Medway Social Isolation
Strategy 2014-2018
Karen Macarthur,
Consultant in Public Health, Medway Council
Overview
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Defining social isolation and loneliness and who is at risk
The impact of loneliness on health
The size of the problem
What works in tackling loneliness and social isolation
Medway’s “Reducing Social Isolation Strategy”
What next?
What are social isolation and loneliness?
• Social isolation broadly refers to the absence of contact with
people.
• Loneliness, which is concerned with negative feelings that an
individual may have due to a lack or loss of meaningful social
relationships. (Social or emotional loneliness..)
Or put more simply
“Isolation is being by yourself, loneliness is not liking it.”
Voluntary sector service provider
Who is at risk?
• Potentially everyone, but some groups are at a higher risk of being isolated
• Older people are significantly more likely to
suffer from social isolation with contributing
factors being loss of friends and family, loss
of mobility, deterioration in physical health
or loss of income
• Other population groups at risk
include carers, refugees and those
with mental health problems and
those with sensory impairment
The impact of loneliness
“There is much suffering in the world physical, material, mental..
But the greatest suffering is being lonely,
feeling unloved, having no one. I have come
more and more to realize that it is being
unwanted that is the worst disease that any
human being can ever experience.”
Mother Teresa
Health effects of being
socially isolated
• Increased risk of dementia, high blood pressure, stress levels
and death and poorer immunity (Holt-Lunstead, J. et al. 2010)
• People with strong social relationships have a 50% increased
likelihood of survival than those with weaker social
relationships, comparable with well-established risk factors for
mortality such as smoking, obesity and physical inactivity
How does loneliness affect health?
• Loneliness increases the risk of high blood pressure (Hawkley
et al, 2010)
• Lonely individuals are also at higher risk of the onset of
disability (Lund et al, 2010)
• Loneliness puts individuals at greater risk of cognitive decline
(James et al, 2011)
• One study concludes lonely people have a 64% increased
chance of developing clinical dementia (Holwerda et al, 2012)
• Lonely individuals are more prone to depression (Cacioppo et
al, 2006) (Green et al, 1992)
• Loneliness and low social interaction are predictive of suicide
in older age (O’Connell et al, 2004
How does loneliness affect health?
• Two main models
– Buffering/ stress regulator hypothesis. Relationships provide
informational/emotional/tangible resources which help reduce
stress and reduced stress encourages us to adopt healthy
behaviours
– Main effects model, social relationships may protect health
through more direct means such as emotional and biological
influences, changes in brain and body.
• High cortisol
• Higher risk of hypertension
• Link to depression
• More focused on self preservation, always vigilant less ability
to be empathetic and form relationships
Loneliness in Older Adults in the UK
• 17% of older people are in contact with family, friends and
neighbours less than once a week and 11% are in contact less
than once a month (Victor et al, 2003)
• Over half (51%) of all people aged 75 and over live alone (ONS,
2010)
• Two fifths all older people (about 3.9 million) say the television
is their main company (Age UK, 2014)
• 63% of adults aged 52 or over who have been widowed, and
51% of the same group who are separated or divorced report,
feeling lonely some of the time or often (Beaumont, 2013)
• 59% of adults aged over 52 who report poor health say they
feel lonely some of the time or often, compared to 21% who
say they are in excellent health (Beaumont, 2013)
Estimates from national studies
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It is estimated that across the present UK population aged
65 and over, that approximately 12% are socially isolated
and approximately 10% feel lonely all or most of the time.
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If this approximation was applied to Medway this would
result in an estimate of 4,698 people over 65 years old
being socially isolated and 3915 feeling lonely all or most
of the time .
Minority ethnic communities
• Research conducted on groups who migrated to UK in 1960’s, 1970’s and
1980’s including Indian, African, Chinese, Caribbean, Bangladeshi and
Pakistani communities.
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15% reported that they always or often feel lonely compared to 10%
in general population
• Less likely to say they take part in social
activities they enjoy (44% - 79%)
• 55% say they have someone who gives them
love and affection compared to 88% in the
general population
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7% of Indian elders report they are often or always lonely compared with
24% of the Chinese population.
2. What works
Evidence shows a number of initiatives can be effective but
evidence shows that ;
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Befriending, visits or phone contact
Mentoring
Community ‘Navigators’ or ‘Connectors’
Social group schemes: arts and crafts/cultural/interest,
walking groups for over 50’s
• Community activities: Asset based community groups
• Volunteering schemes: Time Banks
Costs
• Limited evidence on the cost-effectiveness of interventions to
reduce social isolation.
• One economic analysis has found that a typical service for
befriending would cost around £80 per older person within the
first year and provides about £35 in ‘savings’ due to the reduced
future need for treatment
• One study has found that supportive closed groups can be costeffective and found that there was a saving of €62 per person due
to a reduction of hospital bed days, physician visits and outpatient
appointments
Medway social isolation strategy
• In 2014 Medway Health and Wellbeing Board identified social
isolation as one of the priorities.
• Strategy has been developed and approved
Three strategic objectives;
• Raising awareness and identifying vulnerable individuals
• Action to support individuals
• Community action
Medway social isolation strategy
• Implementation plan developed which went to the
Health and Wellbeing Board in September 2015.
• Implementation group set up includes representation
from Medway Council, Kent Fire and Rescue, Age UK,
Carers First, Medway Voluntary Action, Sunlight
Development Trust, Nucleus Arts…..
Raising awareness and identifying
individuals at risk
• Social isolation index
• Information resource for older people/Citizens
Portal
• Social isolation summit
• Fire and Rescue Service pilot
• Social isolation module being developed as part of
the “A Better Medway Champions programme”
Developing an isolation index for
Medway
• Isolation index based on MOSAIC consumer
classification based on in-depth demographic data
• Index can be used to estimate which communities are
most affected by loneliness/isolation
Relative social isolation per household at lower super output area level of persons
aged under 65
Relative estimated social isolation per household of persons aged 65 years and
over
Direct interventions for individuals and
community approaches:
• One-to-one approaches
Health and Social Care Navigators
• Community Approaches
CPCE project (DERIC) being developed in the Hoo peninsula
and Walderslade.
Intergenerational project
• Information resource lists the others for older
people…. Age UK, Carers First, Men in Sheds, British Red Cross,
Contact the Elderly….
What next?
Reducing social isolation and loneliness
action network
Focus on other groups?
Other ideas?