A Minister for Loneliness

Loneliness damages your health. In fact, research shows that being lonely is as damaging to your health as smoking 15 cigarettes a day, and increases the likelihood of mortality by 26%.

The amount of research that testifies to loneliness being a risk factor for disease is somewhat staggering. Of course, the link with depression and anxiety is no surprise, but what about illnesses that the public tends to think of as organic and physical? A number of studies have found that lonely people have an increased risk of illnesses such as heart disease and stroke. One paper found that lonely people were at a whopping 64% increased risk of developing dementia.

Of course when something has such an impact on morbidity and mortality rates that also equates to huge costs to our health and social care systems. Malnutrition, something we are directly concerned with through our work with BAPEN, costs an estimated £19.6 billion in England each year (15% of the total expenditure on health and social care), and loneliness and social isolation is a clear risk factor.

But what exactly is loneliness and how can it have such a profound impact on our physical health? In an interview he gave to Fortune magazine psychologist John Cacioppo described loneliness as a “perceived social isolation, or the discrepancy between what you want from your social relationships, and your perception of those relationships” and examined some of the ways in which it can affect physical health. “Loneliness increases vascular resistance, which moves blood to the muscles and heart. That’s helpful when there’s a specific threat, but lonely individuals exhibit this over the course of a normal day. As you age, that translates into higher blood pressure. Loneliness also increases base-line levels of cortisol, a powerful stress hormone.” Cacioppo also points to evidence that means that the lonely sleep less well and display signs of altered gene-expression that leaves them more susceptible to illness.

To compound matters, it is not just a causative effect. Loneliness is not only implicated in the development of disease but can also harm recovery from illness and make many conditions harder to live with. And as a kicker, the real or perceived characteristics of some illnesses lend themselves to social isolation too, as we have seen through our work with people adjusting to life with a stoma and suddenly finding themselves reluctant to leave the house, or people living with cancer hiding away because ‘they don’t want to bring people down.’ Whether it is patients themselves, or the reactions of those around them, many find themselves facing illness alone.

Disease and illness is not the only face of this issue. Public health is also affected, parents feeling isolated and lonely may find it harder to parent effectively and healthily, passing a legacy of loneliness consequences on to the next generation. And productivity is likely affected if loneliness in the workforce leads to depression and lack of self-care, resulting in absenteeism and poor performance in the workplace.

All these factors are horribly intertwined, and therefore the new Minister has her work cut out. She has been asked to pull together all strands of government, including the Treasury and the Department of Health, to tackle the problem. We look forward to seeing the execution of the new ‘loneliness measure’ from the Office for National Statistics, and the budget that has been promised to fund innovative solutions at government and charity level. Tracey Crouch, the Minister appointed seems to be a good fit for the role and has described herself as ‘humbled’ by her appointment, rightly paying tribute to the late Jo Cox, whose pioneering work on loneliness has been continued in her name and as part of her legacy by The Jo Cox Foundation and the Jo Cox Commission on Loneliness which she had set up before her death. It was the report issued by the Commission in 2017 that made a call to action during 2017 with recommendations including the appointment of a dedicated Minister. Many other organisations also deserve significant credit for lobbying persistently on the need for national action.

Change will not be easy, such a complex problem, so embedded in the fabric of our society, is not easily unpicked and understood, let alone tackled. This was acknowledged by the new Minister in an interview she gave to Channel 4 News shortly after her appointment was confirmed, when she said “there isn’t one thing that causes this issue. There isn’t one problem and therefore there isn’t one solution.”

As we wait for (multiple) solutions, the question of responsibility will surely be debated, is this a government responsibility or a personal one? Certainly Jo Cox believed we all have a role to play and the ‘Start a Conversation’ campaign is ongoing. One interesting quirk of this story is that while our increasing reliance on mobile technology and social media may be contributing to the isolation many feel, there has been much love on social platforms for the ideas and legacy of Jo Cox. Briefly when the announcement was made, #MinisterforLoneliness was trending on Twitter. Perhaps there is a hope that ‘social’ media will live up to its name, and be a part of the solution.