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Reducing social isolation across the lifecourse

Local action on health inequalities

The issue of social isolation is receiving increasing attention from health and social care professionals, the voluntary sector, community-based organisations and local authorities. One reason for this is the negative impact that social isolation is known to have on individual health and wellbeing at different stages of life. As a result, social isolation brings significant costs to health and social care services. There are links between inequality, social isolation and health: this is because many factors associated with social isolation are unequally distributed in society.

Reducing social isolation is a priority for social care and public health, as reflected in shared indicators across both the Public Health Outcomes Framework1 and the Adult Social Care Outcomes Framework. The current measures draw on self-reported levels of social isolation (using social contact as a proxy) for both users of social care and carers. These indicators assist local authorities in focusing on some of the more vulnerable people in their community.

This practice resource emphasises that social isolation and the relationship with health and inequalities in health is complex and multi-factorial. Consequently, no single sector can tackle social isolation comprehensively if acting alone: efforts to reduce social isolation require working across organisations and government departments. This provides opportunities for health and wellbeing boards to encourage partnership work between community and voluntary services, the NHS and local authorities to engage in strategies to reduce social isolation and loneliness in the community.

Learning from local areas and organisations already addressing social isolation shows that much can be done to tackle social isolation using existing community assets. This is particularly relevant in view of local spending constraints coupled with increasing demands for health and social care. Readers of this practice resource may also wish to view documents which report on phase 1 of the project ‘Working with communities: empowerment evidence and learning’ initiated jointly by PHE and NHS England to draw together and disseminate research and learning on community-centred approaches for health and wellbeing.

This practice resource provides information and guidance to support bodies in local areas, including local authorities, NHS clinical commissioning groups and their stakeholders to develop effective strategies to prevent and reduce social isolation. In particular the paper focuses on reducing social isolation across the life course. In doing so, the report supports efforts to reduce health inequalities, as part of a broad strategic approach through action on the social determinants of health.
This practice resource is presented in three sections:

1. A summary of the evidence on the link between social isolation, poor health outcomes and health inequalities.
2. Identification of who is at risk of social isolation, at what stage of life, and what impact this has on health inequalities.
3. An outline of interventions to reduce social isolation in the groups identified.

Research was carried out through a combination of desk-based research, including peer-reviewed and ‘grey’ literature, and consultation with experts, including academic researchers and practitioners. The approach was not to carry out a systematic review of the evidence, but rather to provide a broad review of known, new and recommended sources, enabling the authors to draw on the evidence base in highlighting promising areas for local action. Relevant references in the bibliographies of papers and reports were followed up.

Evidence used in this report includes evidence from research studies, systematic reviews, evaluations of interventions and evidence from individuals and organisations with relevant expertise. The authors gathered evidence and insights from stakeholders and experts during the public consultation exercise.