
There has been a growing focus on the effects of social isolation and loneliness because of the significant impact they have on mental health and wellbeing, and from a physical health perspective, social isolation increases the odds of death by 29% and loneliness by 26% (1). This is an important focus, with peaks in isolation and loneliness in youth and in older age groups, although people of all ages can be socially isolated or lonely. Alongside this increasing interest is a large amount of work attempting to identify how we can intervene effectively. A recent systematic review found evidence of benefit from some trialled programs but that it is difficult to sustain intervention effectiveness over time (2).
While there is overlap between a feeling of being socially isolated and lonely, the two can occur exclusively as well as together. I wanted to focus on a third concept, social exclusion, which can lead to social isolation and the feeling of loneliness (3,4). Although social exclusion is not the sole or complete cause of social isolation or loneliness, I think it is a component that we can more readily act on in a sustainable way through creating a supportive environment for inclusion.
If we want to think about social isolation and loneliness as a population issue, we should think about the ways in which our society systematically excludes certain individuals and communities. This flip in thinking moves from an outcome – social isolation in an individual – to a process – social exclusion as an active process by society and the systems within it. When we think about social exclusion we think about the “persistent lack of material resources (such as money, housing, employment, education and health), as well as consideration for immaterial resources (such as safety, social relationships, citizen rights and political rights, access to services and a natural and living environment)” (5). In doing so we move from thinking about individual or group sessions as an intervention for loneliness to what can our institutions do to improve inclusion? Where do we have structural discrimination in how our society works? How can we use legislation and decisions on funding allocation to ensure greater inclusion of everyone?
This flip in thinking will help us to intervene on both the material and immaterial resources that are outside of an individual’s control, but within the control of the institutions of society. Further, this has the additional potential benefit beyond social isolation and loneliness to make our society fairer and lift mental wellbeing.
1. Holt-Lunstad J, Smith TB, Baker M, et al. Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review. Perspectives on Psychological Science 2015;10(2): 227-237. https://doi.org/10.1177/1745691614568352
2. Morrish N, Choudhury S, Medina-Lara A. What works in interventions targeting loneliness: a systematic review of intervention characteristics. BMC Public Health 2023;23:2214. https://doi.org/10.1186/s12889-023-17097-2
3. Meehan DE, Grunseit A, Condie J, et al. Social-ecological factors influencing loneliness and social isolation in older people: a scoping review. BMC Geriatrics 2023;23:726. https://doi.org/10.1186/s12877-023-04418-8
4. Filia K, Teo SM, Brennan N, et al. Social exclusion and the mental health of young people: Insights from the 2022 Mission Australia Youth Survey. 2023, Orygen: Melbourne, VIC and Mission Australia: Sydney, NSW
5. United Nations Economic Commission for Europe. Approaches to Measuring Social Exclusion. 2021, available at: Approaches to Measuring social exclusion (unece.org). Accessed 14 Nov 2023.
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