Social isolation a high risk for poor health
Having family and friends around who look out for you and are supportive can have a really positive impact on the way you feel about your life, but what happens when you don’t?
In a society which is becoming more and more fragmented, there is greater awareness of loneliness and its harmful physical and mental impacts.
Dr Hamish Jamieson says if you’re socially isolated, “you are more at risk of depression and anxiety, and some chronic conditions such as pain, can become worse.
“Interaction people have with their friends and colleagues, and neighbours and family members, is really important to help them maintain their sense of independence and help them maintain the idea of looking after themselves.”
The senior lecturer in older persons’ health at the University of Otago is studying the impacts of a lack of social engagement, as part of research for the Ageing Well National Science Challenge.
He says society has changed.
"I think the trend in New Zealand, and in a lot of first world countries, is for increased social isolation, particularly for people who are older or vulnerable.
“More [of the population is] working now and jobs tend to be taking up longer hours. As well as that, people are moving cities more and travelling more.
“All of that has led to the breakdown of communities and of neighbourhood and family supports; for example, it was very normal for older people to live with their children as they got very old and they became very frail but now that’s becoming more and more infrequent.”
What's it costing?
Dr Jamieson says even with churches and community organisations stepping in to help, some older people are still at risk of social isolation.
He’s anticipating there might be higher numbers at risk in cities compared to rural regions.
“Australian experience has shown that people in rural areas are less socially isolated than those in the cities, and that’s probably because that neighbourhood and community network are still anecdotally stronger in those communities, so it will be interesting to see how that compares in NZ.
The study will also look at the impact of culture.
“We’re looking at different ethnic groups – Maori, Pacific Island, Asians to establish any differences because there’s very important cultural components in this,” he says.
“We can only speculate at the moment… as we compare different ethnic groups, specifically Maori, because these are very important aspects for families and their whanau and their community.”
Dr Jamieson will be using data collected by the Ministry of Health.
It’s a standardised assessment of the health of older people called the InterRAI with multiple questions covering, among other things, falls, mobility, depression, social isolation, loneliness and sustainability of social support.
“We’re hoping [this] will provide some data around this particular problem – how much it is affecting older people, both from a number perspective and also a cost perspective; what it’s costing the country,” says Dr Jamieson.
“We want to try and show how much social isolation and loneliness are… predictors of bad outcomes for older New Zealanders, and contributing to people entering residential care."
Keeping people healthy
As the population ages, keeping people healthy for as long as possible is crucial.
“We’re living about 25 years longer than we did 100 years ago. It’s a whole generation longer and it’s a massive change,” he says.
The health expert says it’s in the last few years of people’s lives they become frailer and that’s when it becomes challenging.
“Whether people are living 60 years or 90 years, that last few years is still going to be the key,” says Dr Jamieson.
“I think the challenge is if we can make those better.
“The idea of compression of morbidity is about compressing those years so [people are] more independent, and to get services targeted properly so they are as healthy as possible in those last years.”
If the research shows social isolation is a risk factor for poor outcomes, Dr Jamieson hopes changes will occur.
“If we put numbers down around the actual difference it’s making to older people, it will inform family members, neighbours and community groups of the importance of this.”
He believes health boards might then look at bolstering support for Age Concern’s accredited visiting service, and there may be an impact nationally.
“It will help guide the government on how big the problem is if we can put some strong data around it, and that will help improve policy at a national level.
“We hope this data will then be able to be used to help improve services to minimise social isolation for older people. “
He says living longer is one of the great achievements of society.
“I don’t think we need to look at ageing as a negative thing – it’s a very positive thing,” says Dr Jamieson.
“Ageing is not a burden for New Zealand. It’s something that’s a big opportunity to try and make the most of.
“Older people have a lot of wisdom and a lot of other skills, knowledge they can contribute to society, and we need to help people live longer quality lives.
“We don’t want to say older people are a burden to society.
“What we want to do is turn it around and, using modern science and big data, do research and interventions to help older people live better lives.”