Tackling Loneliness and Isolation in Wales

Introduction

 Loneliness can be defined as:

“A situation experienced by the individual where there is an unpleasant or inadmissible lack of quantity or (quality of) certain relationships. This includes situations in which the number of existing relationships is smaller than is considered desirable or admissible, as well as situations where the intimacy one wishes for has not been realised.”

– Jenny De Jong Gierveld (1998).

Social isolation, defined as the absence of contact with other people, is a common feature of loneliness, which can lead to a range of negative physical and mental health problems.

For example, research indicates that loneliness can increase the risk of dementia by 50%, stroke by 32% and heart disease by 29%.[1] Loneliness and social isolation can also increase the risk of an early death by up to 26%.[2]

Whilst there is growing recognition of loneliness as a key issue for older people and a public health priority – loneliness and social isolation have been identified as one of the cross-cutting themes of the UN’s Decade of Healthy Ageing[3], for example – there is still a great deal of stigma relating to loneliness, which can act as a barrier to people seeking help and support.

Why can loneliness be a particular issue for older people? 

The causes of loneliness and social isolation are complex and can vary for different age groups, but many life-course events that may trigger loneliness are more commonly associated with later life, such as bereavement, retirement, giving up driving, taking on a caring role and the onset of ill health. Alongside this, the impact of wider issues that affect significant numbers of older people – such as poverty, limited public transport and the loss of community services and facilities – also increases the risk of people becoming lonely.

Whilst there are high levels of loneliness amongst people of all ages, according to the latest National Survey for Wales almost three quarters of people aged over 65 (72%) report feeling lonely ‘sometimes’, while 10% of older people in Wales – an estimated 91,000 people – feel ‘consistently’ lonely.[4]

The importance of an intergenerational approach

The Welsh Government’s 2023 ‘Well-being of Wales’ report, which reviewed progress against the seven national well-being goals, noted that alongside high levels of loneliness amongst older people during 2022-23, there were also particularly high levels amongst people aged 16-24.

This highlights why intergenerational approaches to tackling loneliness are crucial, as well as the importance of opportunities for people from different generations to come together and support each other.

There are some good examples of projects focused on bringing generations together being delivered in Wales which can also help to prevent or alleviate loneliness, as highlighted below:

Policy in Wales

Before the pandemic, there was growing recognition of loneliness and its impact on public health, and a range of action was promised by governments throughout the UK through various strategies and plans. This included the Welsh Government’s first tackling loneliness strategy – ‘Connected Communities’ – which was published in February 2020.[5]

The strategy set out a commitment to build a stronger evidence base about the causes of loneliness and how these can be tackled most effectively, promising action across four main priority areas:

• Increasing Opportunities for People to Connect.
• A Community Infrastructure that Supports Connected Communities.
• Cohesive and Supportive Communities.
• Building Awareness and Promoting Positive Attitudes

The strategy also included a commitment to publish a report every two years to provide an update on progress, although to date no such report appears to have been published.

Tackling loneliness and social isolation is also referenced as a priority within the Welsh Government’s Strategy for an Ageing Society, published in October 2021, recognising the impact of loneliness on people’s physical and mental well-being, and the crucial role that age-friendly communities can play in terms of prevention and support.

However, a great deal of momentum appears to have been lost due to the pandemic, despite clear indications that significant numbers of older people may now find themselves at risk of loneliness, as examined in the section below.

Impact of the Covid-19 Pandemic

The pandemic meant that opportunities to spend time with friends and family, get out and about into the community or take part in social activities were lost, which left many older people feeling particularly lonely.[6]

Alongside this, we are also now unfortunately seeing indicators that suggest the pandemic is having a longer-term impact that is potentially putting people at greater risk of loneliness.

For example, members of older people’s groups throughout Wales have told the Commissioner that numbers attending groups and clubs have not returned to pre-pandemic levels. Similarly, older people have shared that they are concerned about potential risks to their health, or lack the confidence to get out and about.

Evidence relating to the use of the concessionary bus pass in Wales, which is estimated to have dropped by around 50%[7], also indicates that a significant number of older people are not using services to connect them with their communities in the way they were before the pandemic, putting them at risk of loneliness and isolation.

Further expected cuts to bus services will exacerbate this issue, and make it even more difficult for many older people to get out and about and do the things that matter to them.

Volunteering

Volunteers played a crucial role in providing a range of support in communities throughout Wales during the pandemic, and many of those volunteering were older people.[8]

The contribution of older volunteers in Wales is significant. According to research from Bangor University, published in 2018, almost a third of people aged 65+ volunteer in some capacity, which was worth around £500 million a year to the Welsh economy.[9]

Without volunteers, many valuable community services and social activities that help to prevent loneliness could not be provided, which is why maximising volunteering opportunities, alongside encouraging and supporting people of all ages to volunteer, is so important.

The benefits of this would be two-fold: first, helping to ensure that activities and services that deliver crucial support can continue to operate, particularly as ongoing funding pressures continue to have an impact, and second, creating new opportunities for people who are lonely to get involved with something new and meet new people.

The role of Age-friendly Communities

Age-friendly communities are places in which older people, communities, policies, services, settings and structures work together in partnership to support us all to age well, and have a key role to play in preventing and alleviating loneliness and social isolation.

Age-friendly communities support us to get out and about, do the things we want to do, and lead active and healthy lives, all of which help to protect us against loneliness and its impact.

In policy terms, the World Health Organization (WHO) has identified eight essential features, or ‘domains’, of age-friendly communities, which provide a framework through which action can be delivered:

• Outdoor spaces and buildings
• Transport
• Housing
• Social participation
• Respect and social inclusion
• Civic participation and employment
• Communication and information
• Community support and health services

Taking forward action in these policy areas and making communities throughout Wales more age-friendly would help to tackle many of the issues that often underpin or reinforce loneliness and isolation, as well as helping to ensure that older people who are lonely can access support.

The Commissioner has seen the positive impact these kinds of initiatives can have first-hand, through her work supporting local authorities throughout Wales to develop their local age-friendly plans and make applications to join the WHO’s Global Network of Age-Friendly Cities and Communities[10], of which the Commissioner is an affiliate member.

Calls for action

As highlighted above, loneliness is a key issue affecting society and while awareness of its impact has grown a great deal in recent years, there are indicators that the pandemic has created new challenges for many older people.

Tackling loneliness and social isolation would not only benefit the health and well-being of individuals, but would also support the wider preventative health agenda in Wales, which is crucial to reduce pressure on health and social care services.

The Commissioner is therefore calling on the Welsh Government to review its 2020 loneliness strategy to ensure it reflects the post-pandemic issues and challenges being faced by older people and sets out how these will be tackled.

Reviewing and updating the strategy (if required) would help to ensure the action being delivered across Wales is still appropriate and effective, and complements other strategies and plans, such as the Welsh Government’s Strategy for an Ageing Society, and would ensure a renewed focus on tackling loneliness and isolation across government and public services.

The Commissioner is also calling for greater support for community-based and third sector groups and organisations that help to prevent loneliness and social isolation through their work, recognising the vital outreach and activities they deliver and the crucial role they play in supporting older people’s health, well-being and independence.

In addition, we all have a role to play as individuals and the Commissioner is encouraging everyone to think about people we know in our own lives who may be lonely, and to reach out to them.

[1] National Academies of Sciences, Engineering, and Medicine. 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press. https://doi.org/10.17226/25663.

[2] Wang, F., Gao, Y., Han, Z. et al. A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality. Nat Hum Behav 7, 1307–1319 (2023). https://doi.org/10.1038/s41562-023-01617-6

[3] https://www.who.int/initiatives/decade-of-healthy-ageing

[4] ​​Welsh Government (2022) National Survey for Wales April 2021 to March 2022 https://www.gov.wales/national-survey-wales-results-viewer

[5] Welsh Government (2020) Connected Communities: A strategy for tackling loneliness and social isolation and building stronger social connections. Available at: https://www.gov.wales/loneliness-and-social-isolation-connected-communities

[6] Age UK (2021) Loneliness and Covid-19. Available at: https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/consultation-responses-and-submissions/health–wellbeing/loneliness-and-covid-19—december-2021.pdf

[7] CPT Cymru (2023) Y Ffordd Gymreig: Delivering franchised bus services the Welsh way. Available at: https://www.cpt-uk.org/media/tmvbjzkc/delivering-franchising-bus-services-the-welsh-way.pdf

[8] Centre for Ageing Better (2022) Age-friendly volunteering emerging from the pandemic. Available at: https://ageing-better.org.uk/blogs/age-friendly-volunteering-emerging-pandemic

[9] Bangor University (2018) Living well for longer: The economic argument for investing in the health and wellbeing of older people in Wales Available at: https://www.bangor.ac.uk/news/archive/older-people-helping-to-grow-the-welsh-economy-37493

[10] https://olderpeople.wales/commissioners-priorities/enabling-everyone-to-age-well/global-network-of-age-friendly-cities-and-communities/