Loneliness is not just a consequence of old age, or geographic isolation, according to a new study, it can be bad for our health.
But what can be done?
Academics have spent the best part of two decades focussing on the issue and the social, psychology and health consequences it can bring.
A study from Brigham Young University, in Utah, USA, revealed loneliness can be more harmful to health than smoking 15 cigarettes a day and information from the Office for National Statistics has pinpointed Britain as the ‘loneliness capital of Europe’.
Public Health England believes 7% of the population between 18 to 64 are socially isolated and, in the North East, this would mean 22,000 people in County Durham alone.
In Durham this year, Anna Lynch, the director of public health, has published her annual report aimed at tackling social isolation and in it she has made some startling discoveries.
The mother-of-four reflects that loneliness, and isolation, is subjective - making it a challenging issue to solve.
“It’s hard to be black and white about it,” she said.
“There are a couple of quotes in the report, ‘loneliness the pain of being alone’ and ‘solitude the glory of being alone’.
“It’s a challenge to find solutions - one of the recommendations of the report is that we should identify those older people, or people at risk of becoming socially isolated.
“It can happen at different times of life, and there’s not one thing we can do.”
Among the risks identified by the report are personal factors, life changes, health, wellbeing and disability and wider or social determinants of health.
Dr Keming Yang, a professor in sociology at Durham University, has spent around 10 years focussing on the issue and believes it is a phenomenon that extends beyond simply health.
“Loneliness, by definition, is a deficit of social relations and by that definition it’s a social problem - not just public health or psychological,” he said.
“It is a social process, which involves all the people around the sufferer.”
Dr Yang said culturally loneliness can vary across the world with people whose culture places a strong emphasis on family life and high expectations from their children and extended family, facing a greater risk, while northern European countries, such as the UK or Germany, do not have the same family structures or expectations.
He added: “People in Greece, Spain and Italy expect quite high levels in terms of the quantity and quality of relations, certainly from their children, but the UK is much lower.
“In China, older people not only expect a lot from their own children but their extended family.
“There is a long list of serious problems, it’s been said it is as damaging as smoking 15 cigarettes a day, damaging to the heart, the lungs.”
In County Durham, economic hardship can provide a barrier to social capital - entertainment and the opportunity to join clubs, which in turn can contribute to a growing problem.
With more than 100,000 people living in poverty, the economic climate proves yet another barrier to the fight against loneliness and isolation.
Ms Lynch added: “We are working with communities to undertake asset mapping, improving links to local health services, promoting the role of voluntary and community services and working with them to help create an environment where people can connect with their neighbours, communities or people of the same interest.
“Social isolation is also one of the seven work streams of County Durham’s Better Care Fund programme.
“However, no one organisation can tackle social isolation.
“It is everyone’s business and we must look at how we can work collectively to tackle this issue. Increasingly, we are seeing that communities and individuals are taking greater responsibility in supporting local people across a range of issues, including social isolation and this report aims to build on this approach and encourage wider awareness and involvement.
“This is about co-production, about less reliance on formal intervention and about working together irrespective of which organisation or community is involved.”
Spending cuts mean an emphasis on agency and community intervention, which is part of the focus of the report.
The report identifies five areas where individuals can take action to try to tackle loneliness and isolation themselves; by taking time to connect with friends and family, to be more active, to make efforts to start conversations, to keep learning and be generous with time.
As the population increases, the number of people suffering from isolation and loneliness is set to increase, putting more pressure on health services and social agencies.
Nationally, almost 40% of the elderly have said they rely on the television for company, which equates to around 36,000 pensioners in Durham using it as their sole source of company.
As Dr Yang mentions, it is not just the amount of contact someone has but the quality of the interactions and the degree of intimacy.
Ms Lynch added: “Estimates suggest that between 5% and 16% of those aged over 65 report loneliness and 20% feel isolated.
“These figures are likely to increase as the number of people aged more than 80 is expected to treble in the next 20 years while those over 90 will double.
“This, combined with increasing family dispersal, indicates that the issue of loneliness and social isolation in old age is likely to escalate.”
The increasing age of the population and a move away from the traditional communities as individuals look to move further from their family home for careers, has resulted in an increase in loneliness at an age where most people use smartphones or social media to stay in constant contact.
“In days gone by, mining communities had welfare organisations and communities were not so dispersed in the way they are now,” Ms Lynch said.
“This has changed society, in particular in communities where there was a major industry.
“So, loneliness is more a modern phenomena than historic.”
Whilst anyone can be lonely or socially isolated, older people are particularly vulnerable.
“Certain risk factors that increase the risk of social isolation are more numerous in the older population.
“These include bereavement, generally poorer health and mobility, sensory impairment, absent family members, reduced income, a small social network, inadequate social support, ageism, potentially unsafe or inaccessible neighbourhood or community (built environment) and a reduction in the ability to travel, which is particularly relevant in rural areas.”
But young people can be equally affected.
Those at risk include hidden young carers who devote their childhood to helping an ill, or disabled relative but are not formally recognised.
Ms Lynch said these issues present a further challenge in tackling what could go on to be a significant health problem.
The report puts the onus on frontline professionals, encouraging carers, health workers and other staff to consider the potential impact of isolation and loneliness on patients.
Ms Lynch also urges a greater ‘connectedness’ between agencies as well as better training for staff to help identify those at risk.
Going forward, Ms Lynch has pledged to keep loneliness and social isolation at the top of the agenda.
“I hope to influence the planning and commissioning of services that will impact on health and wellbeing and improve outcomes for County Durham residents,” she added.
“I will ensure that the issue of social isolation remains a focus of the Community Wellbeing Partnership and that collectively partners consider how they can address this through either their commissioning or delivery of services.
“Social isolation is now being identified as a public health issue and it is clearly going to be a priority for future years as our population profile changes and we have a larger proportion of over 65s and over 85s.
“However, we can only address social isolation by working corroboratively and involving a wide range of partner organisations.
“It is everyone’s business.”