"We are currently living in systemic loneliness where we find ourselves in a community because of circumstance, like say work, while in reality we are "strangers in a strange land."
- AHP Panellist
"When we think of loneliness in Australia, it's often portrayed as the elderly person who can't leave the house and doesn't get visitors, but we need to recognise that loneliness can be experienced by anyone, and that you can be surrounded by people (e.g., have lots of co-workers, share your house with roommates), and still feel lonely, because the connection isn't there."
- AHP Panellist
In late 2020 CHF and the Medibank Better Health Foundation hosted a Loneliness Thought Leadership Roundtable to develop a roadmap for addressing loneliness in Australia. The final report from the Loneliness Roundtable was published in March 2021. To note the publication we asked Australia’s Health Panel about their experiences with loneliness and views on the effects of loneliness in Australia.
For this survey, 155 panellists participated. They were mostly female (81%), mostly aged 46 or older (85%) and lived in major cities of more than 250,000 people (65%). Panellists came from across every state and territory (see Figure 1). Panellists generally reported as healthy, with only 12% reporting they were in poor health. Additionally, 3% identified as Aboriginal or Torres Strait Islander, 10% as LGBTIQA+, 10% as culturally or linguistically diverse and 19% as a person with a disability.
Loneliness experiences and attitudes
In this AHP survey panellists completed an adaption of the De Jong Gierveld Scale, an internationally validated 11-item tool that measures levels of loneliness. This found that the majority of panellists were experiencing some level of loneliness when they participated in the survey. Most (44%) were moderately lonely, with some experiencing severe loneliness (15%) or very severe loneliness (3%).
When asked to self-report how often they felt lonely, the majority of panellists reported that they felt lonely at times, with only 14% reporting that they never felt lonely. A plurality (45%) reported that they ‘sometimes’ felt lonely, while sizeable minorities reported ‘rarely’ feeling lonely (25%) and ‘often’ feeling lonely (16%).
Given the high proportions of panellists who reported having personal experience with loneliness and were currently experiencing some level of loneliness, it was unsurprising that panellists overwhelmingly believed that loneliness was a very important (63%) or important (25%) issue in Australia.
Panellists almost unanimously believed that loneliness had an effect on people’s health, with 46% believing it had a large effect and 42% believing it has a very large effect. A similarly overwhelming majority of panellists (83%) agreed that more needed to be done to address loneliness in Australia.
Causes of Loneliness
When asked what they believed caused or exacerbated loneliness, some common themes emerged from the responses of panellists.
Unsurprisingly, the COVID-19 pandemic was identified as a large contributor to loneliness in Australia- the isolation, the quarantine and lock-downs, and the lack of travel were all mentioned by several panellists as things that had recently escalated levels of loneliness through the forced reduction in interactions with others.
"COVID restrictions have had a big impact. I have been very aware of it as a single person living alone - all my usual networks disrupted. I haven't seen some friends for more than a year. And I haven't been able to visit family in other states."
- AHP Panellist
Another very common theme was that the ‘Big Events’ of life such as having kids, moving out of home as a young person (or having your kids move out of home), moving cities for a career or study, retiring from workforce, going through a divorce or the death of partner or friends due to old age were all contributors to loneliness. In all of these ‘Big Events’ there is a dramatic change in the social circles of people, and if connections are not able to be maintained or replaced then those going through the change can become isolated and lonely.
A suite of health factors was also identified as items that made people more likely to be lonely: chronic illness, physical injuries, disabilities, and frailty (in particular for the elderly) were barriers that prevented people engaging in social activities. Similarly, mental factors such as depression, social anxiety and mental health problems were also mentioned by multiple panellists as less visible but equally powerful barriers to social interactions which exacerbated loneliness levels.
Similarly, economic factors were major causes of loneliness according to panellists. In particular, poverty, and the lack of disposable income preventing people from being able to afford participating in social activities on one hand while on the other, the demands of work/employment prevented others from having the time or energy to engage in social activities.
"Work intensification and work scarcity - people who have work have no time for family, friends, self-care. People who don't work (including some who are unable to work) have no resources to socialise so become socially isolated, and other people have no time for them."
- AHP Panellist
However higher societal level factors were also identified by panellists as significant contributors to loneliness: the broader fragmenting of community, cultural and language barriers for new migrants, geographic barriers for those living in rural and remote areas and a lack of community/cultural organisations for local social opportunities.
"I think the lack of groups with which to identify, such as family, workplace, voluntary work, clubs, etc can make personal connections feel fleeting or without depth. I think when person does not feel understood by those around them, they can feel lonely despite the number of people around."
- AHP Panellist
Shortcomings in infrastructure were particularly highlighted as problems: a lack of accessible transport options to be able to engage in social activities, a lack of places to socialise (in particular without a charge), the poor quality of Australia’s digital infrastructure for remote connections, and even the physical design of modern housing, which isolates people from their neighbours, were identified by multiple panellists as major causes of loneliness.
"We need holistic approaches - so many designs of apartments etc are not conducive to people even interacting with each other never mind getting to know each other. There should be more of an effort not only to welcome people when they arrive in Australia but encourage mixing and sharing of stories and culture."
- AHP Panellist
Regarding how panellists believed that loneliness should be addressed, there was a clear preference for responsibility to fall on the small scale: individuals (89%), family/friends (83%) and local community groups and organisations (80%). There was also a reasonable amount of support among panellists for local governments (67%), and doctors and the medical community (60%) to also have a responsibility in addressing loneliness. While panellists were more mixed around schools or workplaces (55%), state governments (52%) or the federal government (47%) having responsibility.
However, regarding who should take the lead in coordinating actions to address loneliness, the federal government was narrowly the preferred leader with 21% of panellists selecting them. Local community groups and organisations (19%) and local government (15%) were the next two most preferred leaders for coordinating action.
Overall, this suggests that panellists recognise the need for higher-level systemic co-ordination of actions to address loneliness across all of Australia, but that the actual efforts will need to be delivered and managed at the local level to get consumer support.
Mechanisms for countering loneliness
When asked where they would go to access support if they were feeling lonely, only ‘friends and/or family’ (67%) was selected by the majority of panellists and only ‘community organisations e.g. religious group, volunteer organisation, support group, sports club etc’ received a large plurality of panellists (45%).
This suggests two important things regarding efforts to counter loneliness in Australia: the first is that consumers use a wider variety of channels to deal with loneliness and any co-ordinated efforts must utilise those different channels. The second is that, given the one-on-one nature of the two places people were most likely to go to, the priority for initiatives must be to empower and equip individuals on a large scale to personally help other Australians overcome loneliness.
When asked to give their Top 5 priorities of specific actions that should be pursued first in an effort to counter loneliness in Australia the five most commonly selected programs were:
- ‘Funding for local community groups and organisations to build networks and connections’ (53%)
- ‘Improve public safety nets such as income support to ensure everyone has the means to develop and maintain social connections and meet their basic living’ (41%)
- ‘Social prescribing (referral to non-clinical services e.g. art, exercise groups etc.) through the healthcare system’ (40%)
- ‘A community awareness campaign to increase understanding about loneliness and challenge misconceptions’ (40%)
- ‘Increased funding and services in the mental health space such as prevention, self-care and support services’ (39%)
Collectively these not only give advocates and policy-makers clear guidance as to which initiatives will have community support if developed but reinforce that a broad, system-orientated approach is needed to counter loneliness in Australia, as articulated by one panellist:
Health professionals to use social prescribing which should be funded by Medicare; more funding for community-based drop-in centres; publicity to allow individuals to accept loneliness as just not their problem but a society-wide one; more centre-based respite centres for older folk and people with disability, young mothers, and people with mental health issues.
- AHP Panellist
Australians not only experience loneliness in large levels, they are aware they are lonely. They recognise that loneliness can have a large effect on their health and thus believe it is an important issue that needs action.
While there is a slight preference from consumers for the federal government to take the lead in co-ordinating actions to counter loneliness, there is a strong belief that action needs to come through the local level, whether local governments, well-equipped local community organisations/groups or empowered individuals themselves.
Australians recognise that loneliness can be caused and exacerbated by many factors and that to tackle it we need a strategy that uses a broad array of tools. Consumers particularly value starting with system-focused initiatives that raise awareness of loneliness and its effects, empower local communities and services to be able to address loneliness and develop mechanisms for those with loneliness to be linked to those local services and communities.
The results from this survey reinforce to CHF the importance of adequately addressing loneliness within the Australian community. It also shows the timeliness of our CHF Loneliness Thought Leadership Roundtable Report, given the pronounced increase in loneliness caused by the ongoing COVID-19 pandemic. These survey results will help shape our ongoing advocacy initiatives, such as continuing to call for the embedding of Social Prescribing within our health system and our work on the National Preventive Health Strategy Expert Steering Committee to enhance how preventative health in general, and mental health in particular, are approached in the health system.
"At the highest level start a conversation about how loneliness can be countered and then engage with stakeholders and the community across the board to develop a plan of action. Allocate a Minister to have carriage of it."
- AHP Panellist
"More needs to be done to highlight how common loneliness can be. It can be really discouraging to look on social media or even in traditional media and be shown dozens of images of big friend groups, lifelong friendships, and large families. It can make you feel like there's something wrong with you, like your experience is out of the norm. But when I open up to people about my experience, I learn that it's actually not uncommon."
- AHP Panellist
The Consumers Health Forum of Australia would like to thank all panellists for giving up their time to participate in this survey. Any questions about this survey and its findings can be directed to firstname.lastname@example.org
Note: as each question in the AHP survey was optional, the number of responses for each question varies across the survey. As such the total ‘n’ for the set of answers of each question may not add up to the same overall number of survey participants.