Globally and in Australia a litany of recent reports and advocacy efforts have raised the alarm to the emergent public health crisis of loneliness and social isolation.
The latest is the United States Surgeon General’s report Our Epidemic of Loneliness and Social Isolation. This is hugely significant because Surgeon General Advisories are reserved for significant public health challenges that require immediate awareness and action.
There are only a handful of issues that the Surgeon General has named as a public health crisis and one thing is clear: when advisories of this nature are published, change happens.
A key example is the landmark 1964 report on smoking and health which, for the first time, linked smoking cigarettes with several dangerous health effects. This report set in motion a world-wide wave of tobacco control measures that changed the public health landscape in an effort to stamp out smoking.
We can be confident that this latest report describing a “public health crisis of loneliness and isolation” will be an equally powerful impetus for change. It is as practical as it is powerful. The National Strategy to Advance Social Connection it puts forward includes six pillars for action including strengthening social infrastructure in local communities; mobilising the health sector; and building a culture of connection.
Profound health, social and economic costs
Surgeon General Dr. Vivek Murthy says that loneliness is far more than just a bad feeling—it harms both individual and societal health. It is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death.
The mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day, and even greater than that associated with obesity and physical inactivity.
And the harmful consequences of a society that lacks social connection can be felt in our schools, workplaces, and civic organisations, where performance, productivity, and engagement are diminished.
A similar collection of Australian reports and data highlight the same concerns. In a 2021 Snapshot, the Australian Institute of Health and Welfare reported that loneliness has been linked to premature death, poor physical and mental health, and general dissatisfaction with life and that conversely, more frequent social contact is associated with higher life satisfaction and overall health. The Institute’s snapshot tells us that loneliness tends to be more common in young adults, males, those living alone and those with children, either singly or in a couple.
Young people doing it toughest
A report by the Groundswell Foundation, Connections Matter: a report on the impacts of loneliness in Australia, describes profound economic social impacts of loneliness and finds that more than five million Australians are affected by loneliness.
It is young people who are bearing the brunt of the problem, with up to 50% of 18-24 year-olds describing themselves as socially isolated.
Loneliness has been described as a silent killer with lonely people having a 26% increased risk of death. The health impacts of isolation are said to be equivalent to smoking15 cigarettes or consuming six alcoholic drinks per day.
The economic burden is significant, with loneliness-related mental health issues estimated to cost the economy up to $60 billion a year.
Despite the social and economic costs of loneliness, it’s a problem that is seldom spoken about and often overlooked by Australian policymakers. This is prompting organisations like Ending Loneliness Together and Sucide Prevention Australia to develop campaigns to ensure the issue is more prominent in policy agendas.
Redefining progress: factoring in wellbeing
The importance that our community places on wellbeing adds to this milieu, and is building expectations that governments and others need to act on what some might have once-perceived as ‘soft’ policy issues like loneliness and social isolation.
Redefining Progress: global lessons for an Australian approach to wellbeing by the Centre for Policy Development revealed that Australians believe wellbeing should be the guiding purpose of governments. Research by 89 Degrees East in September 2022 indicated that almost 70% of Australians believe people’s wellbeing should be a bigger priority in government budgets.
These are not isolated views. The World Health Organisations’ Council on the Economics of Health For All calls for nation states to reimagine the relationship between economics and health and recognise that physical and mental wellbeing for all people must be a central goal of national economies.
If we need further convincing, the latest Australian Unity Wellbeing Index is sombre reading for all policymakers. Sadly, this Index highlights, yet again, that it is younger people who are doing it the toughest.
The survey measured the wellbeing of more than 2,000 Australian adults against a set of personal and social indicators including relationships, standard of living, life achievement, physical and mental health, and future security.
A number of cohorts are enduring difficult times (including people on household incomes below $30,000 and are in casual work or are unemployed) but the Australians who are facing the biggest struggles are 18 to 25 year-olds, who have recorded the lowest Personal Wellbeing Index since the survey began more than 20 years ago.
The sharp decline in life satisfaction manifests in a worrying spike of mental health issues, with young people suffering higher levels of anxiety, stress, and depression than any other demographic group.
Multiple crises – such as a health pandemic, cost of living pressures, climate change and global uncertainty have crashed down on all of us.
But the impact on younger people has been more acute given the polycrises have coincided with their transition to adulthood, depriving many of defining life experiences and the opportunities to be happy and prosperous enjoyed by previous generations.
The unprecedented challenges facing young Australians underscores the critical need to put their wellbeing at the heart of policy decisions.
Towards solutions
Dr. Vivek Murthy provides pointers for how to build more connected lives and societies. He cautions that if we fail to do so, we will pay an ever-increasing price in the form of our individual and collective health and well-being. And that has economic consequences.
The Surgeon General provides a sweeping blueprint with calls to action for individuals, community organisations, philanthropists, health workers, and governments.
He suggests governments should make social isolation and loneliness an explicit priority in policy agendas, prioritise research funding, create national measures for social connection, and invest in local social infrastructure to bring people together.
Health administrators and workers should integrate social connection into patient care by assessing those at risk of social disconnection, offering psychosocial support services and educating patients about the benefits of social connection and the risk factors of disconnection.
Community based organisations such as arts and education groups, volunteer and youth-led organisations can play a role. This could include public education to elevate the topic of social connection and disconnection in the community and the creation of education, resources and support programs.
Philanthropy can fund new, pathfinder programs that advance social connection, and convene thought leadership activities to develop solutions to social disconnection. Philanthropy could even evaluate social connection as part of other programs they fund.
Action close to home
So what does this mean for us in Australia?
At the pinnacle level of public policy, the Government’s Wellbeing Budget last October commenced consultation about the merits of measuring national and personal progress against a set of metrics across health, social and environmental outcomes in addition to traditional economic measures such as GDP.
The indicators being considered for Australia’s new standalone Measuring What Matters Statement in 2023 are a good starting point. The Statement is ambitious – it envisages a society where people are in good physical and mental health, satisfied with their lives, engaged with their communities, with the intrinsic benefit of close families and friends.
Grouped into five areas with fifty indicators – Prosperous, Inclusive, Sustainable, Cohesive and Healthy – the Treasurer has said in his 2023 Samball Oration that these will be the starting point for measuring what matters and gauging community wellbeing.
These robust indicators of physical and mental health – now and into the future – allow us to monitor the level of social isolation and loneliness in our community over time.
Beyond the Statement, there must be contributory policy with greater emphasis on wellbeing. The spectrum – and opportunity – is broad.
How might education, human services, primary care, preventive health, mental health, aged care, youth, early years and First Nations policies and programs be designed and evaluated to ensure positive contributions are being made to these indicators? After all, these are the indicators that the government will be relying on as it redefines how to measure progress.
As influencers of policy, how might the ‘for purpose’ sector adjust its advocacy towards such re-design and re-definition?
Australia’s bounty has delivered a consistently high standard of living to generations of Australians.
As the beneficiaries of all the good times, policymakers – and every one of us – are now on notice to prioritise the wellbeing of our future generation.
This is our clarion call.
