We are told that levels of loneliness are increasing, figures from the Campaign to End Loneliness suggest that 1 in 5 people are sometimes lonely and that 1 in 10 over 65s are ‘chronically lonely’. Further research tells us that being lonely makes people more susceptible to smoking, obesity, dementia and heart attacks, lonely people are more likely to suffer from mental health problems, and that all of this comes at a cost to the NHS. A recent article in The Guardian goes as far as to suggest that loneliness is catching, a lonely person pushes away friends and family who in turn may become lonely.
The term loneliness is used as if there is a shared understanding of what it means. Studies tell us that 10% of people are often lonely, or that some groups are more lonely than others without telling us what loneliness means to these lonely people. The terms loneliness and social isolation are conflated to the extent that research uses contact with friends and family, membership of groups and measurement of community integration as a proxy for loneliness. In addition, the assumption that loneliness attracts stigma means some traditional survey measures of loneliness are deliberately designed to exclude the term and seek to measure it obliquely. This both perpetuates the assumption that older people are unwilling to talk about such potentially stigmatising experiences and assumes an understanding of what loneliness is.
Where loneliness is measured directly, the most common method is a self-rated loneliness scale asking whether respondents always, sometimes, often or never feel lonely. Clearly there is a link between social isolation and loneliness but few studies actually seek to explore the concept of loneliness in more depth. Studies of social engagement and exclusion rarely seek to distinguish between networks, social support, social isolation and loneliness and relationships are presumed with factors such as living alone with little empirical evidence to support this.
The consensus view is that loneliness results from a deficiency in a person’s social relationships. This may be the absence or loss of a partner/confidante or close friend, the lack or loss of a friendship group, lack of contact with family or friends or lack of social participation. Contact itself may be in person, by phone, or increasingly through e-mail and/or skype. Loneliness, therefore, can be seen as the difference between the quality and quantity of social relationships that an individual has and the quality and quantity of social relationships that they want. This can range from simply having the knowledge that there is someone you can call if you need to talk (regardless of whether you actually contact them or not), to the desire for a phonecall from a son or daughter once a week to the need to see and speak to several people on a daily basis. What constitutes loneliness is subjective but there is wide agreement that the experience is unpleasant.
Work on loneliness and social isolation amongst older people (Victor, Scambler and Bond, 2009) found that loneliness is dynamic in nature and takes one of three courses:
- Increasing loneliness as people get older is linked to family growing up and moving away, friends moving or dying, retirement and the loss of external roles, financial constraints and deteriorating health and is cumulative.
- Decreasing loneliness across time is less common but linked to a specific traumatic event of some kind – usually the loss of a partner or the onset of a restrictive health problem – with alleviation of loneliness stemming from adaptation over time to changed circumstances. A sub-group of single, never-married women experienced decreasing loneliness with a lifting of the social expectation that they should find a partner and acceptance of themselves as single people.
- Enduring loneliness, or what Cacioppo and Patrick (2008) refer to as ‘chronic’ loneliness is consistent and enduring across the lifecourse and is the least common but most debilitating form of loneliness.
In addition, loneliness is temporal, experienced differentially across time. This could relate to specific times of the year, seasons, or days of the week. Evenings, weekends and holiday periods were identified as most problematic with Sundays a particular problem for many of those interviewed.
Research evidence shows clearly that loneliness is a subjective concept, dependent on the relationship between the desired and actual quality and quantity of social relationships that an individual has. Furthermore it is a concept which is dynamic, involving family structures, friendship networks, community integration and participation, the way we view work and social roles, health and social care provision, welfare and the overriding ideology of winners and losers inherent within capitalism. The local work being carried out by charities and other organisations to promote social participation and inclusion for vulnerable groups is crucially important but not sufficient if we want to tackle loneliness, in its most prevalent forms, at its roots. To do this, I would argue that macro level change is required to move from a dominant ideology of individualism to one of shared humanity. From this starting point loneliness, inequality and a whole range of ‘social problems’ can be better tackled.
Practical attempts to tackle social isolation and work with vulnerable or excluded groups to foster better integration and social participation are clearly positive, but loneliness as a concept is poorly understood and poorly measured. The danger is that conflating loneliness with social isolation and exclusion and then seeking to address these problems through targeted, often individualised, interventions fails to address the wider structural issues such as ideology and the relationship between individualism and society.
About the Author: Sasha Scambler is a medical sociologist based at King’s College London. Her main research interests are disability and long term conditions, inequality, social theory and old age.