Preventing loneliness and social isolation: interventions and outcomes

This is one in a series of research briefings about preventive care and support for adults.

Prevention is broadly defined to include a wide range of services that:

• promote independence
• prevent or delay the deterioration of wellbeing resulting from ageing, illness or disability delay the need for more costly and intensive services.

Preventive services represent a continuum of support ranging from the most intensive, 'tertiary services’ such as intermediate care or reablement, down to 'secondary’ or early intervention, and finally, 'primary prevention’ aimed at promoting wellbeing. Primary prevention is generally designed for people with few social care needs or symptoms of illness. The focus, therefore, is on maintaining independence and good health and promoting well-being. The range of these 'wellbeing’ interventions includes activities to reduce social isolation, practical help with tasks like shopping or gardening, universal healthy living advice, intergenerational activities and transport, and other ways of helping people get out and about.

Just as the range of wellbeing services is extensive, so to is the available literature examining how well they work. For this research briefing, the focus has been narrowed to the effectiveness and cost-effectiveness of services aimed at preventing social isolation and loneliness. Our review question was: 'To what extent does investment in services that prevent social isolation improve people’s wellbeing and reduce the need for ongoing care and support?’

While 'social isolation’ and 'loneliness’ are often used interchangeably, one paper examined the distinct meanings that people attach to each concept. 'Loneliness’ was reported as being a subjective, negative feeling associated with loss (e.g. loss of a partner or children relocating), while 'social isolation’ was described as imposed isolation from normal social networks caused by loss of mobility or deteriorating health. This briefing focuses on services aimed at reducing the effects of both loneliness and social isolation. Although the terms might have slightly different meanings, the experience of both is generally negative and the resulting impacts are undesirable at the individual, community and societal level

Scoping and searching

Focused searching began in November 2010 and was completed in January 2011. The scope included 'peer reviewed papers reporting evaluations of interventions aimed at reducing social isolation and loneliness’. Priority was placed on systematic reviews and controlled effectiveness studies. Poor quality studies with no discernible methodology, no outcome measures and no control were excluded from synthesis. Papers published before 2000 were excluded.