <a href="https://www.rbgsyd.nsw.gov.au/Stories/2021/Nature-Therapy-Walks-at-the-Garden">nature therapy walks</a>. In some cases this might even take the form of a “nature prescription” from a <a href="https://www.parkprescriptions.ca/en/about">general practitioner</a>. This is a form of “social prescription”, which has recently been <a href="https://www.racgp.org.au/FSDEDEV/media/documents/RACGP/Advocacy/Social-prescribing-report-and-recommendation.pdf">discussed</a> by the Royal Australian College of General Practitioners and is being tested in the UK’s <a href="https://www.england.nhs.uk/personalisedcare/social-prescribing/green-social-prescribing/">National Health Service</a>. </p>
<p>Approaches like these hold great promise for helping to reduce loneliness and inequities in well-being, if they enable regular contact with nature in safe, positive and sustained ways for people who didn’t have this before.</p>
<p><a href="https://www.mdpi.com/1660-4601/17/12/4213">Better research</a> is needed to fully understand what nature prescriptions are acceptable. Economic, cultural and climatic differences might matter greatly.</p>
<p>We also need to know what nature prescriptions are cost-effective and sustainable at scale, in comparison to alternative strategies for reducing loneliness. Co-benefits of nature contact should also be factored in, such as potential improvements in <a href="https://theconversation.com/increasing-tree-cover-may-be-like-a-superfood-for-community-mental-health-119930">mental health</a>, health-related behaviours like <a href="https://theconversation.com/more-green-more-zzzzz-trees-may-help-us-sleep-132354">sleep</a>, and nurturing of <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2020.00859/full">pro-social</a> and <a href="https://www.sciencedirect.com/science/article/pii/S0160412019313492">pro-environmental behaviour</a> such as recycling.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/7FS1xQsnI_I?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Regular contact with nature has many benefits for health and well-being.</span></figcaption>
</figure>
<p>Investment in randomised controlled trials is needed to ensure programs are based on the best possible evidence of what works, where, when and for whom, to ensure everyone reaps the rewards of urban greening.</p>
<hr>
<p><em>This article is based on a <a href="https://doi.org/10.1093/ije/dyab089">study</a> led by the authors, who wish to acknowledge their co-authors, Terry Hartig, Simon Eckermann, Mark Nieuwenhuijsen, Anne McMunn and Howard Frumkin.</em></p><img src="https://counter.theconversation.com/content/161989/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Thomas Astell-Burt is employed by the University of Wollongong and receives funding from the National Health and Medical Research Council and Hort Innovation Ltd.</span></em></p><p class="fine-print"><em><span>Xiaoqi Feng is employed by the University of New South Wales and receives funding from the National Health and Medical Research Council and Hort Innovation Ltd.</span></em></p>For the areas of cities with less than 10% green space, increasing that to 30% could cut the overall odds of residents becoming lonely by a quarter.Thomas Astell-Burt, Professor of Population Health and Environmental Data Science, NHMRC Boosting Dementia Research Leadership Fellow, University of WollongongXiaoqi Feng, Associate Professor in Urban Health and Environment; NHMRC Career Development Fellow, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1439872020-08-13T03:14:55Z2020-08-13T03:14:55ZIt’s hard to admit we’re lonely, even to ourselves. Here are the signs and how to manage them<figure><img src="https://images.theconversation.com/files/352195/original/file-20200811-22-b4z6qr.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5472%2C3645&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>The COVID-19 pandemic has drawn <a href="https://www.phrp.com.au/issues/june-2020-volume-30-issue-2/how-the-covid-19-pandemic-is-focusing-attention-on-loneliness-and-social-isolation/">attention</a> to loneliness in Australia. </p>
<p>This is especially so as Melburnians entered the <a href="https://theconversation.com/state-of-disaster-called-as-melbourne-moves-to-nightly-curfew-and-stage-4-restrictions-143804">strictest lockdown to date</a>. Meanwhile, the rest of Australia braces for the possibility of a second wave and people are adapting to new habits and restrictions.</p>
<p>This has disrupted our social routines, and in many cases has reduced the number of people we interact with. This makes it harder to maintain meaningful social connections, resulting in loneliness. </p>
<p>But sometimes it can be difficult to tell if you’re feeling lonely or feeling something else. And many people are reluctant to admit they’re lonely for fear it makes them seem deficient in some way. </p>
<p>So what are the signs of loneliness? And how can we recognise these signs and therefore manage them?</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/lonely-in-lockdown-youre-not-alone-1-in-2-australians-feel-more-lonely-since-coronavirus-142724">Lonely in lockdown? You're not alone. 1 in 2 Australians feel more lonely since coronavirus</a>
</strong>
</em>
</p>
<hr>
<h2>I’m not lonely…</h2>
<p>Loneliness is complex. Some people can feel lonely despite having extensive networks, while some others might not, even if they live alone. There are many factors behind this, and the COVID-19 pandemic is another significant one. </p>
<p>Social restrictions during the pandemic mean we are more reliant on existing relationships. People who enjoy brief but multiple social interactions in their daily routine, or simply like being around others, may now find it harder to keep loneliness at bay. </p>
<p>When researchers ask people whether they’re lonely, some deny or reject the idea. But when asked in a different way, like whether they want some company, some of those same people would say yes, they would like company. </p>
<p>This is because there’s a <a href="https://journals.sagepub.com/doi/citedby/10.1177/0146167292182009#top-content-scroll">social stigma to loneliness</a>. We often think it is somehow our own fault or that it reveals some personal shortcoming. Loneliness evokes a particularly vulnerable image, of someone living alone with no one around them.</p>
<p>One survey also found men are <a href="https://journals.sagepub.com/doi/10.2190/AG.78.3.b">less likely</a> to say they’re feeling lonely, although this research was published before COVID-19.</p>
<p>“Max”, aged 21, was interviewed as part of an upcoming project being done by <a href="https://www.endingloneliness.com.au">Ending Loneliness Together</a>, an organisation that addresses loneliness in Australia. He has experienced periods of loneliness, and said:</p>
<blockquote>
<p>I think specifically for men, [they] lock themselves away because they don’t know how to verbalise that feeling. It demonstrates the real disparity in the way in which we expect our men to engage in their emotions.</p>
</blockquote>
<figure class="align-center ">
<img alt="Man lying in bed looking lonely" src="https://images.theconversation.com/files/351910/original/file-20200810-16-olpn6d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/351910/original/file-20200810-16-olpn6d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=457&fit=crop&dpr=1 600w, https://images.theconversation.com/files/351910/original/file-20200810-16-olpn6d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=457&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/351910/original/file-20200810-16-olpn6d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=457&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/351910/original/file-20200810-16-olpn6d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=575&fit=crop&dpr=1 754w, https://images.theconversation.com/files/351910/original/file-20200810-16-olpn6d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=575&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/351910/original/file-20200810-16-olpn6d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=575&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Men are less likely than women to say they’re feeling lonely, even if they are.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>Because of these misconceptions, many who are lonely will overlook their own emerging signs of loneliness in the hope these feelings will go away once they are around people. But seemingly logical solutions like making more friends or knowing more people may not help, if you perceive these relationships to be unhelpful, neutral, ambivalent, or even <a href="https://psycnet.apa.org/record/2009-05887-004">sources of conflict</a>.</p>
<p>Nevertheless, ignoring growing levels of loneliness will increase our risk of developing poorer <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874845/pdf/nihms538929.pdf">physical and mental health</a>. </p>
<h2>Signs you might be lonely</h2>
<p>Loneliness is a normal signal to connect with others, so it’s unlikely you’ll be able to rid yourself completely of lonely feelings during this time. Instead, we should aim to manage our loneliness so it doesn’t become severely distressing.</p>
<p>More often than not, we might not be willing to admit even to ourselves that we’re feeling lonely. The COVID-19 pandemic may be a trigger, but there is a <a href="https://pubmed.ncbi.nlm.nih.gov/32524169/">range of factors</a> that can lead you to feel lonely, sometimes without even realising.</p>
<p>This can make it hard to be consciously aware of any loneliness you might be experiencing, particularly if the pandemic has left you feeling busier and more stressed than usual. </p>
<p>Here are some signs you might be feeling lonely. To a certain extent, you feel that:</p>
<ul>
<li><p>you are not “in tune” with others</p></li>
<li><p>your relationships are not meaningful</p></li>
<li><p>you do not belong </p></li>
<li><p>you do not have a group of friends</p></li>
<li><p>no one understands you</p></li>
<li><p>you do not have shared interests with others</p></li>
<li><p>there is no one you can turn to.</p></li>
</ul>
<p>It’s important to remember, though, not all of these may relate to you and you may experience these in varying degrees.</p>
<figure class="align-center ">
<img alt="Woman staring at computer screen" src="https://images.theconversation.com/files/352433/original/file-20200812-18-1ef252z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/352433/original/file-20200812-18-1ef252z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/352433/original/file-20200812-18-1ef252z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/352433/original/file-20200812-18-1ef252z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/352433/original/file-20200812-18-1ef252z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/352433/original/file-20200812-18-1ef252z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/352433/original/file-20200812-18-1ef252z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">We’re often hesitant to admit we’re lonely because of the stigma associated with loneliness — that it’s somehow our fault or we’re deficient in some way.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>How to manage your loneliness</h2>
<p>Because of the complexity of loneliness, there is no one-size-fits-all solution. To find the best solution for you, reflect on your personal preferences, previous experience, and your capacity to reach out to your social networks.</p>
<p>During the pandemic, the solutions you select will differ depending on the social restrictions in your state. Even under the strictest social restrictions (in Melbourne), some of us have been fortunate to have a friend or a neighbour in our area with whom we can walk and chat while still adhering to public health directives. For others, getting in touch via Zoom or a phone call may be the only option.</p>
<p>For those who can, establishing shared goals or activities with friends, family, or colleagues can be helpful. These provide positive social support and facilitate a sense of achievement when meeting those goals. This might include setting self-care goals such as exercise, meditation, cooking, hobbies, or learning new skills. But equally, it’s not a sign of “failure” if you don’t do these things.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1289861749957517312"}"></div></p>
<p>Friendships are good for our health, but making a new friend can be <a href="https://www.sciencedirect.com/science/article/pii/S1364661317302243">taxing</a> for some people. </p>
<p>Instead, perhaps think about how you can work on existing relationships. Pick what feels right and is feasible for you. If improving the ties you already hold is all you can do, focus on this. And if you are reaching out to people outside your familiar network, it doesn’t have to be confronting. A simple hello is a small step towards more meaningful interactions in the future. </p>
<p>Social restrictions including isolation, quarantining, and social distancing are public health measures we’ve become acquainted with since the onset of COVID-19. Although these restrictions modify our social interactions physically, they don’t mean we can’t stay meaningfully connected to each other. This is why many prefer the alternative term “<a href="https://www.vichealth.vic.gov.au/be-healthy/social-distancing-is-purely-physical">physical distancing</a>”. </p>
<p>We can, and should, stay socially connected while being physically apart.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/loneliness-is-a-social-cancer-every-bit-as-alarming-as-cancer-itself-126741">Loneliness is a social cancer, every bit as alarming as cancer itself</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/143987/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle H Lim is the scientific chair of Ending Loneliness Together</span></em></p>Many who are lonely will overlook their own emerging signs of loneliness in hope these feelings will go away once around other people.Michelle H Lim, Senior Lecturer and Clinical Psychologist, Swinburne University of TechnologyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1267412019-11-18T19:20:47Z2019-11-18T19:20:47ZLoneliness is a social cancer, every bit as alarming as cancer itself<figure><img src="https://images.theconversation.com/files/301686/original/file-20191114-77291-n1zlj5.jpg?ixlib=rb-1.1.0&rect=2%2C4%2C995%2C661&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Young adults and people living in the inner city are among those most likely to be lonely, according to the ABC's Australia Talks project.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/ptsd-mental-health-concept-young-depressed-1157218930?src=4a53bdd8-daa3-4645-a20d-c6a8a4873940-1-8&studio=1">from www.shutterstock.com</a></span></figcaption></figure><p>The ABC’s <a href="https://www.abc.net.au/news/2019-10-06/australia-talks-explained/11570332">Australia Talks</a> project aims to stimulate a conversation on a broad sweep of topics — from job security and sexual habits to national pride and personal finances.</p>
<p>The project is based on the results of a representative survey of more than 50,000 Australians.</p>
<p>One question the ABC’s promotional material focused on was “Are you lonely?” And when ABC chair Ita Buttrose <a href="https://www.abc.net.au/news/2019-10-08/annabel-crabb-australia-talks-what-australians-worry-about/11579644">was asked</a> what she thought was the most surprising and disturbing feature of the whole exercise, she singled out the data on loneliness.</p>
<p>So, does loneliness deserve this billing? Is it really as important an issue as climate change, the economy, or education? We believe it is, and importantly, results from the Australia Talks survey help explain why.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/1-in-3-young-adults-is-lonely-and-it-affects-their-mental-health-124267">1 in 3 young adults is lonely – and it affects their mental health</a>
</strong>
</em>
</p>
<hr>
<h2>Loneliness kills</h2>
<p>First, loneliness is a killer. <a href="https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000316">An influential meta-analysis</a>, which collated and analysed the results of nearly 150 studies, underlines the impact on health of loneliness, or more specifically, lack of social integration and social support.</p>
<p>It found loneliness increases the risk of death more than such things as poor diet, obesity, alcohol consumption, and lack of exercise, and that it is as harmful as heavy smoking.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/dogs-really-can-chase-away-loneliness-125495">Dogs really can chase away loneliness</a>
</strong>
</em>
</p>
<hr>
<h2>People don’t know loneliness kills</h2>
<p>Second, most people generally don’t know loneliness kills. Indeed, some of <a href="https://www.sciencedirect.com/science/article/pii/S0277953617307505?via%3Dihub">our own research</a> found when people in the United Kingdom and United States were asked to rank how important they thought various factors were for health, social integration and social support were at the bottom of their lists. </p>
<p>Yet, in a forthcoming paper, we found the quality of social connections is around four times more important as a predictor of retirees’ physical and mental health than the state of their finances.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/301688/original/file-20191114-77291-1fuupxh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/301688/original/file-20191114-77291-1fuupxh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/301688/original/file-20191114-77291-1fuupxh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/301688/original/file-20191114-77291-1fuupxh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/301688/original/file-20191114-77291-1fuupxh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/301688/original/file-20191114-77291-1fuupxh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/301688/original/file-20191114-77291-1fuupxh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/301688/original/file-20191114-77291-1fuupxh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">When people retire, the quality of their social connections is a much more important predictor of their physical and mental health than how rich they are.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/group-active-senior-women-doing-aqua-487107589">from www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>But when was the last time you saw an advert on TV telling you to get your social life in order (rather than your pension plan) before you stop working? When was the last time a health campaign or your family doctor warned you of the dangers of loneliness?</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/i-really-have-thought-this-cant-go-on-loneliness-looms-for-rising-numbers-of-older-private-renters-118046">'I really have thought this can’t go on': loneliness looms for rising numbers of older private renters</a>
</strong>
</em>
</p>
<hr>
<p>Our ignorance about the health consequences of loneliness is a reflection of the fact that loneliness is not part of our everyday conversations around health. </p>
<p>Hopefully, the Australia Talks project will change that. In the process, its findings also give us plenty of things to talk about.</p>
<h2>Who’s feeling lonely?</h2>
<p>The most striking finding from the Australia Talks national survey is simply how pervasive loneliness is in Australia today. Indeed, only half (54%) of participants reported “rarely” or “never” feeling lonely.</p>
<p>The survey also finds loneliness is a particular challenge for certain sections of the community. Of these, four stand out.</p>
<p><strong>1. Young people</strong></p>
<p>Among people aged 18-24, only a third (32%) “rarely” or “never” feel lonely. More than a quarter (30%) said they felt lonely “frequently” or “always”.</p>
<p>This compares sharply with the situation for older people, over two-thirds of whom (71%) “rarely” or “never” feel lonely. The fact that our <a href="https://core.ac.uk/download/pdf/22876368.pdf">image of a lonely person</a> is typically someone of advanced years suggests we need to update our data (and our thinking).</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/social-media-is-it-really-to-blame-for-young-people-being-lonelier-than-any-other-age-group-104292">Social media: is it really to blame for young people being lonelier than any other age group?</a>
</strong>
</em>
</p>
<hr>
<p><strong>2. Inner-city dwellers</strong></p>
<p>The second group for whom loneliness emerges as a particular problem are people living in inner cities. </p>
<p>Compared to people who live in rural areas, those in inner metropolitan areas are less likely to say that they “never” feel lonely (15% vs 20%), but much more likely to say that they “occasionally”, “frequently”, or “always” do (50% vs 42%).</p>
<p>Again, this runs counter to much of the discourse around loneliness, which often focuses on the plight of those who are physical remote from others. </p>
<p>But this speaks to the psychological reality of loneliness. As we note in our recent book <a href="https://www.routledge.com/The-New-Psychology-of-Health-Unlocking-the-Social-Cure/Haslam-Jetten-Cruwys-Dingle-Haslam/p/book/9781138123885">The New Psychology of Health</a>, people’s health and well-being is very much linked to the strength of their connection to, and <a href="https://journals.sagepub.com/doi/10.1177/1088868314523839">identification with, groups and communities</a> of various forms.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/many-people-feel-lonely-in-the-city-but-perhaps-third-places-can-help-with-that-92847">Many people feel lonely in the city, but perhaps 'third places' can help with that</a>
</strong>
</em>
</p>
<hr>
<p><strong>3. One Nation voters</strong></p>
<p>Interestingly, a third group that reports disproportionately high levels of loneliness is One Nation voters. Nearly one in ten (9%) of Pauline Hanson’s followers report being lonely “always” compared to around 2% for followers of each of the other parties. </p>
<p>We believe feeling disconnected from the world and its institutions often drives people to find solace in marginal political movements. This indeed, is the <a href="https://onlinelibrary.wiley.com/doi/full/10.1348/014466605X48998">developmental trajectory of multiple forms of extremism</a>. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-far-rights-creeping-influence-on-australian-politics-93723">The far-right's creeping influence on Australian politics</a>
</strong>
</em>
</p>
<hr>
<p><strong>4. People on low incomes</strong></p>
<p>Perhaps the most stark finding concerns the fourth predictor of loneliness: poverty. While 21% of people who earn less than A$600 a week feel lonely “frequently” or “always”, the comparable figure for people who earn more than A$3,000 a week is less than half that (10%). </p>
<p>This speaks to the more general (but often neglected) fact that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2920957/">around the world</a> poverty is one of the biggest predictors of <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00150-6/fulltext">poor health</a>, especially depression and other mental illnesses. </p>
<p>It also speaks to our observation that if you are fortunate enough to have a lot of money <a href="https://spssi.onlinelibrary.wiley.com/doi/10.1111/sipr.12049">when you retire</a>, then one of the key things this allows you to do is to maintain and build social connections.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-we-could-make-the-retirement-system-more-sustainable-78185">How we could make the retirement system more sustainable</a>
</strong>
</em>
</p>
<hr>
<h2>What can we do about loneliness?</h2>
<p>So, there is a lot here for us to talk about when it comes to loneliness. This discussion also needs to ask what we are going to do to address a social cancer every bit as alarming as cancer itself. </p>
<p>For us, a large part of the answer lies in <a href="https://psycnet.apa.org/fulltext/2019-47128-002.html">efforts to rebuild group-based social connections</a> that are eroded by the tyrannies of modern life.</p>
<p>This is a world where all types of community — families, neighbourhoods, churches, political parties, trade unions and even stable work groups — are constantly under threat. So let’s get talking.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/designing-cities-to-counter-loneliness-lets-explore-the-possibilities-104853">Designing cities to counter loneliness? Let's explore the possibilities</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/126741/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alex Haslam receives funding from the Australian Research Council. He was a member of the Scientific Advisory Board for the ABC's Australia Talks project</span></em></p><p class="fine-print"><em><span>Catherine Haslam receives funding from the Australian Research Council and the Department of Veterans Affairs</span></em></p><p class="fine-print"><em><span>Tegan Cruwys receives funding from the National Health and Medical Research Council and the Australian Research Council. </span></em></p>Loneliness is a bigger cause of death than a poor diet, obesity, alcohol consumption, and lack of exercise, and it’s on a par with heavy smoking. So let’s get talking about it.Alex Haslam, Professor of Psychology and ARC Laureate Fellow, The University of QueenslandCatherine Haslam, Professor, School of Psychology, Faculty of Health and Behavioural Sciences, The University of QueenslandTegan Cruwys, Senior research fellow and clinical psychologist, Australian National UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1263142019-11-13T11:21:13Z2019-11-13T11:21:13ZHow simple policy changes can help us age better and prevent cognitive decline<figure><img src="https://images.theconversation.com/files/301373/original/file-20191112-178511-r00zvz.jpg?ixlib=rb-1.1.0&rect=0%2C6%2C4193%2C2785&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Ensuring older people can continue to socialise is important for preventing loneliness and cognitive decline. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/group-senior-friends-chatting-416231764?src=750ff30e-cf7f-44e0-9e41-3d5b64188ddb-1-2">Pressmaster/ Shutterstock</a></span></figcaption></figure><p>Many people experience a decline in cognitive function with age, such as a worsening memory and trouble processing information. In most cases, this is perfectly normal. In some cases, however, age-related cognitive decline may affect a person’s ability to carry out complex tasks, such as managing finances or preparing a meal. At times, it may even make it difficult for a person to perform daily tasks, such as dressing and feeding. </p>
<p>Around 18% of the UK’s population is <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/articles/overviewoftheukpopulation/july2017">aged 65 and older</a>. By 2030, it’s estimated that <a href="https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/later_life_uk_factsheet.pdf">one in five UK people</a> will be aged over 65. </p>
<p>But this doesn’t account for the number of people who will experience cognitive decline and dementia as they age. Incidence of dementia sharply rises at the age of 75 – and it is expected that the number of people in the UK living with dementia <a href="https://www.ncbi.nlm.nih.gov/books/NBK513075/">could triple by 2050</a>. Cognitive function is very important to older people’s well-being. It influences <a href="https://www.ncbi.nlm.nih.gov/books/NBK513075/">everything they do</a>, including working and socialising, and has a huge social and economic impact on families. Finding ways to prevent cognitive decline is increasingly important.</p>
<p>We’re often told that the solution to cognitive decline lies in <a href="https://www.alz.co.uk/news/biogen-and-eisai-announce-plans-to-file-for-market-approval-of-alzheimers-drug">new medicines or therapies</a> that can reduce symptoms, or by following a <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32350-9/fulltext">healthy lifestyle</a>. </p>
<p>But recent research by our team found that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3950961/">social and emotional well-being</a> – meaning our feelings of being connected to family and the community, and our subjective experience of positive or negative emotions – may be just as important as therapy and lifestyle for maintaining good cognitive function in older age. <a href="https://g2aging.org/">Numerous studies</a> from around the world have found that social connectedness and loneliness influence older people’s cognitive function, including their memory. </p>
<p>Loneliness affects <a href="https://www.tandfonline.com/doi/abs/10.1080/00223980.2011.609572">approximately 9% of people</a> over 65 in the UK. It’s a complex emotional state where people perceive their social interactions and individual relationships to be inadequate. </p>
<p><a href="https://www.elsa-project.ac.uk/">One major study on ageing</a> – which collects data from more than 18,000 UK over-50s about physical and mental health, well-being, finances and attitudes towards ageing – found that isolation and loneliness were associated with poorer memory, especially among those with lower levels of education. In addition, loneliness in older age was associated with a <a href="https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyz085/5485775">steeper decline in cognitive function</a>. This included worse memory and verbal fluency. </p>
<h2>Cognitive decline and loneliness</h2>
<p>Although these findings are staggering, they also show us how difficult it is to establish if loneliness causes cognitive decline, or if cognitive decline causes loneliness. One way to find out is by looking at whether interventions to reduce loneliness also inadvertently affect older people’s cognitive health too. </p>
<p>We addressed this question in a series of studies looking at the impact that free bus travel had on over-60s. When the UK government gave free bus travel to people over 60 in 2006, it was thought that the measure may reduce loneliness and increase social engagement as it enables older people to remain connected to their social environments. </p>
<p><a href="https://academic.oup.com/aje/article/188/10/1774/5525029">We found</a> that free bus travel significantly increased public transportation use but, in addition, it led to improvements in cognitive function – particularly, improved memory. </p>
<p><a href="https://jech.bmj.com/content/72/5/361">In another study</a>, we found that increased public transportation use also reduced depression and feelings of loneliness. It increased participation in volunteering activities and contact with older people’s adult children and friends. These findings show how a simple policy has had unintended positive consequences. It led to significant improvements in older people’s cognitive function and mental health – potentially by influencing social well-being. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/301515/original/file-20191113-77363-1fddgvg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/301515/original/file-20191113-77363-1fddgvg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=418&fit=crop&dpr=1 600w, https://images.theconversation.com/files/301515/original/file-20191113-77363-1fddgvg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=418&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/301515/original/file-20191113-77363-1fddgvg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=418&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/301515/original/file-20191113-77363-1fddgvg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=525&fit=crop&dpr=1 754w, https://images.theconversation.com/files/301515/original/file-20191113-77363-1fddgvg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=525&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/301515/original/file-20191113-77363-1fddgvg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=525&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Public transport increased community participation, which improved cognitive function and well-being.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/nottingham-nottinghamshire-uk-05282017-three-old-1092811700?src=39224da0-c962-4edc-840b-0128cd0be1dd-1-18&studio=1">Simon Annable/ Shutterstock</a></span>
</figcaption>
</figure>
<p>This isn’t the first time we’ve found how social policy changes can help protecting older people against cognitive decline. For example, <a href="https://jech.bmj.com/content/73/4/370">we examined the impact</a> of a French law that increased the minimum legal school leaving age by 2 years in 1959, from 14 to 16 years of age.</p>
<p>This law effectively increased the years of schooling for French adults presently reaching old age. We found that even decades after leaving school, a longer period in education helped older adults maintain cognitive function – particularly memory – and postponed cognitive decline. </p>
<p>Even policies that affect the whole economy have been found to be an important factor in health and memory. We found that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018975/">older people exposed to an economic recession</a> in the years leading up to their retirement experience faster cognitive decline in their post-retirement years. This suggests that policies that protect older people from the impact of economic decline might help them to maintain good cognitive function in older age. </p>
<p>Long-term care policies that enable older people to maintain independence and continue to socialise may also be important. “<a href="https://www.nia.nih.gov/health/aging-place-growing-older-home">Ageing in place</a>”, an approach that emphasises the importance of supporting older people to continue living in their home and community, has led many governments to offer care for older people with limitations in their own home. </p>
<p><a href="https://www.palgrave.com/gp/book/9783319689685">Our research suggests</a> that only a small fraction of older Europeans that have difficulty performing daily activities (such as dressing, walking or washing) are actually eligible to receive home care through the government. </p>
<p>But we also found that an increase in the amount of care that people receive at home through government-sponsored programmes, paradoxically, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.3665">increases the amount of assistance they receive</a> from friends and family. This suggests that a long-term policy that expands access to home care may help older people maintain social ties, mental well-being, and cognitive function well into older age.</p>
<p>While prospects such as new drugs that protect against cognitive ageing are exciting, research shows that many simple policy changes can also promote social and emotional well-being – which may be just as important for maintaining brain function in later life. Even in the face of declining physical ability, programmes that provide long-term care at home may be critical for maintaining cognitive function and leading a <a href="https://www.pnas.org/content/116/4/1207">meaningful life at older age</a>.</p><img src="https://counter.theconversation.com/content/126314/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mauricio Avendano (<a href="mailto:mauricio.avendano_pabon@kcl.ac.uk">mauricio.avendano_pabon@kcl.ac.uk</a>) receives funding from the Economic and Social Research Council (ESRC), the National Institute for Health Research (NIHR) and the European Commission Horizon2020 Programme. </span></em></p><p class="fine-print"><em><span>Ludovico Carrino is research fellow at the Department of Global Health & Social Medicine at King's College London. He receives funding from the Economic and Social Research Council and the European Commission Horizon 2020 Programme. He is affiliated with the Department of Economics at the Ca' Foscari University of Venezia.</span></em></p>Simple policies, such as the free bus pass for older adults, not only reduce loneliness but also help older people maintain cognitive function.Mauricio Avendano Pabon, Professor of Public Policy & Global Health, King's College LondonLudovico Carrino, Research fellow, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1242672019-09-30T19:45:31Z2019-09-30T19:45:31Z1 in 3 young adults is lonely – and it affects their mental health<figure><img src="https://images.theconversation.com/files/294712/original/file-20190930-185407-orqbnv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">One in three 18 to 25 year olds reported feeling lonely three or more times in the past week.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/uFomxGheuGk">Todd Diemer</a></span></figcaption></figure><p>More than one in three young adults aged 18 to 25 reported problematic levels of loneliness, according to a new <a href="https://www.vichealth.vic.gov.au/loneliness-survey">report</a> from Swinburne University and VicHealth.</p>
<p>We surveyed 1,520 Victorians aged 12 to 25, and examined their experience of loneliness. We also asked about their symptoms of depression and social anxiety.</p>
<p>Overall, one in four young people (aged 12 to 25) reported feeling lonely for three or more days within the last week. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/loneliness-is-a-health-issue-and-needs-targeted-solutions-96262">Loneliness is a health issue, and needs targeted solutions</a>
</strong>
</em>
</p>
<hr>
<p>Among 18 to 25 year olds, one in three (35%) reported feeling lonely three or more times a week. We also found that higher levels of loneliness increases a young adult’s risk of developing depression by 12% and social anxiety by 10%.</p>
<p>Adolescents aged 12 to 17 reported better outcomes, with one in seven (13%) feeling lonely three or more times a week. Participants in this age group were also less likely to report symptoms of depression and social anxiety than the 18 to 25 year olds. </p>
<h2>Young adulthood can be a lonely time</h2>
<p>Anyone can experience loneliness and at <a href="https://journals.sagepub.com/doi/pdf/10.1177/1745691615568999">any point in life</a> but it’s often triggered by significant life events – both positive (such as new parenthood or a new job) and negative (bereavement, separation or health problems). </p>
<p>Young adults are managing new challenges such as moving away from home and starting university, TAFE or work. Almost half (48%) of the young adults in our survey lived away from family and caregivers. Almost 77% were also engaged in some sort of work. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-ideas-of-adulthood-its-rights-and-responsibilities-are-changing-around-the-world-99669">How ideas of 'adulthood', its rights and responsibilities, are changing around the world</a>
</strong>
</em>
</p>
<hr>
<p>Young people at high school may be buffered from loneliness because they’re surrounded by peers, many of whom they have known for years. But once they leave the safety of these familiar environments, they are likely to have to put in extra effort to forge new ties. They may also feel more disconnected from the existing friends they have. </p>
<p>During this transition to independence, young adults may find themselves with evolving social networks, including interactions with colleagues and peers of different ages. Learning to navigate these different relationships requires adjustment, and a fair bit of trial and error.</p>
<h2>Is social media use to blame?</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/294783/original/file-20190930-194829-1l9vz2e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/294783/original/file-20190930-194829-1l9vz2e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/294783/original/file-20190930-194829-1l9vz2e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/294783/original/file-20190930-194829-1l9vz2e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/294783/original/file-20190930-194829-1l9vz2e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/294783/original/file-20190930-194829-1l9vz2e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/294783/original/file-20190930-194829-1l9vz2e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Social media has its positives and negatives.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/m7zKB91brGo">freestocks.org</a></span>
</figcaption>
</figure>
<p>The reliance on social media to communicate is often thought to <em>cause</em> loneliness. </p>
<p>No studies I’m aware of have examined the cause-effect between loneliness and social media use. </p>
<p>There is some <a href="https://www.ncbi.nlm.nih.gov/pubmed/28937910">evidence</a> that those who are lonely are more likely to use the internet for social interactions and spend less time in real life interactions. But it’s unclear whether social media use <em>causes</em> more loneliness.</p>
<p>While social media can be used to replace offline relationships with online ones, it can also be used to both enhance existing relationships and offer new social opportunities. </p>
<p>Further, a recent <a href="https://www.liebertpub.com/doi/full/10.1089/cyber.2019.0176">study</a> found that the relationship between social media use and psychological distress was weak. </p>
<h2>Is loneliness a cause or effect of mental ill health?</h2>
<p>Loneliness is <a href="https://www.ncbi.nlm.nih.gov/pubmed/25910392">bad for our physical</a> and <a href="https://www.ncbi.nlm.nih.gov/pubmed/29684289">mental health</a>. Over a six-month period, people who are lonely are <a href="https://psycnet.apa.org/doiLanding?doi=10.1037%2Fabn0000162">more likely</a> to experience higher rates of depression, social anxiety and paranoia. Being socially anxious can also <em>lead to</em> more loneliness at a later time. </p>
<p>The solution isn’t as simple as joining a group or trying harder to make friends, especially if one also already feels anxious about being with people.</p>
<p>While lonely people are motivated to <a href="https://www.ncbi.nlm.nih.gov/pubmed/19726219">connect with others</a> they are also more likely to experience social interactions as stressful. <a href="https://www.ncbi.nlm.nih.gov/pubmed/18476760">Brain imaging studies</a> show lonely people are less rewarded by social interactions and are more attuned to distress of others than less lonely counterparts.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/294786/original/file-20190930-194866-1mz145w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/294786/original/file-20190930-194866-1mz145w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/294786/original/file-20190930-194866-1mz145w.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/294786/original/file-20190930-194866-1mz145w.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/294786/original/file-20190930-194866-1mz145w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/294786/original/file-20190930-194866-1mz145w.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/294786/original/file-20190930-194866-1mz145w.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Making friends can be a stressful experience.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/JBfdCFeRDeQ">Andrew Neel</a></span>
</figcaption>
</figure>
<p>When lonely people do socialise, they are <a href="https://www.ncbi.nlm.nih.gov/pubmed/19726219">more likely</a> to engage in self-defeating actions, such as being less cooperative, and show more negative emotions and body language. This is done in an (often unconscious) attempt to disengage and protect themselves from rejection. </p>
<p>Lonely people are also more likely to find reasons people cannot be trusted or do not live up to particular social expectations, and to believe others evaluate them more negatively than they actually do. </p>
<h2>What can we do about it?</h2>
<p>One way to address these invisible forces is to help young people think in more helpful ways about friendship, and to understand how they can influence others through their emotions and behaviours. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-parents-can-help-their-young-children-develop-healthy-social-skills-107431">How parents can help their young children develop healthy social skills</a>
</strong>
</em>
</p>
<hr>
<p>Parents, educators and counsellors can play a role in educating children and young people about the dynamics of evolving friendships. This might involve helping the young person to evaluate their own behaviours and thought patterns, understand how they play an active role in building relationships, and to support them to interact differently. </p>
<p>More specific strategies could include: </p>
<ul>
<li>challenging unhelpful thinking or <a href="https://journals.sagepub.com/doi/abs/10.1177/1088868310377394">negative views about others</a></li>
<li>helping young people identify their <a href="https://www.frontiersin.org/articles/10.3389/fpsyt.2019.00604/full">strengths</a> and learn how they’re important in forging strong, meaningful relationships. If the young person identifies humour as a strength, for instance, this might involve discussing how they can use their humour to establish rapport with others.</li>
</ul>
<p>Educational programs can do more to address the social health of young people and these discussions can be integrated into health education classes.</p>
<p>Additionally, because young people are already frequent and competent users of technology, carefully crafted digital tools could be developed to target loneliness. </p>
<p>These tools could help young people learn skills to develop and maintain meaningful relationships. And because lonely people are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4021390/">more likely to avoid others</a>, digital tools could also be used as one way to help young people build social confidence and practise new skills within a safe space.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/many-people-feel-lonely-in-the-city-but-perhaps-third-places-can-help-with-that-92847">Many people feel lonely in the city, but perhaps 'third places' can help with that</a>
</strong>
</em>
</p>
<hr>
<p>A cornerstone of any solution, however, is to normalise feelings of loneliness, so feeling lonely is seen not as a weakness but rather as an innate human need to connect. Loneliness is likely to negatively impact on health when it is <em>ignored</em>, or <em>not properly addressed</em>, allowing the distress to persist. </p>
<p>Identifying and normalising feelings of loneliness can help lonely people consider different avenues for action.</p>
<p>We don’t yet know the lifelong impact of loneliness on today’s young people, so it’s important we take action now, by increasing awareness and giving young people the tools to develop and maintain meaningful social relationships.</p>
<p><em>Michelle Lim, the author of this piece, is available for a Q+A on Tuesday the 1st October from 3pm-4pm AEST to take questions on this topic. Please post your questions in the comments below.</em></p><img src="https://counter.theconversation.com/content/124267/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle H Lim receives funding from Barbara Dicker Brain Sciences Foundation. The Young Australian Loneliness report was produced by VicHealth and Swinburne University of Technology.</span></em></p>Loneliness is often triggered by significant life events, and young people have these in abundance. But the solution isn’t as simple as joining a group or trying harder to make friends.Michelle H Lim, Senior Lecturer and Clinical Psychologist, Swinburne University of TechnologyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1180462019-06-11T20:13:24Z2019-06-11T20:13:24Z‘I really have thought this can’t go on’: loneliness looms for rising numbers of older private renters<figure><img src="https://images.theconversation.com/files/278797/original/file-20190611-52776-m2eyee.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">People living in private rental housing were much more likely than social housing residents to say they felt lonely.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/portrait-sad-lonely-pensive-old-senior-45607705">Dundanim/Shutterstock</a></span></figcaption></figure><p>Loneliness is increasingly recognised worldwide as a critical social issue and one of the <a href="https://www.ncbi.nlm.nih.gov/pubmed/25910392">major health hazards of our time</a>. Our <a href="https://www.publish.csiro.au/book/7269/">research</a> shows older private renters are at high risk of loneliness and anxiety. This is a growing concern as <a href="https://theconversation.com/why-secure-and-affordable-housing-is-an-increasing-worry-for-age-pensioners-69350">more Australians are renting housing later in life</a>. By contrast, only a small proportion of the <a href="https://housing.vic.gov.au/social-housing">social housing</a> tenants we interviewed said they were lonely.</p>
<p>The links between housing arrangements and loneliness could have profound <a href="https://www.psychology.org.au/for-members/publications/inpsych/2018/December-Issue-6/The-impact-of-loneliness-on-the-health-and-wellbei">implications for our health</a>. As former US surgeon general Vivek H. Murthy <a href="https://www.washingtonpost.com/news/on-leadership/wp/2017/10/04/this-former-surgeon-general-says-theres-a-loneliness-epidemic-and-work-is-partly-to-blame">said</a>:</p>
<blockquote>
<p>The reduction in life span [for people experiencing loneliness] is similar to that caused by smoking 15 cigarettes a day, and it’s greater than the impact on life span of obesity … Look even deeper, and you’ll find loneliness is associated with a greater risk of heart disease, depression, anxiety and dementia.</p>
</blockquote>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-secure-and-affordable-housing-is-an-increasing-worry-for-age-pensioners-69350">Why secure and affordable housing is an increasing worry for age pensioners</a>
</strong>
</em>
</p>
<hr>
<h2>What causes loneliness?</h2>
<p>The causes of loneliness are multifaceted and <a href="https://www.sciencedirect.com/science/article/abs/pii/S0167494305000361">complex</a>. The <a href="https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/2071.0%7E2016%7EMain%20Features%7ESnapshot%20of%20Australia,%202016%7E2">number of people living alone</a> in Australia is <a href="https://www.ahuri.edu.au/__data/assets/pdf_file/0016/2095/AHURI_Final_Report_No164_Housing,_loneliness_and_health.pdf">clearly a factor</a>. In 2016, just under one in four households (24.4%) were single-person households. That’s up from one in five in 1991. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/one-in-four-australians-are-lonely-which-affects-their-physical-and-mental-health-106231">One in four Australians are lonely, which affects their physical and mental health</a>
</strong>
</em>
</p>
<hr>
<p><a href="https://www.kff.org/other/report/loneliness-and-social-isolation-in-the-united-states-the-united-kingdom-and-japan-an-international-survey/">Research</a> suggests low-income individuals are more likely to experience loneliness. So, too, are people who have a serious mental or physical health condition or have had a serious disruptive event (financial or job loss, illness or injury, or relationship breakdown) in the last couple of years.</p>
<p>The <a href="https://www.ahuri.edu.au/__data/assets/pdf_file/0016/2095/AHURI_Final_Report_No164_Housing,_loneliness_and_health.pdf">impact of housing tenure on loneliness</a> has received little attention. While recognising that there are no definite associations, we interviewed about 80 older (65-plus) private renters and social housing tenants who depended on the <a href="https://www.humanservices.gov.au/individuals/services/centrelink/age-pension">Age Pension</a> for their income. These in-depth interviews indicated that their housing tenure was a critical factor in their risk of experiencing loneliness.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/when-falling-home-ownership-and-ageing-baby-boomers-collide-102846">When falling home ownership and ageing baby boomers collide</a>
</strong>
</em>
</p>
<hr>
<h2>Many older private renters are lonely</h2>
<p>Many older private renters have little disposal <a href="https://www.publish.csiro.au/book/7269/">income</a>, because the cost of housing uses up much of their income. They also live with the constant possibility that they may be asked to vacate their <a href="https://journals.sagepub.com/doi/10.1177/1440783317707833">accommodation</a>. Their limited budgets mean they often end up living in a poorly located property. These features, individually or in combination, create fertile ground for anxiety and loneliness.</p>
<p>Their dire financial situation was often an obstacle to social activities. One interviewee told of how she had to choose between food or breaking her isolation by using public transport.</p>
<blockquote>
<p>Well, you sort of think what you can do with $2.50. That’s a loaf of bread type of thing. <strong>– Beverley</strong> *</p>
</blockquote>
<p>A 72-year-old woman living by herself said she could not afford the outings organised by her church.</p>
<blockquote>
<p>There’s quite an active social club at the church for over-55s but I can’t go to any of those … Sometimes I think it would be nice to go on something that appeals to me, yes. And they might have an afternoon at somebody’s home and you’re asked to bring a plate [of food]. You see, I couldn’t afford to do that.</p>
</blockquote>
<p>Peter, 67 and divorced, had left the workforce prematurely due to ill-health.</p>
<blockquote>
<p>I’ve become very isolated. I used to, before I had the hip operation, I used to play tennis and I loved to play tennis … but I really can’t afford it. I’ve found a few clubs that I could go and play in. I’d like to get back to it, but they say, ‘Ah, the fees are this and you pay it annually,’ and I can’t come up with $150 or $200 or whatever.</p>
</blockquote>
<p>Lack of money and insecure tenure were sources of enormous distress and anxiety, which further discouraged social contact. Brigette (67) was brutally honest:</p>
<blockquote>
<p>You do get depressed and I believe that’s why people suicide … And there have been times when I’ve thought, what is the point to life? I really have thought this can’t go on, you know … I feel sorry for people because it is hard, and once you stay in it’s like crawling out of a slime pit … I have to say, ‘Get up and go out, go up the shops … Pretend you need potatoes or something.’</p>
</blockquote>
<p>Not all of the private renters interviewed experienced loneliness. These interviewees usually had strong family ties or had managed to find affordable and secure accommodation.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/many-people-feel-lonely-in-the-city-but-perhaps-third-places-can-help-with-that-92847">Many people feel lonely in the city, but perhaps 'third places' can help with that</a>
</strong>
</em>
</p>
<hr>
<h2>Social housing tenants feel less isolated</h2>
<p>In sharp contrast, only a small proportion of the social housing tenants interviewed said they were lonely. Almost all were adamant they did not experience loneliness and felt they had strong social ties. Their affordable rent, security of tenure, long-term residence and having neighbours in a similar position meant they could socialise and were not beset by anxiety. </p>
<p>An 85-year-old long-established social housing tenant’s response to the question about loneliness and isolation was typical:</p>
<blockquote>
<p>I do like it around here. I know where everything is and I know all the people, especially around these units you know. I know everyone and they know me. I like it around here. This is my home, you know. This is a community, I think. Like I know all the people and we’ve become really good friends. I couldn’t think of being anywhere else. <strong>– Kay</strong></p>
</blockquote>
<p>Pam, who had been a private renter before being allocated social housing, reflected on how her life had changed:</p>
<blockquote>
<p>Well, it is changed because I’m happier and I think I’m healthier and I have a lot of new friends. I also have a lot more people around me for support if anything does happen. If I get sick and if they don’t see me for a few days someone will come and say, ‘Pam, are you OK?’ In private housing there was nobody.</p>
</blockquote>
<p>The <a href="https://journals.sagepub.com/doi/abs/10.1177/1440783313500856?journalCode=josb">residualisation</a> of social housing meant some tenants were living in what they perceived to be unbearable conditions. However, they generally were able to deal with their situation. Patricia coped with her very challenging neighbours by going to the local community centre.</p>
<blockquote>
<p>No, I hate it [public housing]. I live here [at the community centre] every day. Yes, I’m on the committee here and I do things every day. This is my home, my family. Everybody is friendly with everybody. We have outings and things.</p>
</blockquote>
<p>What the interviews indicate is that the housing tenure of age pensioners often plays a fundamental role in whether they are able to escape the experience of loneliness. Older private renters are far more likely to experience loneliness than their counterparts in social housing and that loneliness can be acute.</p>
<p><em>* All the names used are pseudonyms.</em></p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/designing-cities-to-counter-loneliness-lets-explore-the-possibilities-104853">Designing cities to counter loneliness? Let's explore the possibilities</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/118046/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alan Morris does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p><p class="fine-print"><em><span>Andrea Verdasco does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Increasing numbers of older Australians don’t own their homes. Whether they are private renters or live in social housing can make a big difference to their risk of loneliness and anxiety.Alan Morris, Research Professor, University of Technology SydneyAndrea Verdasco, Research Associate, University of Technology SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1112222019-02-12T11:53:35Z2019-02-12T11:53:35ZA pill for loneliness? If only it were that simple<figure><img src="https://images.theconversation.com/files/258278/original/file-20190211-174883-1jnxmf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Loneliness is being medicalised.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/asian-beautiful-woman-tablets-medicine-water-258794147?src=WKg5G22wgHQhh81TXrrEJA-2-7">PrinceOfLove/Shutterstock</a></span></figcaption></figure><p>Loneliness affects people of all ages, <a href="https://theconversation.com/loneliness-is-not-just-an-issue-in-old-age-young-people-suffer-too-91931">young</a> as much as old. It’s now seen as so serious it’s classified as a <a href="https://theconversation.com/loneliness-on-its-way-to-becoming-britains-most-lethal-condition-94775">public health problem</a>. It’s presented as <a href="https://www.bbc.co.uk/news/uk-42887932">an “epidemic”</a> causing a wide range of health problems that threaten to <a href="https://www.theguardian.com/society/2016/feb/01/loneliness-forces-older-people-into-hospitals-and-strains-services-say-senior-doctors">cripple health services</a>.</p>
<p>In response to this perceived crisis the, UK government has even created a <a href="https://www.bbc.co.uk/news/uk-42708507">minister for loneliness</a> to roll out its <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/750909/6.4882_DCMS_Loneliness_Strategy_web_Update.pdf">loneliness strategy</a>. This proposes a range of approaches that usually involve encouraging people to become more involved in their families and communities.</p>
<p>But researchers from the US are working on a more radical solution to the perceived contemporary problem of loneliness: <a href="https://www.theguardian.com/us-news/2019/jan/26/pill-for-loneliness-psychology-science-medicine">a pill</a>. The rationale for this work is that loneliness negatively affects how <a href="https://www.psychologytoday.com/gb/blog/the-social-brain/201802/feeling-lonely-your-brain-may-be-risk">our brains</a> and <a href="https://www.medicalnewstoday.com/articles/303084.php?utm_source=TrendMD&utm_medium=cpc&utm_campaign=Medical_News_Today_TrendMD_1">other systems</a> in the body work and that drug treatments could help prevent or reduce this effect. The researchers argue that this might not solve the underlying problem, but at least it would help limit its effects. In the meantime, we can look for deeper solutions that address the fundamental issue for lonely people, which is their lack of meaningful relationships.</p>
<p>In this way, loneliness is being equated with medical conditions such as depression and anxiety by suggesting a similar pharmacological treatment. The problem is that the analogy is clearly limited and, ultimately, this approach seeks to unnecessarily medicalise a normal part of the human experience.</p>
<h2>Not a medical condition</h2>
<p>Anxiety and depression are mental health disorders that can have a variety of emotional and physiological causes. Loneliness, on the other hand, is caused by social problems related to our (lack of) interactions with other people.</p>
<p>Depression and anxiety also have clear clinical and diagnostic signs and symptoms, with established ways to screen for and diagnose it. But there is no established process to clinically identify lonely individuals. Even working out how you define what counts as being so lonely that it becomes a medical problem is difficult. Is it defined by the duration, frequency or intensity of the experience, for example?</p>
<p>There are a range of different effective treatments for depression, including drugs, talking therapy and lifestyle adaptations such as exercise that have been built up over the past five decades. But we’ve only just begun trying to understand loneliness and how to tackle it and there are, as yet, <a href="https://whatworkswellbeing.org/product/tackling-loneliness-full-review/">few interventions</a> for loneliness that have proven benefits.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/258286/original/file-20190211-174851-1h9u3rs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/258286/original/file-20190211-174851-1h9u3rs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/258286/original/file-20190211-174851-1h9u3rs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/258286/original/file-20190211-174851-1h9u3rs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/258286/original/file-20190211-174851-1h9u3rs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/258286/original/file-20190211-174851-1h9u3rs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/258286/original/file-20190211-174851-1h9u3rs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Few interventions for loneliness are proven.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/two-sad-diverse-women-talking-home-793862932?src=7Uq3EN4EfpLQ91ynkpX0GA-1-28">Prostock Studio/Shutterstock</a></span>
</figcaption>
</figure>
<p>Because loneliness isn’t a medical condition, we should be wary of such well-intentioned developments that over-simplify the complex nature of loneliness. Going straight to a pill with inevitable side effects seems premature when we still need to deepen the evidence base on the link between loneliness and brain health. And by only tackling the physical and physiological aspects of loneliness, we inevitably ignore other negative effects such as low wellbeing and quality of life.</p>
<p>We should also question whether loneliness really is a rapidly growing issue that’s damaging people’s health. The <a href="https://www.ageuk.org.uk/latest-press/articles/2018/october/all-the-lonely-people-report/">evidence shows</a> that the proportion of people in Britain who report feeling lonely has changed little over the past five decades.</p>
<p>Loneliness may be associated with poor physical and mental health but association doesn’t imply a causal link. People may be lonely because they have a mental health problem and feel excluded by family, friends and the community in ways that are bad for their wellbeing. That doesn’t mean their experience of loneliness is causing their health problems.</p>
<p>Similarly, the evidence that loneliness is going to overwhelm the healthcare system <a href="https://www.youtube.com/watch?v=vd2Z-wMIuOw">is limited</a>. Warning people about the toll loneliness is taking on medical services may have the unintended consequence of discouraging lonely people from seeking help.</p>
<h2>Positive experiences</h2>
<p>The other thing to consider is that we only ever describe loneliness as a negative experience, something to fear, and rarely ask if there might be a positive side to it. Evidence from the <a href="https://www.bbc.co.uk/programmes/articles/2yzhfv4DvqVp5nZyxBD8G23/who-feels-lonely-the-results-of-the-world-s-largest-loneliness-study">BBC Loneliness Experiment</a>, which surveyed 55,000 people, suggests that loneliness can prompt people to improve their relationships and seek out new ones.</p>
<p><a href="https://www.bbc.co.uk/programmes/articles/3nDZXgD7Fz7lBGc3YSQV9jr/nine-ways-to-feel-less-lonely">The solution</a> to loneliness lies not in doling out a pill and turning an important human experience into something needing medical treatment, but in creating communities and opportunities that enables people to build positive social relationships. </p>
<p>To date, we don’t know how best to do this. Many ways have been proposed for tackling loneliness including <a href="https://www.independent.co.uk/life-style/gadgets-and-tech/features/robot-carer-elderly-people-loneliness-ageing-population-care-homes-a8659801.html">using robots</a> or <a href="https://www.itv.com/news/granada/2018-08-31/could-chickens-help-beat-loneliness-and-depression/">animals such as chickens</a> as companions, or taking up <a href="https://www.ukactive.com/blog/can-physical-activity-tackle-the-uks-loneliness-crisis/0">physical activity</a>. Intervening to help someone feel less lonely can be done online or face-to-face, in groups or on an individual basis. What unites these different interventions is that they are all focused on developing meaningful social relations. This seems a more humane and appropriate way to intervene to combat loneliness than resorting to pills.</p><img src="https://counter.theconversation.com/content/111222/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christina Victor receives funding from Wellcome Trust, Dunhill Medical Trust and ESRC for her work related to loneliness in later life.</span></em></p>By trying to tackle just the health impact of loneliness, scientists risk ignoring the underlying causes.Christina Victor, Professor of Gerontology and Public Health, Brunel University LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1054392018-11-21T13:58:04Z2018-11-21T13:58:04ZPrescribing social activities to lonely people prompts ethical questions for GPs<figure><img src="https://images.theconversation.com/files/246645/original/file-20181121-161612-1aynd67.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Starting new conversations. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-striped-red-white-shirt-working-431933083?src=GRvTAKqFyLmw0DkPJnipAA-1-5">Belushi/Shutterstock</a></span></figcaption></figure><p>GPs in England will now be able to prescribe social activities to their patients, such as dance classes, art groups, walking clubs and volunteer work, as part of the government’s ground-breaking new <a href="https://www.gov.uk/government/publications/a-connected-society-a-strategy-for-tackling-loneliness">loneliness strategy</a>. This social prescription initiative funded by the NHS, which has been piloted in <a href="https://www4.shu.ac.uk/research/cresr/sites/shu.ac.uk/files/eval-doncaster-social-prescribing-service.pdf">South Yorkshire</a> and elsewhere and is now used by approximately 25% of GPs, will expand nationwide by 2023. Although there is no fixed model for social prescriptions, GPs will typically refer patients to intermediaries known as “link workers” who will facilitate access to local social activities as well as community-based therapeutic services and practical support. </p>
<p>This initiative, endorsed by the <a href="http://www.rcgp.org.uk/about-us/news/2018/may/national-campaign-needed-to-tackle-loneliness-epidemic-says-rcgp.aspx">Royal College of General Practitioners</a>, is certainly eye-catching. But is it ethical?
As moral philosophers, we ask not just whether the consequences of an initiative are acceptable, but also whether the initiative respects and honours people as people.</p>
<p>One danger is that social prescriptions are dismissive and paternalistic toward people. Being given a social prescription might feel like being prescribed broccoli on the NHS. It might seem to trivialise the pain of loneliness as something easily solved with some chat, the social equivalent of eating more greens. If a GP gives someone a social prescription, he might leave her office feeling more disheartened and incompetent than when he walked in. </p>
<p>Yet, having a doctor not just advise, but prescribe regular social activity could also be a powerful motivator. According to social neuroscientist John Cacioppo, people who endure chronic acute loneliness <a href="https://books.google.co.uk/books?isbn=039307031X">have to combat the withdrawal and passivity</a> that come with feeling threatened. They need a safe place to test out the uplifting sensations that come from simple moments of social connection. With a prescription in hand, they might be better able to <a href="https://www.psychologytoday.com/gb/blog/connections/200812/easing-your-way-out-loneliness">take the baby steps necessary to reintegrate.</a></p>
<h2>The stigma of loneliness</h2>
<p>It’s also possible that by medicalising basic needs for positive social contact, social prescriptions risk heightening the stigma of loneliness.</p>
<p>Yet, we believe a medical solution offers some advantages. It normalises the fact that some people need help integrating, just as some people need medicine to treat ordinary ailments. A medical response lessens the impression that loneliness is a person’s own fault, and so can help to reduce its stigma. </p>
<p>What might reduce the stigma more, however, is a flagship policy that expands people’s opportunities to be meaningful social contributors. </p>
<p>The fact that the new loneliness strategy lacks such a policy is striking. As economist-cum-happiness-czar Richard Layard <a href="https://www.youtube.com/watch?v=sVm21f7Sdes">points out</a>, a critical element in getting out of loneliness is feeling useful to others. It’s vital that connections involve contributing to others’ well-being, and that the government invest in strategies that can foster that sense of supportive purpose. </p>
<p>The government could expand people’s opportunities to serve each other, for example by creating incentives for people to participate in community volunteer work or piloting mandatory community service. It could also work with the RSPCA to invest in <a href="https://www.ncbi.nlm.nih.gov/pubmed/24047314">re-homing more companion animals</a>, or offer incentives to engage in family socialising by subsidising holidays with extended family members. Policies could also ensure that non-standard working hours don’t deny families <a href="https://books.google.co.uk/books?isbn=1400883687">shared free-time</a>, and provide incentives for people to <a href="https://www.ageuk.org.uk/our-impact/programmes/homeshare/">live with others</a> rather than on their own. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/246647/original/file-20181121-161630-z8a3w4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/246647/original/file-20181121-161630-z8a3w4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/246647/original/file-20181121-161630-z8a3w4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/246647/original/file-20181121-161630-z8a3w4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/246647/original/file-20181121-161630-z8a3w4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/246647/original/file-20181121-161630-z8a3w4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/246647/original/file-20181121-161630-z8a3w4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Loneliness: a different kind of prescription.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/530654728?src=ulEJfnIubczkjqwh6N1SVQ-1-31&size=medium_jpg">Igorstevanovic/Shutterstock</a></span>
</figcaption>
</figure>
<h2>Long-term bonds</h2>
<p>Given that chronic loneliness is correlated with many health risks including depression, alcoholism, reduced immunity, suicidal thoughts, and even early <a href="https://www.ahsw.org.uk/userfiles/Research/Perspectives%20on%20Psychological%20Science-2015-Holt-Lunstad-227-37.pdf">death</a>, a person who is prescribed social activity will be quite vulnerable. Yet, despite that, they will be instructed to go into a foreign setting with strangers. So, social prescriptions do come with risks: that other people won’t be kind and won’t provide a safe space to experiment in socialising. It will be key for GPs, link workers and community groups to manage such risks. </p>
<p>Even if social prescriptions are not unduly risky, they would be ill-advised and self-defeating if they corrupted the social bonds people could make through new activities. Some philosophers would question how <a href="https://www.jstor.org/stable/2025782?seq=1#metadata_info_tab_contents">sincere</a> someone’s socialising can be if they are there on their doctors’ orders. But, a doctor’s referral need not have this compromising effect. Children must go to school, but that doesn’t corrupt the friendships they make there. We can be sincere in our social overtures even when a different motivation got us through the door. </p>
<p>It’s the end game that matters most. With a course of antibiotics, we aim to recover and stop taking the medicine. When it comes to social connections, however, we have deep interests in ensuring our bonds persist. If all goes well, a social prescription will continue indefinitely. This means that the providers of the dance classes, art groups, or walking clubs must have the resources to ensure people can continue their prescribed social activities after their NHS allocation runs out. </p>
<p>The new loneliness strategy is the beginning of a process. The government deserves applause for appointing the world’s first loneliness minister, Tracey Crouch, to take seriously the late MP Jo Cox’s crusade to uncover the hidden tragedy of widespread loneliness in the UK. It also deserves credit for tackling loneliness through cross-government proposals that are necessarily tentative and open to review, as more evidence emerges on the causes and remedies of loneliness. </p>
<p>For now, although we have raised legitimate concerns about the expansion of social prescription, we do not think they are unethical.</p><img src="https://counter.theconversation.com/content/105439/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kimberley Brownlee receives funding from the Leverhulme Trust, Independent Social Research Foundation, and learned societies. She volunteers for the charity Contact the Elderly. </span></em></p><p class="fine-print"><em><span>David Jenkins receives funding from The Leverhulme Trust as part of his postdoctoral work. He is also a member of and volunteer for the Labour Party.</span></em></p>As part of a new strategy to combat loneliness GPs will be able to prescribe social activities. But is this ethical?Kimberley Brownlee, Professor of Philosophy, University of WarwickDavid Jenkins, Postdoctoral Research Fellow, University of WarwickLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1062312018-11-08T19:33:52Z2018-11-08T19:33:52ZOne in four Australians are lonely, which affects their physical and mental health<figure><img src="https://images.theconversation.com/files/244501/original/file-20181108-74787-97nmyz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Younger Australians struggle more with loneliness than older generations.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/WY_J0_9sVFg">Toa Heftiba</a></span></figcaption></figure><p>One in four Australians are lonely, our new report has found, and it’s not just a problem among older Australians – it affects both genders and almost all age groups. </p>
<p>The <a href="https://psychweek.org.au/loneliness-study/">Australian Loneliness Report</a>, released today by my colleagues and I at the <a href="https://www.psychology.org.au">Australian Psychological Society</a> and <a href="https://www.swinburne.edu.au">Swinburne University</a>, found one in two (50.5%) Australians feel lonely for at least one day in a week, while more than one in four (27.6%) feel lonely for three or more days.</p>
<p>Our results come from a survey of 1,678 Australians from across the nation. We used a comprehensive measure of loneliness to assess how it relates to mental health and physical health outcomes. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/politics-with-michelle-grattan-andrew-giles-on-the-growing-issue-of-loneliness-106544">Politics with Michelle Grattan: Andrew Giles on the growing issue of loneliness</a>
</strong>
</em>
</p>
<hr>
<p>We found nearly 55% of the population feel they lack companionship at least sometime. Perhaps unsurprisingly, Australians who are married or in a de facto relationship are the least lonely, compared to those who are single, separated or divorced.</p>
<p>While Australians are reasonably connected to their friends and families, they don’t have the same relationships with their neighbours. Almost half of Australians (47%) reported not having neighbours to call on for help, which suggests many of us feel disengaged in our neighbourhoods.</p>
<h2>Impact on mental and physical health</h2>
<p>Lonely Australians, when compared with their less lonely counterparts, reported higher social anxiety and depression, poorer psychological health and quality of life, and fewer meaningful relationships and social interactions.</p>
<p>Loneliness increases a person’s likelihood of experiencing depression by 15.2% and the likelihood of social anxiety increases by 13.1%. Those who are lonelier also report being more socially anxious during social interactions. </p>
<p>This fits with previous research, including a <a href="https://www.ncbi.nlm.nih.gov/pubmed/27124713">study</a> of more than 1,000 Americans which found lonelier people reported more severe social anxiety, depression, and paranoia when followed up after three months. </p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/244509/original/file-20181108-74775-zhtep7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/244509/original/file-20181108-74775-zhtep7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/244509/original/file-20181108-74775-zhtep7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/244509/original/file-20181108-74775-zhtep7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/244509/original/file-20181108-74775-zhtep7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/244509/original/file-20181108-74775-zhtep7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/244509/original/file-20181108-74775-zhtep7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Older Australians are less socially anxious than younger folks.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/KioSWLPXFXM">Fabio Neo Amato</a></span>
</figcaption>
</figure>
<p>Interestingly, Australians over 65 were less lonely, less socially anxious, and less depressed than younger Australians. </p>
<p>This is consistent with previous studies that show older people fare better on particular <a href="https://www.psychiatrist.com/jcp/article/Pages/2016/v77n08/v77n0813.aspx">mental health and well-being</a> indicators. </p>
<p>(Though it’s unclear whether this is the case for adults over 75, as few participants in our study were aged in the late 70s and over). </p>
<p>Younger adults, on the other hand, reported significantly more social anxiety than older Australians.</p>
<p>The evidence outlining the negative effects of loneliness on physical health is also growing. Past research has found loneliness <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=Loneliness+and+Social+Isolation+as+Risk+Factors+for+Mortality%3A+A+Meta-Analytic+Review">increases the likelihood of an earlier death by 26%</a> and has negative consequences on the <a href="http://dx.doi.org/10.1037/0022-3514.85.1.105">health of your heart</a>, <a href="http://pss.sagepub.com/content/13/4/384.full.pdf">your sleep</a>, and <a href="https://ac.els-cdn.com/S0306453003000866/1-s2.0-S0306453003000866-main.pdf?_tid=cdefeaff-e369-438e-912f-514b4eeb3048&acdnat=1529311650_63a5438f3a90a9bd5dcdc77e901dd944">levels of inflammation</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/loneliness-is-a-health-issue-and-needs-targeted-solutions-96262">Loneliness is a health issue, and needs targeted solutions</a>
</strong>
</em>
</p>
<hr>
<p>Our study adds to this body of research, finding people with higher rates of loneliness are more likely to have more headaches, stomach problems, and physical pain. This is not surprising as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5143485/#!po=8.62069">loneliness is associated with increased inflammatory responses</a>. </p>
<h2>What can we do about it?</h2>
<p>Researchers are just beginning to understand the detrimental effects of loneliness on our health, social lives and communities but many people – including service providers – are unaware. There are no guidelines or training for service providers. </p>
<p>So, even caring and highly trained staff at emergency departments may trivialise the needs of lonely people presenting repeatedly and direct them to resources that aren’t right. </p>
<p>Increasing awareness, formalised training, and policies are all steps in the right direction to reduce this poor care. </p>
<p>For some people, simple solutions such as joining shared interest groups (such as book clubs) or shared experienced groups (such as bereavement or carers groups) may help alleviate their loneliness. </p>
<p>But for others, there are more barriers to overcome, such as stigma, discrimination, and poverty. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/244502/original/file-20181108-74772-15fx4wp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/244502/original/file-20181108-74772-15fx4wp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/244502/original/file-20181108-74772-15fx4wp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/244502/original/file-20181108-74772-15fx4wp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/244502/original/file-20181108-74772-15fx4wp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/244502/original/file-20181108-74772-15fx4wp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/244502/original/file-20181108-74772-15fx4wp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Shared interest groups can help some people feel less alone.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/3ckWUnaCxzc">Danielle Cerullo</a></span>
</figcaption>
</figure>
<p>Many community programs and social services focus on improving well-being and quality of life for lonely people. By tackling loneliness, they may also improve the health of Australians. But without rigorous evaluation of these health outcomes, it’s difficult to determine their impact.</p>
<p>We know predictors of loneliness can include <a href="https://www.ncbi.nlm.nih.gov/pubmed/25910391">genetics</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2810252/?report=reader">brain functioning</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/28320380">mental health</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/20668659">physical health</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/29468772">community</a>, <a href="http://faculty.wharton.upenn.edu/wp-content/uploads/2012/05/Work_Loneliness_Performance_Study.pdf">work</a>, and <a href="https://www.ncbi.nlm.nih.gov/pubmed/27357305">social</a> factors. And we know predictors can differ between groups – for example, young versus old. </p>
<p>But we need to better measure and understand these different predictors and how they influence each other over time. Only with Australian data can we predict who is at risk and develop effective solutions. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-deadly-truth-about-loneliness-43785">The deadly truth about loneliness</a>
</strong>
</em>
</p>
<hr>
<p>There are some things we can do in the meantime. </p>
<p>We need a campaign to end loneliness for all Australians. Campaigns can raise awareness, reduce stigma, and empower not just the lonely person but also those around them. </p>
<p>Loneliness campaigns have been successfully piloted in the <a href="https://www.campaigntoendloneliness.org">United Kingdom</a> and <a href="http://modensomhed.dk">Denmark</a>. These campaigns don’t just raise awareness of loneliness; they also empower lonely and un-lonely people to change their social behaviours. </p>
<p>A great example of action arising from increased awareness comes from <a href="http://www.rcgp.org.uk/policy/rcgp-policy-areas/loneliness.aspx">the Royal College of General Practitioners</a>, which developed action plans to assist lonely patients presenting in primary care. The college encouraged GPs to tackle loneliness with more than just medicine; it prompted them to ask <em>what matters to the lonely person</em> rather than <em>what is the matter with the lonely person</em>.</p>
<p>Australia lags behind other countries but loneliness is on the agenda. Multiple <a href="https://www.endloneliness.com.au">Australian organisations</a> have come together after identifying a need to generate Australian-specific data, increase advocacy, and develop an awareness campaign. But only significant, sustained government investment and bipartisan support will ensure this promising work results in better outcomes for lonely Australians.</p><img src="https://counter.theconversation.com/content/106231/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle H Lim receives funding from Barbara Dicker Brain Sciences Foundation. </span></em></p>Half of Australians feel lonely for at least one day a week, while one in four feel lonely for three or more days. This can impact on sleep, heart health and levels of anxiety.Michelle H Lim, Senior Lecturer and Clinical Psychologist, Swinburne University of TechnologyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/947752018-04-18T10:11:48Z2018-04-18T10:11:48ZLoneliness on its way to becoming Britain’s most lethal condition<figure><img src="https://images.theconversation.com/files/215355/original/file-20180418-163998-hnr14h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/lonely-tree-523522765?src=library">Shutterstock</a></span></figcaption></figure><p>People of all ages are at risk from diseases brought on by loneliness, <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/lonelinesswhatcharacteristicsandcircumstancesareassociatedwithfeelinglonely/2018-04-10">new data</a> has revealed. According to figures published by the Office for National Statistics, 2.4m adult British residents – of all ages – suffer from chronic loneliness. </p>
<p>That number, combined with research highlighting the <a href="https://www.nytimes.com/2017/12/11/well/mind/how-loneliness-affects-our-health.html">medical dangers</a> posed by loneliness, could see the condition being recognised as the UK’s most dangerous health issue.</p>
<p>The latest figures form part of efforts to further the work of murdered MP Jo Cox, who launched a <a href="https://www.jocoxloneliness.org">commission on loneliness</a> shortly before <a href="https://www.theguardian.com/uk-news/2016/jun/16/labour-mp-jo-cox-shot-in-west-yorkshire">her death</a> in June 2016. They also follow the death last month of leading loneliness researcher <a href="http://www.johncacioppo.com">John Cacioppo</a>. Both <a href="https://www.theatlantic.com/health/archive/2017/04/how-loneliness-begets-loneliness/521841/">Cacioppo</a> and the <a href="https://www.jocoxloneliness.org/pdf/a_call_to_action.pdf">Cox Commission</a> believe the number of adults suffering from loneliness in the UK is even higher than the ONS suggests – at up to 9m adults. </p>
<p>Loneliness has long been linked with psychological problems like alcohol and drug abuse, eating disorders and depression. But Cacioppo’s key insight was that loneliness is fundamentally a biological problem. Its key causes are not in the mind or society, but in the body. And so is its most profound effect – death.</p>
<p>Analysis of <a href="https://s3.amazonaws.com/academia.edu.documents/33124623/journal.pmed.1000316.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1523588488&Signature=4uiEdtqkgqcChQCxqLP5fTAz1jU%3D&response-content-disposition=inline%3B%20filename%3DSocial_Relationships_and_Mortality_Risk.pdf">300,000 people in 148 studies</a> found that loneliness is associated with a 50% increase in mortality from any cause. This makes it comparable to smoking 15 cigarettes a day, and more dangerous than obesity. </p>
<p>As the lead researcher of the analysis, Julianne Holt-Lunstad, comments:</p>
<blockquote>
<p>Loneliness significantly increases risk for premature mortality.</p>
</blockquote>
<p>Only when this shocking connection is understood will we start to treat loneliness as the public health emergency it is. </p>
<p>Loneliness has reached epidemic proportions in the UK, where <a href="https://www.theatlantic.com/health/archive/2017/04/how-loneliness-begets-loneliness/521841/">researchers estimate</a> that up to one in four people suffer from it. This number will certainly rise as the population ages, as more people live alone, and workplace automation further weakens bonds between people. </p>
<p>Cacioppo, who argued that the root cause of loneliness is evolution, pointed out that modern society is worlds away from the community-based life for which we are designed. Humans are such deeply social animals that it makes no more sense to consider a person in isolation than it does an ant or a bee. Even as adults, we are so dependent on our groups that for millennia, separation from them was a de facto death sentence. </p>
<p>For this reason, said Cacioppo, we evolved to experience social rejection in <a href="https://www.researchgate.net/profile/Ethan_Kross/publication/50891907_Social_rejection_shares_somatosensory_representations_with_physical_pain/links/02bfe511265bae8eef000000/Social-rejection-shares-somatosensory-representations-with-physical-pain.pdf">the same way as physical pain</a>. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2752489/">Brain scans</a> have shown that “social pain”, such as being shunned by a community, activates the same region – the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC117593/">dorsal anterior cingulate</a> – as bodily trauma.</p>
<p>When we feel threatened by isolation, evolved responses drive us into a state of cognitive hypervigilance. We voraciously scour situations for social information that might allow us to reestablish personal connections. </p>
<p>Tragically, though, the very same hyper-alert state creates characteristic errors in social thinking that make us negatively misinterpret the information we detect. When we are lonely, we tend to misread others’ intentions as critical, competitive or threatening. We are less able to imagine things from their perspective.</p>
<h2>A nation of isolation</h2>
<p>At the same time, loneliness makes our own thinking more self-centred, caustic and distant. Responses made with this mindset can easily provoke the rejection we most fear, causing a self-fulfilling feedback loop. This, said Cacioppo, is the Catch 22 of loneliness: to escape it, we need other people, but the emotion itself impairs our ability to attract them.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/_0hxl03JoA0?wmode=transparent&start=204" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>In Cacioppo’s theory, cognitive bias causes us to poorly frame the problems of isolation. But the same insight suggests a route to tackling loneliness. <a href="https://theconversation.com/explainer-what-is-cognitive-behaviour-therapy-37351">Cognitive Behavioural Therapy</a> (CBT) is a well established, proven intervention which is designed precisely to reframe faulty thinking about distressing situations. </p>
<p><a href="http://journals.sagepub.com/doi/abs/10.1177/1745691617713052?journalCode=ppsa">Research</a> conducted by Cacioppo and his colleagues compared CBT with enhancing social skills, giving greater social support and providing more chances for interaction. All reduced people’s loneliness, but social cognitive therapies were three times more effective than alternatives.</p>
<p>CBT is cost effective compared to other forms of therapy. But the numbers requiring help are daunting. They will become more so as structural and demographic forces weaken social connections further and result in ever more people living in isolation. Unless we find the will – and the money – to decisively tackle loneliness, the coming decades could see it recognised as Britain’s biggest killer.</p><img src="https://counter.theconversation.com/content/94775/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Joe Smith is affiliated with the Wellcome Centre for Cultures of Health at Exeter University</span></em></p>The condition is nothing short of a public health emergency.Joe Smith, Researcher, University of LiverpoolLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/919312018-03-05T14:19:47Z2018-03-05T14:19:47ZLoneliness is not just an issue in old age – young people suffer too<figure><img src="https://images.theconversation.com/files/208889/original/file-20180305-65511-jkj3p4.jpg?ixlib=rb-1.1.0&rect=3%2C329%2C2488%2C1968&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/picture-lonely-girl-walking-along-city-61626385?src=32aPL5BaUzAdO9NqUw5gow-2-83">Shutterstock.</a></span></figcaption></figure><p>In old age, many people experience a decline in their physical health, which can mean they are less confident about getting around and socialising as they used to. Loneliness affects over <a href="https://www.ageuk.org.uk/information-advice/health-wellbeing/loneliness/">a million older adults</a> across the UK; <a href="http://webarchive.nationalarchives.gov.uk/20160105214013/http://www.ons.gov.uk/ons/rel/census/2011-census-analysis/do-the-demographic-and-socio-economic-characteristics-of-those-living-alone-in-england-and-wales-differ-from-the-general-population-/story-characteristics-of-those-living-alone.html#tab-Age-and-sex-analysis">over half</a> of people aged 75 and over live alone, and <a href="https://www.ageuk.org.uk/Documents/EN-GB/For-professionals/Policy/ID202014_agenda_for_later_life_report_2014.pdf?dtrk=true">one in ten</a> people over 65 say they always or often feel lonely. And there’s evidence to show that feeling lonely can cause existing physical health problems such as <a href="https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/health--wellbeing/rb_april15_vulnerability_resilience_improving_later_life.pdf">frailty or chronic pain</a> to get worse.</p>
<p>But while <a href="https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/health--wellbeing/rb_april15_vulnerability_resilience_improving_later_life.pdf">awareness has grown</a> about loneliness among older people, far less attention is given to how it affects young people. <a href="https://www.nspcc.org.uk/what-we-do/news-opinion/loneliness-key-concern-thousands-children/">An NSPCC report</a> revealed that in 2016-17, Childline counselled over 4,000 young people about loneliness. <a href="https://universitybusiness.co.uk/Article/uk-students-admit-loneliness">Students are affected too</a>, with almost half admitting to feeling lonely during their time at university. Indeed, a <a href="http://www.tandfonline.com/doi/full/10.1080/09638237.2018.1437608?needAccess=true">recent survey</a> of university students suggested that loneliness is the leading predictor of mental distress. </p>
<h2>A social issue</h2>
<p>Loneliness is not only a health issue, but a social issue. That’s why social psychologists like myself set out to explore the social causes of loneliness, and understand why people may begin to feel lonely in the first place. People of all ages can face difficulties when adjusting to life’s changes, or seeking a sense of belonging among others who share similar goals and interests. </p>
<p>Young people experience periods of transition, just as older people do. Whether they’re facing changes at school, college, university or work, or difficulties with friends or family, most young people need to readjust to big changes at several points throughout their teenage years or early adulthood. </p>
<p>Transitioning from one stage of life to another often means a shift in identity, which challenges our sense of self. Establishing a new identity can take time, as can finding and connecting with others who seem to think like us, or share similar interests and goals. Whether old or young, most people have a strong need to feel a <a href="http://onlinelibrary.wiley.com/doi/10.1002/1520-6629(198601)14:1%3C6::AID-JCOP2290140103%3E3.0.CO;2-I/abstract">sense of belonging</a>, and a connection with like-minded others.</p>
<h2>A social solution</h2>
<p>Communities can provide the sense of identity and belonging, which protects people from feeling lonely in times of change. Whether it be a physical community, such as a neighbourhood or campus, or a community of people with shared experiences, passions or culture, having a hub of people to connect with is good for our <a href="http://www.compsy.org.uk/Making%20a%20difference%20(proof%203).pdf">health and well-being</a>. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/208892/original/file-20180305-65529-uaok66.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/208892/original/file-20180305-65529-uaok66.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/208892/original/file-20180305-65529-uaok66.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/208892/original/file-20180305-65529-uaok66.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/208892/original/file-20180305-65529-uaok66.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/208892/original/file-20180305-65529-uaok66.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/208892/original/file-20180305-65529-uaok66.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Fancy a cuppa?</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-granddaughter-visiting-her-grandma-laughing-628433561?src=HfrQnJc8ztIdjHXItitAtw-2-12">Shutterstock.</a></span>
</figcaption>
</figure>
<p>Fostering community is one way to take action against loneliness. Bringing <a href="https://theconversation.com/heres-why-some-dutch-university-students-are-living-in-nursing-homes-68253">older and younger people together</a> can help to tackle loneliness across the course of life, by identifying common interests shared across the generations. Activities such as gardening, photography or simply sharing a cup of tea can spark friendships which span the age gap, and foster a sense of belonging. </p>
<p>For example, the <a href="http://www.emil-network.eu/wp/wp-content/uploads/eScouts-EMIL-case-study.pdf">eScouts</a> intergenerational learning exchange, which took place in several countries across Europe, had almost 100 young people teach 420 older adults skills needed to access digital technology and the internet. The exchange improved quality of life and social inclusion among young and old. And London-based charity <a href="https://magicme.co.uk/">Magic Me</a> runs intergenerational arts projects and works with schools, care homes and communities to bring people of all ages together in creative activities.</p>
<p>These sorts of projects are promoted as a way of reducing loneliness and isolation in older people. But younger people can benefit just as much, given the chance to connect with a community and forge rewarding friendships. Still, community projects alone will not solve the problem of loneliness in young or old. To truly succeed, projects need to be built with older and younger people and not simply for them, they need time and space to develop and appropriate resources such as accessible community centres and equipment. </p>
<p>Beyond that, bigger factors such as <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1468-2397.2007.00503.x/full">poverty and inequality</a> can fuel loneliness in both younger and older people. Community projects alone cannot address these causes, though they do provide opportunities for young and old to connect and build a sense of belonging. For that reason, youth groups, schools, colleges and universities should create as many opportunities as possible for young people to connect with older adults – after all, both will benefit.</p><img src="https://counter.theconversation.com/content/91931/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Katie Wright-Bevans received funding from the Beth Johnson Foundation and Stoke-on-Trent Public Health to support research on intergenerational practice.</span></em></p>Both young and old can feel like they don’t belong. But loneliness is a social problem, with a social solution.Katie Wright-Bevans, Lecturer in Psychology, Keele UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/888622017-12-31T14:18:58Z2017-12-31T14:18:58ZTrust Me, I’m an Expert: Risk<p>Ah, the new year. A time for throwing off your shackles, following your bliss, quitting your job and abandoning your family to finally start the artisinal yak-butter-sculpture studio of your dreams. </p>
<p>But big choices come with big risks. In this episode of Trust Me, I’m an Expert, Hassan Vally, an expert in epidemiology from La Trobe University, talks about “<a href="http://www.bmj.com/content/345/bmj.e8223">microlives</a>”, which measure how much your life span is increased or decreased by particular activities.</p>
<p>We all make trade-offs between risk and reward, Vally explains on the podcast and in an <a href="https://theconversation.com/stay-on-the-couch-or-go-for-a-run-theres-an-app-that-can-calculate-the-bigger-risk-86846">article</a> on The Conversation today. Every hour of television on the couch, for example, knocks 15 minutes off your life expectancy, on average. On the other hand, a daily serve of vegetables will increase your life expectancy by a couple of hours, and three coffees will add half an hour to your tally.</p>
<p>Even medical procedures can cost us “microlives”, as detailed in a <a href="https://cdn.theconversation.com/assets_for_articles/2017-12-22-microlife-table.pdf">table</a> Vally put together for us. </p>
<p>“Having a mammogram costs you four hours off your life span, but if that diagnoses a cancer that’s going to save you maybe 20 years on your life. You’ve got to be really careful about understanding the costs and benefits,” Vally says. </p>
<p>Also in this episode, Michelle Lim, a lecturer in clinical psychology at Swinburne University of Technology, discusses one of the biggest risks we face as social animals: loneliness.</p>
<p>Loneliness and isolation seem to be on the rise, but Lim explores the ways we can understand – and overcome – loneliness, without being afraid of it. </p>
<p>And finally, we ask the big question: have you stuck with your cocktail, liquor or tipple of choice over the holiday season? Alex Russell, a wine expert at CQ University, asks why we’re so reluctant step outside our gastronomic comfort zones, and how we can expand our horizons.</p>
<p>As an encounter with “spit-bucket gin” proves, it’s not a totally risk-free endeavour, but Russell says that with awareness and intention we can open up a whole new world of flavour. </p>
<p>Lastly, we wanted to pay a quick tribute to Jesse Cox, a friend and audio producer who recently died from a brain tumour. He was a giant in the podcasting world. He worked on programs like Trace, This Is About and Long Story Short, and helped influence many of the podcasters working in Australia today, including some of us here at The Conversation. </p>
<p>We’ve included in this episode a montage of Jesse’s work that was first broadcast on RN Breakfast <a href="http://www.abc.net.au/radionational/programs/breakfast/remembering-jesse-cox/9281560">here</a>, and check out his incredible back catalogue <a href="http://www.abc.net.au/radionational/jesse-cox/4119240">here</a>. </p>
<hr>
<p><strong>Music in this episode of Trust Me, I’m an Expert</strong></p>
<p>Kindergarten by Unkle Ho, from <a href="https://www.elefanttraks.com/">Elefant Traks</a></p>
<p><a href="http://freemusicarchive.org/music/Podington_Bear/Textural/Gears_Spinning">Gears Spinning</a> by Podington Bear</p>
<p><a href="http://freemusicarchive.org/music/Cletus_Got_Shot/none_given_1243/Cletus_Got_Shot_-_Working_Songs_for_the_Drinking_Class_-_05_Pour_Me_Another">Pour Me Another</a> by Cletus Got Shot: Free music archive</p>
<p><a href="http://freemusicarchive.org/music/Stompin_Riffraffs/Live_On_WFMUs_Fools_Paradise_with_Rex_11-10-12/StompinRiffRaffs_-_08_-_Wine_Wine_Wine">Wine Wine Wine</a> by Stompin Riff Raffs: Free music archive</p>
<p><a href="http://freemusicarchive.org/music/Ergo_Phizmiz/Timperley_Rhapsodies_Music_for_Frank_Sidebottom/08_Smells_Like_Timperley_Spirit_For_Robin_1629">Smells like Timperley Spirit</a> by Ergo Phizmiz: Free music archive</p>
<p><a href="http://freemusicarchive.org/music/Guitar_Lightnin_Lee_and_His_Thunder_Band/Live_at_WFMU_on_Burn_It_Down_with_Nate_K_11152015/Crawfish_And_Beer">Crawfish and Beer</a> by Guitar Lightnin Lee and His Thunder Band: Free music archive</p>
<p><a href="http://freemusicarchive.org/music/Waylon_Thornton/Rat_Brew/10_Muscadine_Wine">Muscadine Wine</a> by Waylon Thornton: Free music archive</p>
<p><a href="http://freemusicarchive.org/music/The_Blue_Onesies/Jim_Rogers_Party_Shack_EP/03_The_Blue_Onesies_-_Glass_of_Wine_1464">Glass of Wine</a> by The Blue Onesies: Free music archive</p>
<p><a href="http://freemusicarchive.org/music/Dazie_Mae/Velvet_Dress__Stockings/01_-_Drink_Beer_Till_The_Day_That_I_Die">Drink Beer (Till The Day That I Die)</a> by Dazie Mae: Free music archive</p>
<p><a href="http://freemusicarchive.org/music/Lee_Rosevere/The_Big_Loop_-_FML_original_podcast_score/Lee_Rosevere_-_The_Big_Loop_-_FML_original_podcast_score_-_02_Easy_Life">Easy Life</a> by Lee Rosevere: Free music archive</p>
<p><a href="http://freemusicarchive.org/music/Podington_Bear/Soul/Blue_Highway">Blue Highway</a> by Podington Bear: Free music archive</p>
<p><a href="https://www.bensound.com/royalty-free-music/track/ofelias-dream">Ofelia’s dream</a>: Bensound</p>
<p><strong>Additional sound</strong></p>
<p><a href="https://www.youtube.com/watch?v=3OG6itojBiI">WH.GOV</a></p>
<p><a href="https://www.youtube.com/watch?v=s7L2PVdrb_8">Game of Thrones</a> theme music</p>
<p><a href="https://www.youtube.com/watch?v=2I91DJZKRxs">Jaws</a> theme music</p>
<p><a href="https://freesound.org/people/albertofrog/sounds/328633/">Pouring Whiskey</a>, Albertofrog: freesound.org</p>
<p><a href="https://freesound.org/people/JohnsonBrandEditing/sounds/243373/">Small crowd pre-concert talking party bar walla talking</a>, JohnsonBrandEditing: freesound.org</p>
<p><a href="https://freesound.org/people/megashroom/sounds/390335/">Pouring beer into short glass</a>, megashroom: freesound.org</p>
<p><a href="https://freesound.org/people/ultradust/sounds/166923/">Champagne cork pop and pour</a>, ultradust: freesound.org</p>
<p><a href="https://www.youtube.com/watch?v=-Gq5JZNMgIs">New Years Eve Sydney</a>, MrRobAU: YouTube</p><img src="https://counter.theconversation.com/content/88862/count.gif" alt="The Conversation" width="1" height="1" />
This month, we're talking risk. Three experts give their perspective on how long you might live, how to deal with loneliness – and how to step outside your comfort zone.Madeleine De Gabriele, Deputy Editor: Energy + EnvironmentLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/889722017-12-18T14:16:02Z2017-12-18T14:16:02ZLoneliness is not just for Christmas – but by the flurry of charity messages you’d think otherwise<figure><img src="https://images.theconversation.com/files/199695/original/file-20171218-27607-1syam0q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">It seems loneliness among older people is expected – by everyone except the elderly themselves.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/publicplaces/7465687106/in/photostream/">publicplaces</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>A new pre-Christmas tradition has emerged alongside the traditional activities of present buying, planning huge meals, and attending school nativity plays: a focus in the media by predominantly by age-related charities on loneliness among older people.</p>
<p>And like all other aspects of Christmas this starts earlier each year. I received my first Christmas appeal letter on the subject from Age UK at the end of September, urging that “no one should have no one at Christmas”. The charity created a <a href="https://www.ageuk.org.uk/get-involved/no-one/">short film linked to the campaign</a> highlighting the plight of lonely older people at Christmas. The following week another arrived from the Alzheimer’s Society, bearing the slogan: “No tree, no lights, no family.”</p>
<p>Now that Christmas is almost upon us, the focus on loneliness has intensified. Silverline, a telephone support service for older people, is running a campaign entitled <a href="https://www.thesilverline.org.uk/foamalone/">Foam Alone</a>, with their services <a href="http://www.telegraph.co.uk/news/2017/12/09/got-look-otherduchess-cornwall-urges-public-volunteer-fight/">endorsed by prominent supporters including royalty</a>. Barbers are offering elderly men free haircuts as part of a campaign entitled <a href="http://metro.co.uk/2017/11/22/campaign-urges-barbers-to-tackle-loneliness-by-offering-free-haircuts-to-elderly-men-7097724/0">Shave The Day</a>, while a pub in Wimbledon, south London, is offering a <a href="https://twitter.com/TheAlexSW19/status/930081574204399616">free Christmas meal</a> to old folks who are alone on Christmas day.</p>
<p>Taken together these campaigns paint a specific picture about loneliness in contemporary Britain, and the focus upon older people is obvious. Although some philosophers have argued that <a href="http://www.iep.utm.edu/sartre-p/">loneliness is simply part of being human</a>, it is more typically portrayed as almost inevitably a “problem” that is part of normal ageing: to grow old is to grow alone.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/199697/original/file-20171218-27607-6i7jkf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/199697/original/file-20171218-27607-6i7jkf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/199697/original/file-20171218-27607-6i7jkf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/199697/original/file-20171218-27607-6i7jkf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/199697/original/file-20171218-27607-6i7jkf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/199697/original/file-20171218-27607-6i7jkf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/199697/original/file-20171218-27607-6i7jkf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">An Age UK campaign that focuses on social isolation among those in later life.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/howardlake/14488831179">howardlake</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<h2>Perception more than reality</h2>
<p>Surveys which look at people’s expectations of old age show that about one third of respondents indicate they believe loneliness to be one of the major challenges they face. Other data from the <a href="http://www.tandfonline.com/doi/full/10.1080/13607863.2015.1023767">English Longitudinal Survey of Ageing</a> suggest that around 30% expect to get lonelier as they age, and 25% think increased feelings of loneliness is part of ageing. But among older people themselves, only 15% see it as an issue.</p>
<p>Loneliness can be measured in many ways. However research consistently shows that, at any one time, about 10% of those aged 60 and over report significant feelings of loneliness, and that this proportion is <a href="https://www.cambridge.org/core/journals/ageing-and-society/article/has-loneliness-amongst-older-people-increased-an-investigation-into-variations-between-cohorts/34604FCD5672C84FC2D65EEDDE332E35">largely unchanged since the late 1940s</a>. The level of loneliness reported by young adults aged 16-24 is comparable to that for older people – but discussions about loneliness at Christmas rarely feature young people.</p>
<p>As a gerontologist, someone who studies older age, perhaps I should not worry about the exclusion of younger people from debates about loneliness at Christmas, and should celebrate that for once issues around old age and older people are being taken seriously by the media. But the representation of older people as lonely, without family or friends, is not a very positive prospect to look forward to. </p>
<p>It is one of the many negative depictions of older people and later life that abound, and which may explain why many of us have such low expectations of our twilight years. We dread old age, rather than see the opportunity to grow old as a privilege that is a consequence of improvements in public health, workplace safety, and access to good food and housing – the lack of which shortened many lives in the early 20th century.</p>
<p>Another issue is the timing. The Age UK survey from 2017 reports that <a href="https://www.ageuk.org.uk/latest-news/articles/2017/december/almost-a-million-older-people-feel-lonelier-at-christmas/">almost 1m older people feel lonelier at Christmas time</a>. Without comparable data for younger people or other groups, we cannot say whether the perception of increased loneliness at Christmas is exclusive to older people, or something that affects other groups equally.</p>
<p>As an example, a unique but small study asked older people in West London how they felt over the course of a year, and found that feelings of loneliness <a href="https://benthamopen.com/ABSTRACT/TOPSYJ-8-97">rose in summer rather than in winter or at Christmas time</a>. We might speculate that while families may invite older relatives for Christmas lunch, they may be less likely to invite grandma to a family holiday abroad or to a summer barbecue. But without data to compare with other age groups we can draw only limited conclusions.</p>
<p>The new <a href="https://www.jocoxloneliness.org/pdf/_a_call_to_action.pdf">Jo Cox Commission</a> report into loneliness and social isolation, launched after a “loner” and white supremacist <a href="https://www.theguardian.com/uk-news/2016/nov/23/thomas-mair-found-guilty-of-jo-cox-murder">murdered the MP during the EU referendum campaign</a> reported that loneliness does not discriminate between young or old. This should serve to prompt us to turn our obsession away from loneliness among older people at Christmas towards a broader understanding that loneliness can affect other groups of all ages and at any time. Loneliness is not just for Christmas.</p><img src="https://counter.theconversation.com/content/88972/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christina Victor receives funding from ESRC, Dunhill Medical Trust.</span></em></p>Older people are less lonely than we think, but more importantly loneliness is something they face all year round – not just at Christmas.Christina Victor, Professor of Gerontology and Public Health, Brunel University LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/872092017-12-07T13:33:34Z2017-12-07T13:33:34ZIt’s time to recognise how harmful high-rise living can be for residents<figure><img src="https://images.theconversation.com/files/198143/original/file-20171207-5048-1dio4x5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/34547181@N00/28371618145/sizes/l">Phillippe Put/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span></figcaption></figure><p>The fire at Grenfell Tower has catapulted high-rise social housing into the public consciousness, in a way not seen since the 1960s. Back then, high-rise tower blocks represented a new vision of social progress. They were greeted with hope and optimism by housing officials, architects and town planners across the UK. But now, the mood has turned to one of bitterness, anger and fear. Over the years, most of these so-called “villages in the sky” have become <a href="https://theconversation.com/thatcher-helped-people-to-buy-their-own-homes-but-the-poorest-paid-the-price-50133">concrete containers</a> for society’s poorest and neediest people.</p>
<p>This is not just an issue in the UK. Today, millions of people live in high-rise apartment blocks around the world. In <a href="https://www.emporis.com/statistics/skyline-ranking">Moscow alone</a>, there are 11,783 high-rise towers, in Hong Kong there are 7,833, and in Seoul there are over 7,000, many of which are residential. Understanding the link between high-rise living and mental health is crucial to protect the well-being of tower block residents across the globe. </p>
<h2>Living in fear</h2>
<p>High-rise living evokes unsettling fears – residents could be trapped in a fire, or fall or jump from the tower. The sheer number of people sharing a single building can also increase the threat from communicable diseases such as influenza, which <a href="https://www.cdc.gov/flu/about/disease/spread.htm">spread easily</a> when hundreds of people share a building’s hallways, door handles and lift buttons. </p>
<p>Sharing semi-public spaces with strangers can <a href="http://www.tandfonline.com/doi/abs/10.3763/asre.2007.5002">make residents</a> more suspicious and fearful of crime. Many feel an absence of community, despite living alongside tens or hundreds of other people. And in earthquake-prone countries, residents of high-rise towers face the possibility that <a href="https://www.theguardian.com/cities/2015/sep/18/mexico-city-earthquake-30-years-lessons">their entire building could collapse</a>.</p>
<p>Perhaps most poignant of all is the fear of isolation. During ongoing <a href="https://link.springer.com/article/10.1007/s11205-017-1812-0?wt_mc=Internal.Event.1.SEM.ArticleAuthorOnlineFirst">research into social isolation</a> among older people in the English city of Leeds, residents of high-rise buildings reported feeling lonely and isolated – some were afraid to even open their front doors. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/197964/original/file-20171206-910-1jkratm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/197964/original/file-20171206-910-1jkratm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/197964/original/file-20171206-910-1jkratm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/197964/original/file-20171206-910-1jkratm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/197964/original/file-20171206-910-1jkratm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/197964/original/file-20171206-910-1jkratm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/197964/original/file-20171206-910-1jkratm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A lonely life.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/old-lady-sadly-sitting-near-window-769083229?src=9xqshzFU7UQYGWBWXprb4Q-1-0">from www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>Many of these older residents rely on networks of neighbours, friends and family to help them get around and perform basic chores. One wheelchair user explained how she relied on her neighbour to help her get to the lift and out of the block. If her neighbour is not there, she is stuck. </p>
<p>Living with fear every day means that residents of high-rise housing – and especially social housing – <a href="https://www.mentalhealth.org.uk/a-to-z/f/fear">are vulnerable to</a> mental health issues. Psychologists <a href="http://bjp.rcpsych.org/content/128/3/259.short">have been investigating</a> this link since the 1970s – a <a href="http://trove.nla.gov.au/work/9163615?selectedversion=NBD1538169">1979 study</a> based in Glasgow found evidence that high-rise residents were presenting psychological symptoms more often than other housing residents. </p>
<p><a href="http://www.tandfonline.com/doi/abs/10.1300/J083v16n03_06">Another paper</a> from 1991 compared elderly African-Americans living in high-rise and low-rise buildings in Nashville. The high risers had a higher incidence of depression, phobias, schizophrenia. </p>
<h2>The true causes?</h2>
<p>But researchers aren’t always comparing like with like. In Nashville, although the residents shared the same ethnic background, high risers were poorer, less educated and had fewer social contacts: all factors which may contribute towards mental ill health. </p>
<p>So it’s difficult to say whether it’s the building itself, or other hardships such as poverty, which cause high-rise residents such difficulties. Yet there is some evidence to suggest that high-rise buildings themselves are actually responsible for some of the harms done to residents. </p>
<p>For example, in Singapore, between 1960 and 1976, the percentage of people living in high-rise buildings climbed from 9% to 51%. During the same period, the per capita rate of suicides by leaping from tall buildings <a href="http://www.tandfonline.com/doi/abs/10.3763/asre.2007.5002">increased fourfold</a>, while suicide by other means declined. </p>
<p>This could be for one of two reasons. Either more people became suicidal and would have found a way to commit suicide by any means – or greater access to tall buildings gave more people a means of killing themselves, which they wouldn’t otherwise have done. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/197959/original/file-20171206-910-q0kfv3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/197959/original/file-20171206-910-q0kfv3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=332&fit=crop&dpr=1 600w, https://images.theconversation.com/files/197959/original/file-20171206-910-q0kfv3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=332&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/197959/original/file-20171206-910-q0kfv3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=332&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/197959/original/file-20171206-910-q0kfv3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=417&fit=crop&dpr=1 754w, https://images.theconversation.com/files/197959/original/file-20171206-910-q0kfv3.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=417&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/197959/original/file-20171206-910-q0kfv3.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=417&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Singapore’s high rise residences.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/volvob12b/17386735395/sizes/l">Bernard Spragg/Flickr</a></span>
</figcaption>
</figure>
<p>The overall suicide rate in Singapore increased by 30% over the aforementioned period but the rate by leaping increased many times faster, which suggests that having more tall buildings leads to more suicides. While suicide rates have been stable for five decades now, jumping from buildings remains a <a href="http://eu.wiley.com/WileyCDA/WileyTitle/productCd-1118903277.html">common method for suicide</a> there, as well as in other cities where high rise buildings are ubiquitous – such as Hong Kong, New York City, Taipei City. </p>
<p>Yet high-rise living can have its positives. Roughly four in five Singaporeans live in public housing – almost all of it high-rise. Older buildings are regularly refurbished and most are near to local food markets, parks and sports halls. Some even have sky gardens and rooftop running tracks. </p>
<p>All of these factors can help to create a less stressful environment. What’s more, in Singapore, the residents of public housing are deliberately <a href="https://www.ft.com/content/49955844-6563-11e7-9a66-93fb352ba1fe">mixed by income and ethnicity</a>, so that each neighbourhood is reflective of the population as a whole – this helps to avoid the kind of social segregation that tends to occur in the UK. If this example is followed in other cities across the globe, then living in high-rise towers might not be quite so damaging after all.</p><img src="https://counter.theconversation.com/content/87209/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Andrea Wigfield receives funding from Leeds City Council. </span></em></p><p class="fine-print"><em><span>Royce Turner does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Residents may be right to fear for their lives.Royce Turner, Research assistant and policy analyst, University of HuddersfieldAndrea Wigfield, Director, Care-Connect, University of SheffieldLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/872172017-11-12T23:09:53Z2017-11-12T23:09:53ZLoneliness could kill you<figure><img src="https://images.theconversation.com/files/194015/original/file-20171109-13296-zeo2ob.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Studies are showing that loneliness can be deadly, even more so than obesity. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Independence is glorified in North American culture as a symbol of strength. As a society, we value individual achievement and extol self-reliance.</p>
<p>I am an expert on aging and retirement and I also help employees transition from work to retirement by facilitating seminars and workshops in corporate Canada. And I often wonder however if our “go at it alone” attitude has led us down a lonely and isolating path.</p>
<p>Here are some recent stats: </p>
<ul>
<li><p>40 per cent of Americans <a href="https://hbr.org/cover-story/2017/09/work-and-the-loneliness-epidemic">don’t feel close to others</a> at any given time. And the number of lonely Americans has doubled since the 1980s.</p></li>
<li><p><a href="http://www.carp.ca/2017/06/05/loneliness-survey-results/">In a recent Canadian Association of Retired People poll</a>, 16 per cent of Canadians indicated that they lacked companionship</p></li>
<li><p>Fifteen per cent in the CARP poll said they had nobody to turn to or talk to</p></li>
<li><p>Fifteen per cent were unhappy doing things alone.</p></li>
</ul>
<p>I suspect that these numbers are even higher among the general Canadian population, not just CARP members.</p>
<p>According to science, loneliness shortens our lifespan. <a href="https://news.uchicago.edu/article/2014/02/16/aaas-2014-loneliness-major-health-risk-older-adults">Twice as much as obesity.</a> Yes, you read that right.</p>
<p>Dr. John <a href="http://psychology.uchicago.edu/people/faculty/cacioppo/">Cacioppo</a>, the world’s foremost authority on loneliness, maintains that the number of people in your life does not inoculate you from experiencing loneliness. Rather, it’s the feeling of being lonely that places the brain and body at risk.</p>
<p>Cacioppo equates feeling lonely with feeling hungry. We compromise our survival and well-being when either is ignored.</p>
<p>We are biologically hardwired to respond to our environment. When we experience low blood-sugar levels, we crave food. The feeling of our stomachs being empty is a warning sign to eat and it’s essential to our very survival.</p>
<p>When we feel lonely, we desire connection with others, much like the loud rumble that your tummy makes when hungry.</p>
<h2>A lonely brain is restless</h2>
<p>Loneliness triggers “hyper-vigilance.” That is your brain is on the lookout for social threats, which consequently puts us on the defensive. We become more reactive to negative events and perceive daily hassles as more stressful.</p>
<p>A lonely brain awakens often, experiences fragmented sleep and cannot recover from the day’s stressful events.</p>
<p>A lonely brain is also subject to an increase in depressive symptoms and has difficulty self-regulating. That is why you may find yourself irritable and impulsive.</p>
<p>A lonely brain is also at risk of cognitive and physical decline.</p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/23232034">A three-year Dutch study</a> followed more than 2,000 participants aged 65 to 86. While none of the participants had signs of dementia at the outset of the study, results revealed that those who reported feeling lonely had a 64 per cent increase in the risk of developing dementia.</p>
<p>People also experience an increase in loneliness when they retire from work. That’s why you want <a href="http://rewiretoretire.com/delay-retirement/">to make sure that you’re retiring <em>to</em> something</a>, and that you have friends outside of your place of employment. </p>
<h2>A lonely body</h2>
<p>Loneliness also affects the body. Psychologist <a href="https://irp.nih.gov/pi/stephen-suomi">Stephen Suomi’s</a> research indicates that loneliness distorts the expression of certain genes. An experiment separating newborn primates from their mothers during their first four months of life resulted in the altered development of immunity-related genes that help the body fight viruses.</p>
<p>Social psychologist <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633610/">Lisa Jaremka’s research</a> indicates that lonely people have higher levels of activated viruses in their system and are at greater risk of suffering from chronic inflammation, which has been linked to Type 2 diabetes, arthritis, heart disease and even suicide.</p>
<p>While obesity increases your odds of an early death by 20 per cent, loneliness increases <a href="https://www.ucsf.edu/news/2012/06/12184/loneliness-linked-serious-health-problems-and-death-among-elderly">your odds by 45 per cent</a>.</p>
<p>What are we to do with an emotional state that is so powerful that it can alter our brains, compromise our physiology and cut short our longevity?</p>
<h2>The antidote to loneliness</h2>
<ol>
<li><p>Seek out connection: We all need a tribe!</p></li>
<li><p>Stop denying and accept “feeling lonely” as simply a craving for connection.</p></li>
<li><p>Acknowledge the consequences of prolonged loneliness. If you ignore hunger, you starve. Same is true of our need for belonging. If you feel lonely, reach out to others.</p></li>
<li><p>Recognize that quality relationships are most effective at feeding this void.</p></li>
</ol>
<p>We are physiologically and psychologically primed for connection.</p>
<p>The next time you feel lonely and out of sorts, acknowledge it as a signal that you are in need of connection and seek out companionship.</p>
<p>Your body and your brain will be thankful that you did, and you may even increase your longevity.</p><img src="https://counter.theconversation.com/content/87217/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gillian Leithman does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Loneliness shortens our life spans and some studies suggest it’s even more lethal than obesity. We are physiologically and psychologically primed for connection, so don’t shrug off your loneliness.Gillian Leithman, Assistant Professor of professional business skills and aging, retirement, and knowledge management researcher, Concordia UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/762482017-04-14T00:49:53Z2017-04-14T00:49:53ZWhy addressing loneliness in children can prevent a lifetime of loneliness in adults<figure><img src="https://images.theconversation.com/files/165296/original/image-20170413-25898-sud4tc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Loneliness in adults is often a result of loneliness in childhood. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/small-boy-sad-expression-548630776?src=V48QRwFTqd_mdEdytsi6gQ-1-82">From www.shutterstock.com </a></span></figcaption></figure><p>The Republicans’ controversial effort to repeal the perhaps optimistically named Affordable Care Act because of rising premiums may be fatally stalled. But there are other ways to rein in health care costs that have been almost entirely overlooked. Making a serious effort to reduce loneliness could make a real difference. </p>
<p>Lonely people put <a href="http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2014.302427">heavy demands on our health care system</a>. Loneliness impairs immune response and makes people more likely to develop serious medical problems like <a href="http://dx.doi.org/10.1136/heartjnl-2015-309242">heart disease and stroke</a>.</p>
<p>According to <a href="http://journals.sagepub.com/doi/abs/10.1177/1745691614568352">one meta-analysis</a>, loneliness increases the risk of early death as much as smoking or being 100 pounds overweight. The risk is highest in people younger than 65. But lonely people don’t go to doctors just for medical care. They’re also dying for social contact.</p>
<p>Although loneliness is now recognized as a <a href="http://www.ucsf.edu/news/2012/06/12184/loneliness-linked-serious-health-problems-and-death-among-elderly">major public health problem</a>, there hasn’t been much discussion about how to address it. </p>
<p>As a clinician who treats mental health issues caused by loneliness, I’ve come to believe that we can’t develop effective interventions for loneliness without first understanding what causes it.</p>
<h2>More than social isolation</h2>
<p>Although <a href="http://ccn.aacnjournals.org/content/33/6/8.full">isolation</a> is an important risk factor, having company doesn’t always prevent loneliness – and being alone doesn’t always cause it.</p>
<p>Someone in a bad marriage may feel lonely in the presence of a distant or rejecting spouse, for example. Loneliness is the experience of being not alone but without the other in a way that feels meaningful. What matters is the internal experience.</p>
<p>Some people are content on their own. As the British psychoanalyst <a href="http://www.goodtherapy.org/famous-psychologists/donald-winnicott.html">Donald Winnicott</a> explained, people like this never actually feel alone internally. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/165300/original/image-20170413-25862-1df0ecn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/165300/original/image-20170413-25862-1df0ecn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=427&fit=crop&dpr=1 600w, https://images.theconversation.com/files/165300/original/image-20170413-25862-1df0ecn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=427&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/165300/original/image-20170413-25862-1df0ecn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=427&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/165300/original/image-20170413-25862-1df0ecn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=537&fit=crop&dpr=1 754w, https://images.theconversation.com/files/165300/original/image-20170413-25862-1df0ecn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=537&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/165300/original/image-20170413-25862-1df0ecn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=537&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/happy-mother-child-daughter-salad-n-492345094?src=-slICfYUPffqh8vCPobv-g-2-42">From www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>What protects them is the early experience of having what he called “a good-enough mother.” A good-enough mother isn’t perfect, but she cares deeply for her child and values him for who he is. Wherever these contented souls go, they carry with them an ongoing sense of the mother’s caring and attentive presence.</p>
<p>But many people are not that lucky. It’s well-known that <a href="https://www.childwelfare.gov/topics/can/impact/long-term-consequences-of-child-abuse-and-neglect/health-and-mental-health/">people who were abused</a> as children are at higher risk of getting into abusive relationships as adults. Similarly, people who suffered from <a href="https://www.cdc.gov/violenceprevention/childmaltreatment/consequences.html">emotional neglect</a> as children have a high risk of reliving that experience as well. They felt lonely and uncared for as children, and they feel that way as adults too.</p>
<p>Chronic loneliness can be the aftermath of early emotional neglect. This kind of neglect is often invisible to others. A child may grow up in a family where everything seems normal on the outside, but still feel lonely if he can’t get from his mother the love and attention he needs to thrive.</p>
<p>A depressed, withdrawn mother is not likely to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724169/">emotionally available</a> to her child, even if she goes through the motions of doing what’s needed. Sometimes a mother may feel so depressed and deadened herself that she <a href="http://www.apadivisions.org/division-39/publications/reviews/dead-mother.aspx">deadens the relationship </a>with her child, as described by the French psychoanalyst Andre Green.</p>
<p>In other cases, the mother may be distant and rejecting – or so oblivious to her child’s thoughts and feelings, and so out of touch with who he is, that she leaves the child feeling stranded emotionally and alone.</p>
<p>Fathers are very important too, of course; they can mitigate or worsen the effect of mothers in this regard. But since mothers are usually the primary caretakers, particularly of very young children, they usually have the greatest effect when it comes to providing a buffer from loneliness or leaving children vulnerable to it.</p>
<p>Anyone who tried to get close to his mother as a child and failed may well feel hopeless about developing close relationships later in life. Sometimes hopelessness has a neurological basis: <a href="https://www.ncbi.nlm.nih.gov/pubmed/25455063">Severe early neglect</a> impedes development of neurons responsible for optimism.</p>
<h2>Lessons learned from neglect can harm for decades</h2>
<p>But, sadly, people who suffered from emotional neglect as children may also act in such a way as to make the expectation of loneliness a self-fulfilling prophecy.</p>
<p>Children who feel uncared for generally blame themselves. As adults, they may <a href="https://www.sciencedaily.com/releases/2013/05/130508092835.htm">hang back from others</a> because of a lingering sense of shame about feeling unwanted, or because they feel they don’t deserve to be loved.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/165305/original/image-20170413-25886-18beng8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/165305/original/image-20170413-25886-18beng8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/165305/original/image-20170413-25886-18beng8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/165305/original/image-20170413-25886-18beng8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/165305/original/image-20170413-25886-18beng8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/165305/original/image-20170413-25886-18beng8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/165305/original/image-20170413-25886-18beng8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sad-lonely-nerd-student-126450782?src=FD_t9dIh6ORTrIuFPwcY1g-4-39">From www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>Some people do more than hang back. They almost seem to cling to loneliness and to the social isolation that feeds it. <a href="https://www.ncbi.nlm.nih.gov/pubmed/22079507">Neurobiological mechanisms</a> may play a part in this, because loneliness activates the fight-or-flight response, making people hypersensitive to threat and more likely to respond to others in a fearful or defensive manner.</p>
<p>But psychological factors are important too. If loneliness was the most powerful feeling you had with your mother, you may cling to the feeling of loneliness because that’s what connects you most closely to her. Without realizing it, some people may be reluctant to relinquish isolation and the loneliness it creates because loneliness feels like a kind of private space which is shared with a distant and rejecting mother.</p>
<p>Of course, we could all ask, “Why would you want to hold onto that?”</p>
<p>Well, we’re not always rational! We all bear the imprint of early relationships with parents; most of us replay even painful parts of those relationships over and over again. Freud called this the <a href="https://www.ncbi.nlm.nih.gov/pubmed/20798678">repetition compulsion</a>. We fall into old patterns in part because they’re familiar, and in part perhaps as a way of showing loyalty to parents who were once everything to us.</p>
<p>According to the Scottish psychoanalyst <a href="http://psychoanalysis.org.uk/our-authors-and-theorists/ronald-fairbairn"> W.R.D. Fairbairn</a> and others, nothing motivates us more powerfully than the longing for intimate connections with others. All else being equal, nobody would choose a painful relationship, but if that’s what he’s given as a child, that’s what he has – and that’s what he holds tight to. Painful relationships are better than nothing.</p>
<p>This can be seen in a highly controversial experiment by American psychologist <a href="http://www.pbs.org/wgbh/aso/databank/entries/bhharl.html">Harry Harlow</a>. Harlow first deprived baby monkeys of maternal affection, causing them to become panicky, and then offered each monkey a choice between a cloth mother and a bare wire mother that held a bottle with food. The monkeys preferred the more huggable cloth option; each baby monkey became attached to its own cloth mother, and would cling to this inanimate surrogate even though it offered no food.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/_O60TYAIgC4?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Harry Harlow studies love with baby monkeys.</span></figcaption>
</figure>
<h2>Children have a need to love, even when they’ve been harmed</h2>
<p>Children love their parents even when they’ve been abused. The same holds true for children who’ve been neglected. If a child’s relationship with his mother leaves him feeling profoundly lonely, that’s what he has, and that’s what he holds tight to.</p>
<p>Paradoxically perhaps, the less emotional nourishment someone gets from her mother, the more tightly she may want to hold on. It’s a lot easier to separate from a mother who makes you feel loved and secure in the world than it is to turn away from a mother who seems to be on the brink of disappearing emotionally herself.</p>
<p>Some people may cling to social isolation because isolation is what most closely reflects their emotional experience as children. Longstanding loneliness may signal what is perhaps best understood as a kind of attachment disorder, with ongoing attachment to a depressed, withdrawn or rejecting mother.</p>
<p>When chronic loneliness comes from childhood neglect, social outreach programs are not likely to be sufficient. We need to think more carefully about what causes loneliness, and what seems to be the peculiar attachment of some people to a condition which they find deeply painful. Then we can tailor interventions to address the cause, rather than just the condition of being alone.</p><img src="https://counter.theconversation.com/content/76248/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Elizabeth Tillinghast does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Loneliness is a major cause of health problems, and many programs have aimed to alleviate it among the elderly. But it might be wise to treat loneliness at its roots, which for many is in childhood.Elizabeth Tillinghast, Assistant Clinical Professor of Psychiatry, Columbia UniversityLicensed as Creative Commons – attribution, no derivatives.