All the lonely people
Is modern life making us lonely? And what should we do about it?
Expect to hear this word more and more. Loneliness. Loneliness is where depression was when it was on the cusp of mainstream discussion, stepping out of the shadows and no longer a taboo.
Some call loneliness a health crisis, some even call it an epidemic.
Either way, loneliness is no longer anyone’s fault. Modern life is to blame or technology. Or the precariousness of work. Or housing, urban planning or longevity. Or perhaps it is just the human condition, as innate and unavoidable as grief.
One reason you are hearing more about loneliness is because the UK Government recently appointed a minister for loneliness, Tracey Crouch, to tackle the ‘‘sad reality of modern life,’’ as Prime Minister Theresa May put it.
The British are leading the lonely field. Age Concern New Zealand’s national social connection adviser Louise Rees was in London last September for the Campaign to End Loneliness conference, where the minister was announced. Murdered UK Labour MP Jo Cox had led a Commission on Loneliness; Cox’s replacement, Rachel Reeves, has suggested that loneliness be added to British economist William Beveridge’s famous list of five social ills – want, disease, squalor, ignorance and idleness – that shaped the creation of the modern welfare state.
‘‘Young or old, loneliness doesn’t discriminate,’’ Jo Cox said.
But in New Zealand, loneliness is still viewed as a problem that largely afflicts the elderly, as Age Concern’s Rees explains.
‘‘What we are seeing in the UK and New Zealand is an ageing population,’’ Rees says. ‘‘The older old are disproportionately lonely and also living alone. We’re going to get more and more people in the over 80 age group more vulnerable to loneliness.
‘‘It’s been known for a long time that loneliness is a health issue and there’s more evidence that the cost benefits of addressing issues of loneliness and social isolation is one reason why it’s become a government priority. It’s seen as a way to mitigate the potential health costs of our ageing population.’’
Health costs? Former US surgeon general Vivek Murthy has said that the impact of loneliness on people’s life spans is the same as smoking 15 cigarettes a day and even worse than obesity.
Despite this, the idea of a minister for loneliness has not been immune to mockery. ‘‘This is so British,’’ marvelled US comedian Stephen Colbert. ‘‘They’ve identified the most ineffable human problem and come up with the most cold, bureaucratic solution.’’
What next, another joked. A minister for feeling annoyed?
There are no plans for this to happen here. The Minister for Seniors, Tracey Martin, has said that loneliness in New Zealand is already well served by her and other ministers.
But health researcher Hamish Jamieson can see the rationale. A senior lecturer in medicine at the University of Otago in Christchurch, Jamieson coauthored a recent study on ageing, loneliness, living arrangements and ethnicity in New Zealand for
the Australasian Journal on
Ageing. He says that fighting loneliness falls into a lot of camps: ‘‘It’s information technology for the elderly. It is councils and services like libraries. It’s housing, urban planning and health.’’
A minister for loneliness would be able to draw on several portfolios, as one of Jamieson’s University of Otago co-authors Sally Keeling explains: ‘‘If you want to make a difference, maybe you have to do more than one thing at a time. We should always include a social dimension in our models of service.’’
As for the title, Keeling has doubts.
‘‘I have a thing about labels,’’ Keeling says. ‘‘While we use the word loneliness because that’s a measure in our study, I think it’s best to talk about connection. We’ve got to be careful not to stigmatise and blame people who are experiencing loneliness by thinking there’s something wrong with them. We’ve got to build up ways to make it better for everyone and that can come through ways of facilitating connection.’’
A minister for social connection, then? Even Colbert wouldn’t laugh at that.
How many people are lonely? The study Keeling and Jamieson worked on draws from nearly 72,000 assessments of people with an average age of 82.7 years. Of that large group, 21 per cent ‘‘reported feelings of loneliness’’. One in every five.
But there are other ways of slicing numbers that reveal more. Loneliness is not just being alone: while 29 per cent of those who live alone say they are lonely, that means nearly two thirds of elderly people who live alone feel they are not, and 14 per cent of those who live with others say they are lonely. Break that down further: 20 per cent of the elderly who live with adult children are lonely and 11 per cent of those living with spouses are lonely.
You can be lonely in relationships, in families, in crowds. Loneliness is subjective and self-diagnosed, whereas social isolation is objectively measurable.
There are ethnic variations. Keeling and Jamieson wanted to see how it played out across four groups. The European elderly are the most likely to live alone, followed by Ma¯ ori, Asian and Pasifika. Ma¯ ori are almost equally lonely whether they live alone or with others. More Pasifika and Asians were lonelier living with others than by themselves. The reverse applied for Europeans.
The majority of Ma¯ ori, Pasifika and Asian elderly are living with children or spouses and not feeling lonely. But this group is a minority among Europeans, who are the only ethnicity to have more of the elderly living alone than with others.
Keeling cites these numbers to stress the need for caution when making ‘‘bland generalisations’’ about loneliness and the elderly. But some global trends seem obvious.
‘‘I think it does infiltrate all dimensions of our social lives,’’ she says. ‘‘I’m absolutely clear that rising longevity and increasing individualism makes it harder to reinvent a sense of community and connection.’’
‘‘We no longer have natural local communities that are intergenerational. We have to think about housing, we have to think about neighbourhoods. A growth in single person households of all ages is something no human society has ever had before. Humans were designed to live in mixed age groupings locally.
‘‘We’ve known this from the census for the last 30 years,’’ she adds. ‘‘It’s been a long time coming and now we’re thinking it’s a problem in old age but it’s actually
affecting all cohorts. We’ve done it very unthinkingly and now we’re having to rethink our housing model to higher density, more variety, so that these individualised single-person households are not in a context of their own.’’
According to the 2013 census, about 23 per cent of New Zealanders live alone – the figure has not shifted since 2001. Of those living alone, 79.9 per cent were over 45 years old. Single-person homes are most common on the West Coast of the South Island, where they are 30.7 per cent of homes, and lowest in Auckland, at just 19 per cent.
People are living longer and can afford to live apart. Could loneliness just be a side effect of prosperity, as though the modern world itself is making us sadder and lonelier?
‘‘The other side is it implies everything was rosy 100 years ago and I don’t subscribe to that either,’’ Keeling says. ‘‘We had different problems in the past.’’
But the more you look into it, the more you see nuances and even contradictions. Despite your gut response, living alone may or may not correspond with loneliness. Also, despite what could be assumed about high density living as a solution to the loneliness problem, Jamieson says that Australian research tells us that rural people say they are less lonely than people in cities. He expects the same would apply here.
No one has done this yet, but you could even calculate the least lonely and most lonely cities in New Zealand. Jamieson says they are also looking at the Christchurch numbers and while the research is unpublished, it seems ‘‘there was a slight decrease in loneliness in Christchurch after the earthquakes’’.
Those stories about greater connectedness and community, people checking on neighbours as the city shook – they were true.
Again in the UK, the Compassionate Frome Project, launched in Frome, Somerset in
2013 with the aim of combating social isolation, has reportedly reduced emergency hospital admissions by 17 per cent, even as they rose elsewhere in Somerset.
Guardian journalist George Monbiot noticed ‘‘a buzz of sociability, a sense of common purpose and a creative, exciting atmosphere that make it feel quite different from many English market towns’’.
In New Zealand, Age Concern has run its visiting service since
1989. There are about 2500 clients on its books, mostly over 80, visited by the younger elderly. The number has remained static as District Health Board funding ‘‘has not increased with the growth of the older population’’, Rees says.
It could be extended with extra funding.
‘‘As the number of people over 80 increases, our ability to operate with our current resources will be stretched, and we will be looking at how we can work with government, the business sector and other service providers to meet the needs of greater numbers of older people at risk of social isolation and loneliness.’’
So much attention has been on the elderly, but it is not just the elderly who are lonely. In fact, the young may be lonelier than anyone else.
The 2014 New Zealand General Social Survey found that people aged
15-24 had the highest levels of loneliness, at 16.8 per cent. It slipped in middle age and was at its lowest for those aged 65-74 before rising again for those over 75. Women were lonelier than men and, in this survey, Ma¯ ori and Asians were lonelier than Europeans and Pasifika.
Money helps. Who knew that loneliness declines as personal income rises? Those earning under
$30,000 were twice as lonely as those earning over $70,000.
The four authors of another report, ‘‘Who are the lonely? A typology of loneliness in New Zealand’’, published in the Australian and New Zealand Journal of Psychiatry in 2017, used Ministry of Social Development figures that have 36.1 per cent of New Zealanders over 15 feeling lonely at least some of the time. Again, the marginal and vulnerable are the worst affected: the young, the old, the poor, the chronically ill, the mentally unwell.
This report goes deeper into loneliness, which it calls ‘‘a key contributor to the onset of depression’’. There are links to other negative mental health outcomes, such as social anxiety, obsessivecompulsive disorder, cognitive decline and paranoia, as well as physical health problems. Loneliness comes to be seen as the expression of some greater sense of not belonging, rather than simply being alone. Loneliness and social isolation are ‘‘only weakly correlated’’, the authors say.
There is still much work to be done and a sense that loneliness is a wide open land waiting to be explored by academics and specialists, as ‘‘little is known about the diverse ways in which members of the population feel loneliness’’ and ‘‘no previous study has investigated whether there are qualitatively distinct subgroups of loneliness within the New Zealand population’’.
The lonely are more likely to believe they are in poor health, to have lower self-esteen and lower life-satisfaction, to believe they lack social support and are more likely to experience psychological distress. They are more neurotic and less extroverted.
Perhaps this all seems selfevident. But there are still significant gaps in local knowledge. Netsafe chief executive Martin Cocker says he knows of no local studies of whether levels of loneliness in New Zealand youth have any link to internet or social media use. Anecdotal views that too much screen time is making our kids sad have some support – a US paper in Clinical Psychological
Science in 2017 suggested that increasing social media might be a ‘‘possible reason for the suspected increase in mental health issues’’.
The idea, as the paper explains, is that ‘‘humans’ neural architecture evolved under conditions of close, mostly continuous face-to-face contact with others’’ and ‘‘in-person social interaction provides more emotional closeness than electronic communication’’.
Cocker would direct readers instead to a paper by Unicef researcher Daniel KardefeltWinther who argues that digital technology is good for children’s social relationships, but in moderation. He draws a U shape: too much can have a negative impact, but so can no technology use at all. The middle is just right.
Back then to Hamish Jamieson, who might be the closest thing New Zealand has to a go-to guru of loneliness. Yes, loneliness has always been with us but it is increasing as society fragments, people work more, institutions decline and families live apart. It is complex with no single solution but maybe the time has come for something like loneliness awareness.
‘‘It’s important for older people to admit they’re lonely,’’ Jamieson says. ‘‘More people talk about depression or mental health problems but I don’t think people are good at admitting they’re lonely. It doesn’t make it easy to treat or identify. There is perhaps a lot of shame associated with it.’’
What about the Colbert view that loneliness, like grief or happiness or even feeling annoyed, is just one part of the spectrum of human experience? Do we really need to medicalise it?
‘‘The next part of the research is how it’s affecting health outcomes and hospital admissions,’’ Jamieson explains. ‘‘We haven’t got final results but overseas research shows it has big impacts on health outcomes. So the health system is already dealing with this.
‘‘If society is looking after people and loneliness is a problem, we need to be open about it and need to deal with it. Maybe 20 years ago, people used to say the same thing about mental health.’’
‘‘This is so British. They’ve identified the most ineffable human problem and come up with the most cold, bureaucratic solution.’’
US comedian Stephen Colbert, on the UK’s appointment of a Minister of Loneliness