New Perspectives on Loneliness
and the Lifecourse
Thomas Scharf
Irish Centre for Social Gerontology, NUI Galway
Project Lifecourse Seminar Series, 28 May 2014, NUI Galway
Outline
• Rethinking loneliness:
– As a public health issue
– As a lifecourse issue
• Loneliness:
– Definitions and characteristics
– Links to other forms of disadvantage
– Prevalence
– Cross-national and within-nation variation
• Interventions to address loneliness
• Considerations for policy, practice and research
Impacts of loneliness
In research, loneliness has been associated with:
• Reduced quality of life
• Premature mortality
• Broad range of physical and mental health conditions (e.g.
sleep disorders, risk of cardiovascular disease, low selfesteem, dementia, depression)
• Increased use of medications
• Increased alcohol consumption
Loneliness as a public health issue
“Individuals with adequate social relationships have a 50%
greater likelihood of survival compared to those with poor or
insufficient social relationships. The magnitude of this effect is
comparable with quitting smoking and it exceeds many wellknown risk factors for mortality (e.g., obesity, physical inactivity).”
Holt-Lunstad J, Smith TB, Layton JB (2010) Social Relationships and Mortality Risk:
A Meta-analytic Review. PLoS Med 7(7): e1000316.
doi:10.1371/journal.pmed.1000316
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000316
Comparison of odds of decreased mortality
across conditions associated with mortality
Social and economic impacts of loneliness
Loneliness has broader social impacts that reach beyond the
individual:
• Impacts on families, friends and neighbours (loneliness as
‘contagious’)
• Impacts on communities (e.g. community-based
interventions to tackle loneliness)
• Impacts on broader society (e.g. increased use of
health/social care services; GP consultations; emergency
admissions to hospital; re-admission to hospital; entry into
institutional care)
Loneliness: as a lifecourse issue
Loneliness to be considered in terms of a lifecourse approach:
• Individuals’ experiences of loneliness likely to fluctuate
across life, reflecting changing personal circumstances
• Loneliness may be more characteristic of certain life stages
(e.g. ‘empty-nest’ stage; retirement for some people)
• Some life transitions may be more closely associated with
loneliness than others (e.g. leaving home, relationship
breakdown, migration, bereavement, onset of chronic ill
health)
• Loneliness as a cohort issue (e.g. impact of AIDS/HIV)
Loneliness: definitions
• Loneliness is a subjective and negative experience:
“[T]he unpleasant experience that occurs when a person’s
network of social relations is deficient in some important way,
either quantitatively or qualitatively” (Perlman and Peplau,
1981, p.31)
• Social isolation is an objective measure reflecting an
individual’s lack of contacts or ties with others
Loneliness: forms
Weiss (1973) distinguishes between emotional and social
forms of loneliness:
• Emotional loneliness reflects a person’s perceived lack of an
intimate attachment – perhaps a spouse/partner, a best
friend, or someone else whom one can confide in
• Social loneliness refers to a person’s sense that they are not
part of an engaging social network of family, friends and
others (Dykstra, 2009)
Individuals may be experience emotional and social forms of
loneliness at the same time
Loneliness: forms
• Emotional loneliness: “I wouldn’t say friends. We laugh and
talk and you know … I don’t really go to them with my
problems … We talk about the weather and talk about our
arthritis and so on.”
• Social loneliness: “My neighbour’s pretty ill and when her
son goes out … I go and sit with her … to keep her
company … I do that every day. As I say, it’s a bit of
company for me because I don’t see anybody and we have
a cup of tea and a chat.”
Loneliness: duration
• ‘Transient’ loneliness: may occur from time to time, but
passes over the course of a day
• ‘Situational’ loneliness: may arise after a specific change in
an individual’s circumstances, but passes with time
• ‘Chronic’ loneliness: refers to persistent feelings of
loneliness that may endure over a considerable period of
time (Young, 1982)
• ‘Seasonal’ loneliness: typically associated with winter
months and/or with particular seasonal events (e.g.
Christmas and New Year period)
Loneliness: duration
• ‘Chronic’ loneliness: “But, my husband died in, well he’s
dead now 13 years, and since he died I feel very lonely and
eh…it can be very lonely, really… As I said I can’t…change
the fact that it is very lonely when you’re a widow and living
alone.”
• ‘Seasonal’ loneliness: “The clocks alter, you draw the
curtains at four o’clockish and you don’t see anybody again.
And I’m off the main road, so I can’t even see people going
past.”
Loneliness and social exclusion
• Helpful to recognise loneliness within the context of other
aspects of an individual’s life
• Loneliness may be related to other forms of disadvantage
(experienced by older people):
– Poverty
– Lack of civic engagement
– Limited use of or access to services
– Negative perceptions about the local community
Prevalence of loneliness in later life
• Surveys conducted in the UK since the 1940s consistently
suggest that 7-10% of people aged over 60/65 identify
themselves as being often or always lonely (Victor et al.,
2005)
• Intense loneliness affects only a minority of the older
population. But demographic change means that more people
are affected by feelings of loneliness
• Assuming a loneliness rate of 7-10%:
– In Ireland, between 37,500 and 53,600 of 536,000 people
aged 65+ likely to be often/always lonely
Prevalence of loneliness in later life
Loneliness tends to be higher amongst:
• People aged 75 and over (especially aged 85 and over)
• People who live alone
• People who are widowed, divorced or separated, or never
married
• People in poor physical and/or mental health
• People living on limited material resources
• People belonging to some black and minority ethnic groups
• People who spend a lot of time alone
Prevalence of loneliness across age-groups
• European Social Survey data for Britain show two agerelated peaks in the prevalence of loneliness: late
adolescence/early adulthood (ages 16-24) and later life (age
65+) at 9% and 11% respectively (Victor & Yang, 2012)
• In the UK, Griffin (2010) reports an inverse relationship
between age and loneliness (highest rates in those aged 1834 as compared with 35-54 and 55+)
• In Australia, Lauder et al. (2006) report the highest mean
loneliness for people aged 40-49 years as compared with
those aged 18-19 and 60 and over
Loneliness in context
• Loneliness and ageing do not necessarily go hand in hand –
otherwise the prevalence of loneliness in later life would be
the same everywhere
• Cross-national and within-nation variation in loneliness rates
suggests that context matters:
– National contexts (culture, socio-economic level, welfare
state etc.)
– Local contexts (urban/rural environments etc.)
Loneliness in context: national variation
• Walker and Maltby (1997) reported that the prevalence of
loneliness amongst older people in Europe ranges from:
– under 5% in Denmark
– around 5% to 9% in Britain, the Netherlands and Germany
– to over 20% in Portugal and 35% in Greece
• More recent work points to similar cross-national variation
(e.g. Fokkema et al., 2012), with especially high rates of
loneliness amongst older people in former Soviet bloc
nations (Yang & Victor, 2011)
Loneliness in context: urban/rural
The (limited) research evidence relating to specific types of
environment suggests that the prevalence of loneliness is:
• Lower in rural than urban communities in some European
nations, including Austria, Sweden, and the UK, but not in
others such as the Netherlands, Luxembourg or Italy (Burholt
et al., 2007)
• Higher in socially deprived urban communities, although
variations exist across such communities (Scharf & De Jong
Gierveld, 2008)
Socio-spatial features of loneliness
Increased risk of loneliness potentially influenced by:
• Design/planning, which may limit older people’s capacity to
form/maintain meaningful social relationships (e.g. poor
transport; lack of seating; inaccessible buildings; poor
pavements; topography; age-segregated living etc.)
• Population change, which disrupts older people’s social
relationships (e.g. migration patterns; commuting habits;
‘zones of transition’)
• Social problems (e.g. crime; absence or loss of services;
poor housing etc.)
Loneliness in the city
• “We’ve lost all our neighbours. Well they were more than
neighbours. They were friends and even our relatives. They
had their children when I had my children…Now there’s
nobody. If I really needed anybody there isn’t anybody around
that I think that I could go to”.
• “You don’t see anybody because you don’t go anywhere.
There’s nowhere to go. I used to meet people at the Post
Office…but you don’t see them now. The chemist is the only
place you’re likely to see anybody you might know.
It’s...rather a sort of lonely estate…it’s like being in the middle
of a cemetery…”
Loneliness in rural communities
• “It’s a lonely experience in a small village.”
• “Now last weekend I didn’t see one soul from when I came
home from town on Friday until Monday morning…nobody…
It’s a long weekend. I usually go to my daughter every
Sunday, but she was working.”
• “It’s okay when you’re younger, you know, but when you get
old it’s not… [It gets] very lonely…because…the neighbours
are nearly all working…and you wouldn’t see them… I’m on
my own a lot.”
Preventing loneliness
• “There isn’t time [to be lonely]. Because, if I got lonely I’d put
one thing aside and I’d get something else, and there
wouldn’t be any lonely… It’s good to be busy. It keeps your
mind occupied and keeps you from worrying… It’s like people
going to the hospital and you’re saying “Oh, they had to
spend the night on a trolley.” I spent the night on a trolley; I
thought it was the best of craic!”
• “[The] home help comes Sunday and Tuesday…and maybe
she’ll come on Friday…but that means there’s always
someone here… I don’t…ever feel lonely.”
Features of successful interventions
• Group interventions with focused educational input or
provision of targeted support activities
• Interventions addressing loneliness amongst specific groups
of older people (e.g. women, informal carers, widow/ers,
people with mental health conditions)
• Interventions broadly representative of group targeted
• Interventions had degree of participant and/or facilitator
control, involved consultation ahead of implementation
• Interventions originated and conducted within existing service
(Cattan et al., 2005; Cattan, 2010).
Drivers of loneliness in later life
• Structural drivers: changing norms and behaviours around
social relationships; social and economic policies; global
trends (migration patterns, individualisation) etc.
• Environmental drivers: changing (urban/rural) communities;
planning policies; age-segregated living etc.
• Individual drivers: disrupted social (support) networks;
transitions/life events; ill health and disability; loss of mobility;
personal and family migration patterns; psychological factors
etc.
Potential responses to loneliness
• Structural: addressing societal values/behaviours (towards
ageing adults); guaranteeing access to sufficient
resources/supports at all life stages; anti-poverty measures;
supports for transnational families etc.
• Environmental: creating and maintaining sociable
environments; community development; counteracting trends
towards age-segregated living
• Individual: preventative strategies at all stages of the life
course; co-ordinated services/supports to help individuals at
times of need; forms of befriending; digital literacy schemes,
ICTs, telecare etc.
Considerations for policy, practice and
research
• Loneliness a major challenge for public policy and
professional practice (e.g. public health; social policy;
community development; urban and rural planning)
• Loneliness shaped by life-course factors, necessitating
interventions across the entire lifecourse
• Loneliness associated with other forms of disadvantage
• Variation in loneliness rates across communities points to
possibility for interventions to reduce loneliness
• Loneliness interventions require careful consideration and
should be subject to formal evaluation
Contact
thomas.scharf@nuigalway.ie