What do we know about social isolation and loneliness in Devon? Simon Chant Locum Consultant in Public Health Wednesday 28th February 2018

1. It is common

Loneliness and Wellbeing in Devon For adults (18+) living in Devon an estimated: 64,000 are often lonely* 203,000 are sometimes lonely* 46,000 have a low happiness score~ 22,000 have a low life satisfaction score~ 25,000 have a low score for feeling worthwhile~ 113,000 have a high anxiety score~ Projected to rise as population grows and ages * Source: Mental Health Foundation and English Longitudinal Study of Ageing 2010 ~ Source: Office for National Statistics National Wellbeing Survey, 2016-17

2. The impact of loneliness on health and wellbeing is considerable

The link between loneliness, mental health and physical health Self-reported health status and quality of life is poorer for the lonely Risk of ill-health and accidents higher Studies have highlighted that increasing loneliness is associated with higher levels of health and social care service use Likelihood of mental ill health is greater Vicious cycle of loneliness, mental ill health and physical ill health

Health and care costs and loneliness Additional annual costs arising from lack of social support for lonely older people GP visits £150 per person A&E visits £27 per person Unplanned admissions £56 per person Additional annual costs arising from increased ill health for lonely older people Residential care £2,250 per person Depression £1,975 per person Dementia £4,800 per person Physical inactivity £2,700 per person Source: Social Finance, 2015, ‘Investing to tackle loneliness: a discussion paper’

3. It can affect anyone but is more common in certain groups

Loneliness ‘Triggers’ Being single or divorced Living alone Poor health Immobility Personal Circumstances Health and Disability Cognitive impairment Sensory impairment Living on a low income Living in residential care Dual sensory impairment Aged 75 and over Personal Characteristics Ethnic minority Being gay or lesbian Deprivation Bereavement Geography Transitions Source: Campaign to End Loneliness / English Longitudinal Study of Ageing Starting or giving up caring Retirement Crime

Loneliness by age

National wellbeing by age

Social care users who have as much social contact as they would like

Social care users who have as much social contact as they would like Lower rates evident for carers Female (44.7%) rate lower than males (46.4%) nationally Levels fall with age and are highest for social care clients aged 18 to 24 (58.5%), lowest at age 55 to 64 (40.8%) and increase slightly at age 85 and over (44.8%) Minority groups less likely to have as much social contact as they would like

4. The relationship between social and geographic isolation is complex

Risk of Loneliness Map (Age UK)

Social vs geographic isolation Estimated levels of loneliness in population typically lower in rural and village locations This is due to lower levels of deprivation, lower levels of care homes, and in-migration of people aged 80 and over into towns Whilst less common, the dual impact of social and geographic isolation can be severe Increasing social isolation in rural areas can prompt a move Farming Communities Health Needs Assessment identified ‘hidden’ loneliness in rural areas

5. We can do something about it

What works to combat loneliness No single ‘magic bullet’ – a holistic approach focused on individual circumstances is best Peer support groups, group activities, support for mental health, information sharing and signposting may all be involved Some limitations in evidence base, new initiatives require robust evaluation frameworks Social Care Institute for Excellence to publish updated review in early 2018

Local Example: Wellbeing Exeter

Majority typically start with a lower than average wellbeing score Some Stats Over 1438 referrals: average 16 a week from 10 practices with 70+ GPs referring electronically with open referral criteria. Majority typically start with a lower than average wellbeing score 54 Carers or cared for supported 62% FEMALE 47% UNDER 60 YRS 68% No occupational role Majority are single -Range ages -68% have no occupational role - could they become assets in their community -Range of outcomes – health & Wellbeing, financial security, safe & sound, contributing citizen, housing & housing support. 18 -80 age range 20% have MULTIPLE NEEDS

How can challenges be overcome Political and leadership support Establishing an honest dialogue Prioritising preventive approaches to loneliness and social isolation Committed, flexible and supportive individuals A pragmatic approach to new initiatives and the need for longer-term support Source: Social Care Institution for Excellence, 2018 www.scie.org.uk/prevention/connecting/loneliness-social-isolation