Lonlieness and social cohesion

Help the Aged have released details of a survey today. They conclude that 1.4m older people in the UK feel socially isolated and that 1.25m are often or always lonely.

I am often dubious about the way in which surveys are interpreted. However, the findings of this survey do bear out many of the sadder observations made in general practice. 

I have long thought that social cohesion is one of the best things for both quality and quantity of life. The current approach to improving health in older people seems to be focused on prescribing more drugs to treat blood pressure, cholesterol and depression. I would much rather see one’s cardiovascular risk factors and mood addressed through meaningful activity, pleasurable and varied diet, and companionship.

Here is Sir Michael Marmot (author of The Status Syndrome, among others) on neighbourhood effects on health: “Rates of mortality and illness differ markedly between areas…Cities all over the world have variations in health by area according to socio-economic level to a greater or lesser extent…Evidence suggests that neighbourhood characteristics such as social cohesion are crucial.”

A systematic meta-analysis published earlier this year  exploring how psychosocial factors relate to health found evidence that favorable psychosocial environments “go hand in hand with better health”.

A couple of years ago in Iceland, I was deeply impressed at the convivial atmosphere after work when whole neighbourhoods seemed to gather every evening – regardless of age or sex – in cheap, local hot spas. The conversation and welcome was fabulous, old people and young people all welcome alike. There was not much exercise going on: mainly people just sat around and chatted. Icelanders have a famously long lifespan. I suspect social cohesion has something to do with it.

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