Loneliness has significant effects on health and wellbeing


A program to address social isolation and reduce burden on the health care system is being trialled in Australia, thanks to a partnership led by The University of Queensland.

The Ways to Wellness Social Isolation Project – officially launched on 26 June – is a partnership between UQ, the Queensland Community Alliance, the Mt Gravatt Community Centre and the Mt Gravatt Men’s Shed.

The program uses ‘social prescribing,” where patients are referred to a link worker and on to non-medical group programs in the community.

Associate Professor Genevieve Dingle of the UQ School of Psychology said the community-led initiative hopes to address the serious health consequences caused by loneliness and social isolation.

“Loneliness has significant effects on health and wellbeing, being linked to poor mental health and increased risk of coronary heart disease, stroke, and premature death,” Dr. Dingle said.

Social isolation has been shown to pose a greater health threat than smoking, poor diet and lack of exercise.

“It’s a widespread problem – in a 2018 Australian survey, 50 percent of people reported feeling lonely in the week of the survey; nearly a third rarely felt they were part of a group of friends; and three quarters never or seldom had a neighbor available to talk to.

“Moreover, the report revealed that loneliness afflicts people of all ages, genders, and cultural backgrounds.”

Dr. Dingle said that along with addressing health issues, the project hopes to reduce the burden on the health care system.

“Most GPs struggle with what are called ‘frequent attenders,’ the 10 percent of patients who account for as many as 50 percent of appointments,” she said.

“Frequent attenders are more likely to be socially isolated, and their GP is often one of the few ways of connecting with another person who listens to them and tries to help.

“It would seem that unmet social needs are an important cause of frequent GP attendance.

“A community-led approach has the potential to ease the pressure on our primary health system at the same time as meeting the social needs of individuals.”

The Ways to Wellness Social Isolation Project has received $100,000 funding for 12 months from the Queensland Government and more than $200,000 funding from the Federal Government.

Link Worker Wendy Blackmon, based at the Mt Gravatt Community Centre, will receive client referrals from GPs, members of the community and self-referrals.

She will meet with clients to discuss their health and wellbeing goals and identify groups or activities in the local area that align with their interests.

Examples of groups include technical and trades groups at the Men’s Shed through to art classes, group singing and exercise programs such as Parkrun.

A team of researchers, led by Dr. Dingle, will examine the effects of the social prescribing project with a view to developing a model that can be implemented in multiple settings across Australia.

Social relationships are integral to human well-being, and research consistently documents that social integration and support have protective effects on morbidity and mortality outcomes.1–4

Yet loneliness and social isolation are often overlooked, despite being vital public health concerns, with mortality risk comparable to well-established risk factors such as cigarette smoking and even exceeding the influence of physical activity and obesity.5

Often described as the discrepancy between desired and perceived social relationships,6 loneliness can be particularly important among older adults, for whom decreases in economic resources, increases in impairments, and the deaths of contemporaries can heighten the risk of social isolation and loneliness.3 

Prevalence statistics indicate that nearly 1 in 3 older adults report loneliness in the United States.7 

Although loneliness is not a problem exclusively for elders, the oldest old (those aged 80 years and older) appear to have relatively high rates of loneliness—by some estimates, 40% to 50% report that they are often lonely.8

Research has consistently found that social relationships are associated with a variety of comorbid conditions, in addition to premature mortality.

Negative health outcomes linked to loneliness include high blood pressure,9 cardiovascular disease,10 disability,11 cognitive decline,12 and depression.13 

Such morbidities may, in turn, create higher need for health care and be linked to higher health care utilization,14 especially among older adults, who are more likely to suffer from multiple conditions.15

Some research suggests that there may also be a direct link between loneliness and health care utilization, regardless of health status.

Although relatively limited, research has found that socially isolated persons are more likely to seek medical assistance to satisfy their need for interaction and interpersonal stimulation.16–18

 In a study of older women in the San Francisco, California, area, Cheng found that loneliness–distress significantly explained higher physician utilization, independent of health factors.18 

Similar findings have been reported in Europe. In Sweden, researchers found that frail elders who were lonely used more outpatient services than those who were not lonely.

This included contacts with a physician and more visits to an emergency department as an outpatient.19 

Among elders in Ireland, loneliness was independently associated with emergency hospitalization.20 

And in Scotland, researchers found that among their sample of people aged 40 and 60 years, those who were lonely reported greater frequency of consultation with a general practitioner or family doctor.17 

In essence, it is possible that lonely persons seek physician care less for medical needs than to have someone to talk to.

Despite the high prevalence of loneliness and its clear implications on health outcomes, relatively little attention has been paid by public health officials and other medical professionals to the importance of loneliness,5 especially in the United States.

More information: Elyse Williams et al. Identification with arts-based groups improves mental wellbeing in adults with chronic mental health conditions, Journal of Applied Social Psychology (2018). DOI: 10.1111/jasp.12561

Tegan Cruwys et al. Social Isolation Predicts Frequent Attendance in Primary Care, Annals of Behavioral Medicine (2018). DOI: 10.1093/abm/kax054

Journal information: Annals of Behavioral Medicine , Journal of Applied Social Psychology
Provided by University of Queensland


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