The claim

“Work matters, particularly for older people, not just for money but absolutely for social contact…We know smoking is really bad for you. But much worse are things like social relationships.”
David Halpern, 10 February 2012

The background

Buried deep in the corridors of power is a slightly mysterious body called the Behavioural Insight Team, a group of academics enlisted by the government to help “nudge” people into changing their lifestyles for the better.

The team’s director David Halpern made a rare foray into the headlines today when he suggested that it might be good for some older people to carry on working after they reach pensionable age, for the good of their health.

Mr Halpern told the UK-Nordic Baltic Summit that loneliness was “a more powerful predictor of whether you will be alive in ten years’ time, more than almost any other factor, certainly more than smoking”.

Will loneliness really kill you quicker than smoking? Is it a big problem among old people? And is getting a job in your twilight years the answer?

The analysis

The claim that loneliness is more unhealthy than smoking has been around for a while, and has been repeated endlessly in the media.

Many articles on the subject repeat the claim that the World Health Organisation (WHO) has ranked loneliness as a higher risk to health than smoking and as great a risk as obesity.

In fact, that appears to be something of a myth.

The WHO told us: “We have never done a study on loneliness – it is not considered to be a global public health issue (yet) and we have no technical department that is working on this study. We do not know where this quote attributed to WHO came from.”

The Campaign to End Loneliness, a group that aims to prevent social isolation among old people, says it has now dropped references to the WHO from its campaign material because it couldn’t find the origin of that claim.

The Cabinet Office told us that Dr Halpern used this study “to inform his talk”. The paper is a 2009 review of 148 studies that had already been published on the subject.

The team collected results covering more than 300,000 people over an average of 7.5 years and concluded that “individuals with adequate social relationships have a 50 per cent greater likelihood of survival compared to those with poor or insufficient social relationships”.

That’s a big difference, suggesting that loneliness is about as unhealthy as smoking, and worse than obesity and physical inactivity in terms of predicting an early death.

If we wanted to split hairs, we’d point out that the researchers don’t actually say that loneliness is worse than smoking. They rank the two as about the same. But the findings are still significant.

Professor John Cacioppo, probably the world’s leading expert in the psychology of loneliness, also says the difference between and lonely and a sociable person is like the difference between “a smoker and a non-smoker” in terms of health.

His research suggests that a sense of isolation can have an immediate, measurable effect on physical health, causing higher blood pressure and stress levels, depressing the immune system, disrupting sleep, encouraging overeating and alcohol consumption, and leading to an increased risk of Alzheimer’s.

Prof Cacioppo puts forward the hypothesis that human beings have evolved to depend on social networks and pangs of loneliness, like hunger and pain, are physical danger signs that there is a threat to an individual’s survival.

But neither his work nor the 2009 paper lend much weight to the idea that getting a job is the obvious answer for elderly people who may be feeling isolated.

Professor Cacioppo say you don’t necessarily feel lonely just because you are alone, and simply having more contact with people won’t always make you feel better.

He uses the example of US college freshmen who report feelings of loneliness after leaving their families and high school friends behind, even though they are surrounded by lots of people.

By the same logic, retired people won’t automatically feel more socially connected just because they get a job in a local shop.

It all depends on how you feel about your social situation, which is why Prof Cacioppo found that changing patterns of negative thoughts was a better treatment for lonely people than just encouraging more social interaction.

There’s also some confusion about how many older people have a problem with loneliness.

Mr Halpern was quoted today as saying that most over-75s feel lonely “all or most of the time”, but that doesn’t chime with other findings.

The Cabinet Office pointed us towards various surveys carried out by charities on the subject. It appears that 51 per cent of all people aged 75 and over live alone – but as we have seen, that doesn’t mean all of those people feel isolated.

About 11 per cent of people aged 65 or over in the UK say they are always or often feel lonely, according to a 2009 survey. The Campaign to End Loneliness says a fairly constant proportion (6-13 per cent) of older people say they feel lonely “often” or “always”.

The verdict

If it’s not quite true to say that loneliness is “much worse” than smoking as a predictor of bad health, the fact there is a strong correlation is still a surprising and worrying insight, backed up by a growing body of academic research.

Mr Halpern may be on slightly less firm ground if he thinks that getting a job will automatically cure for the feelings of isolation that appear to trigger poor health. Treating loneliness is more complicated than just seeing more people.

And while there is evidence that a significant number of older people feel lonely, it doesn’t seem to be a problem of epidemic proportions.

By Patrick Worrall