Social isolation, loneliness and health

I think for most of us, Corona-virus and the strict lockdown measures we've had since April have taught us how much we rely on our social interactions to keep us healthy both physically and mentally and something we may have taken for granted. Many of us think that social isolation and loneliness are terms for the same thing, but there is a difference.

What we are currently experiencing is social isolation, this is an objective measurement of how many contacts we have with other people. Once lock-down eases we can increase the number of people we come into contact with, reducing our social isolation.

Loneliness on the other hand is a subjective feeling of the perceived quality of the relationships people have (1). So you could be someone who sees people regularly and appear as having lots of friends but if those interactions are not quality interactions then you can still experience loneliness. Spending time with people with who we have things in common and share similar interests makes us feel more connected to each other and what we often describe as quality time with someone or feeling part of something.

Unfortunately, as people get older, people lose loved ones and friends, move away from their social networks to be closer to family in anticipation of needing more care, have a deterioration in their health which makes it more difficult to get out and about, had a fall or fear of falling are some of the reasons people become more socially isolated and lonely.

As a community nurse I see first hand the prevalence of loneliness and social isolation and the impact this has on my patient's mental and physical health. I think for most of us we have this idea that being lonely and isolated only affects people psychologically and emotionally but this is just the tip of the iceberg. The physical effects are often worse in terms of disability and morbidity and this adds to the psychological burden, and it becomes a vicious cycle.

Some of the physical effects can be your ability to carry out activities of daily living (ADL's) and a decline in your functional status (2)

Being more sedentary increases our risk of cardiovascular disease and strokes (3)

It can increase blood pressure and dampen our immune system (4)

It can affect our sleep quality (4)

Reduce wound healing in chronic leg ulcers (5).

The list goes on and on...

So from the list above and the known health benefits of regular exercise, it's obvious that being more active, such as attending a class or group will solve all their problems, you get to see people, work out and improve your health. Problem solved! If only it was that easy? Human beings are complex and of course there other issues that play a role in health behaviours but for the purpose of this post I won't go into them now.

The reason I wanted people to know the difference between social isolation and loneliness is that solutions should not purely focus on increasing opportunities to be more physically active but to also build and maintain meaningful relationships. The desire for connection is often the main draw to attending classes or gyms and the exercise is just a bonus.

This is the foundations on which I want to build my business, it's not about providing another fitness class for older people to turn up and do purely to clock up the recommended minutes of exercise a week, it's about providing connections with like-minded people. Making it something they can enjoy, look forward to, and feel part of.

(1) AGE UK, S. Alden. Loneliness and isolation - understanding the difference and why it matters. Date viewed 26/5/2020. Available at:

(2) Shankar, Aparna, et al. Social isolation and loneliness: Prospective associations with functional status in older adults. Health psychology. 2017, 36 (2),pp 179.

(3) Carter, S; Hartman, Y; Holder, S; Thijssen, D.H; Hopkins, N. Sedentary Behavior and Cardiovascular Disease Risk: Mediating Mechanisms. Exercise and Sport Sciences Reviews: 2017; 45(2)- p 80-86

(4)Holt-Lunstad, Julianne. The potential public health relevance of social isolation and loneliness: Prevalence, epidemiology, and risk factors. Public Policy & Aging Report. 2017; 27(4), pp 127-130.

(4) Cacioppo, J.T., Hawkley, L.C., Crawford, L.E., Ernst, J.M., Burleson, M.H., Kowalewski, R.B., Malarkey, W.B., Van Cauter, E. and Berntson, G.G. Loneliness and health: Potential mechanisms. Psychosomatic medicine, 2002; 64(3), pp.407-417.

(5) Edwards H, Courtney M, Finlayson K, Shuter P, Lindsay E. A randomised controlled trial of a community nursing intervention: improved quality of life and healing for clients with chronic leg ulcers. Journal of Clinical Nursing. 2009;18(11):1541–1549.