Loneliness in later life: analysis of the English Longitudinal Study of Ageing Christina Victor, Brunel University [email protected]

Campaign to End Loneliness Seminar December 2013

Overview of presentation

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Project introduction

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Definitions & data

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Expectations of loneliness

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Prevalence of loneliness

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Who is vulnerable to loneliness?

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Loneliness: a fluid concept?

Campaign to End Loneliness Seminar December 2013

Project details

• • • • • • Project title:Loneliness in later life: a longitudinal analysis using the English Longitudinal Study of Ageing Funder: Economic and Social Research Council –grant reference: ES/K004077/1 Co-Investigator:Prof Ann Bowling Research fellow: Dr Jitka Pitkahova Partner: Campaign to End Loneliness Duration: April 2013 –October 2014 Campaign to End Loneliness Seminar December 2013

Project research questions

• To understand longitudinal changes in loneliness for those aged 50+ by addressing 3 substantive research questions:  How does loneliness status change over a 10 year period?

 What factors are associated with changes to feelings of loneliness over this time?

 Does loneliness predict health outcomes over a 10 year period?

Campaign to End Loneliness Seminar December 2013

What is loneliness?

Loneliness: the difference between desired and actual social relations (Perlman & Pelau, 1981) either in quantity or quality of relationships (or both)-perhaps also the mode of relationships Living alone Loneliness-emotional, social, existential Isolation

Language... has created the word "loneliness" to express the pain of being alone. And it has created the word "solitude" to express the

glory of being alone.” - Paul Tillich Campaign to End Loneliness Seminar December 2013 Being alone Solitude

Data

• • • • Secondary analysis – English Longitudinal Study of Ageing (ELSA) ELSA started in 2002 and is a longitudinal study of people aged 50+ The study is repeated every 2 years (waves 1 to 5 available) Modelled on Health & Retirement survey in the USA Includes bio-medical, health, psychological and social questions about ageing and later life Campaign to End Loneliness Seminar December 2013

Measuring loneliness?

Can we measure loneliness?

I think it’s a very difficult thing to quantify, ….And I think perhaps it is something which you can’t quantify because it is something which is within oneself perhaps, one’s outlook on life. (F aged 67 married)

Can we measure it if we can’t talk about it? Some argue that language can never convey all that is intended, by words such as loneliness “even if the other manages to visit for a moment, he can never stay” (Mijuskovic, 2012, p67). Campaign to End Loneliness Seminar December 2013

Measuring loneliness

MEASURES OF LONELINESS

Have you felt lonely much of the time during past week? (Y/N)

w1 w2 w3 w4 w5

+ + + + + + (7-point Likert scale) + + + (3-point Likert scale) How often do you feel lonely? (3-point Likert scale) I expect to grow lonelier as get older (5 point Likert scale) Old age is a time of loneliness(5 point Likert scale)

+ +

Campaign to End Loneliness Seminar December 2013 + + +

Characterising loneliness

• • Loneliness an opportunity for personal growth Loneliness as pathological – Associated with high levels of stigma, stereotyping & ‘othering’ of older people as excluded from society – Seen as being a key problem of ‘old age’ Campaign to End Loneliness Seminar December 2013

This is not new...

‘’A distressing feature of old

age is loneliness. All who have done welfare work among the old have found it the most common, if at the same time the most imponderable, of the ills from which the aged suffer, and its frequency was amply confirmed by our study’’

(Rowntree, 1947,52) Campaign to End Loneliness Seminar December 2013

Why are we interested in loneliness?

“Social relationships, or the relative lack thereof, constitute a major risk factor for health— rivaling the effect of well established health risk factors such as cigarette smoking, blood pressure, blood lipids, obesity and physical activity”

House, Landis, & Umberson; Science 1988 Campaign to End Loneliness Seminar December 2013

“Being isolated shortens life and increases disability. It is equivalent to 15 cigarettes a day.”

Duncan Selbie, Chief Executive of Public Health England

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Beliefs & expectations

% agreeing old age is a time of loneliness • % expecting to get more lonely with age Source: ELSA Wave 2 analysis Campaign to End Loneliness Seminar December 2013

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Loneliness: a self fulfilling prophesy? &

% of those who are lonely by expectation of loneliness in old age • % lonely by expectation of loneliness Campaign to End Loneliness Seminar December 2013

Prevalence of loneliness

6 4 2 14 12 10 8 0 <25 25-34 35-44 Source: Victor & Yang, 2012 45-54 55-64 65-74 ≥75 Campaign to End Loneliness Seminar December 2013 Male Always lonely Female Always lonely

Prevalence of loneliness

LONELINESS

Low score (3/4) Medium score (5/6/7) High score (8/9)

Males <65 years Females < 65 years Males > 85 years Females > 85 years

74% 68% 57% 48% 24% 3 % 28% 4% 37% 5 % 42% 10% Campaign to End Loneliness Seminar December 2013

‘Risk factors’ for loneliness

• • Large number of risk factors for loneliness – focus on vulnerability, NOT protective factors Vulnerability = widowhood, time alone, expectations of health in old age, psychological ill health, perceived health, perceived increase in loneliness Protective = increased age, education Note: the presence of a risk factor does not guarantee loneliness, for example 40% of those widowed in ELSA become lonely but 60% do not Pets not the answer!

Interpersonal Engagement Intrapersonal Factors Wider Social Structures Campaign to End Loneliness Seminar December 2013 Life Stage Events Social Environment

Loneliness across Europe

% not lonely

100 95 80 75 90 85 70 Italy France Spain Belgium Austria Germany Netherlands Sweden Switzerland Denmark U.K.-ELSA Campaign to End Loneliness Seminar December 2013

2004 2011

% lonely

Loneliness and ethnicity

Campaign to End Loneliness Seminar December 2013

Longitudinal changes in loneliness?

Loneliness pathway Never lonely Always lonely Out of loneliness Into loneliness Fluctuation* UCLA scale waves 2 to wave 5 66.2% 6.7% 9.8% 8.7% 8.7% Self rating scale wave 1 to wave 5 71.3% 2.0% 6.8% 4.6% 15.4% * 8 pathways for UCLA scale and 22 for self rating Campaign to End Loneliness Seminar December 2013

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Longitudinal changes in loneliness?

Fluctuating pattern of loneliness 0=not lonely 1=lonely 0 Wave 1 Wave 2 Wave 3 Wave 4 Wave 5 Campaign to End Loneliness Seminar December 2013

Variations in loneliness?

Loneliness described as both temporal & spatially experienced.

’I'm lonely of a night. ‘’(Man 16) ‘’Such a lonely life … Saturdays and Sundays are a bit dead for me…’’ (Woman 21) ‘’So long [Sunday] and so lonely.’’ ‘’I never sat on my own as my husband was always there’’ (Woman 9) ’’I was always sat in that chair there and whenever I looked up from here she was there. But when she'd gone she was not ‘’ (Man 8).

Campaign to End Loneliness Seminar December 2013

Loneliness is not at a given time. It

comes and it goes.” (73 yr old widow) 2 1 4 3 0 июн.12

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0 – Never 1 – Rarely 2 - Sometimes 3 – Often 4 – Most of the time июн.13

It comes and it goes...

2 1 4 3 0 июн.12

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0 – Never 1 – Rarely 2 - Sometimes 3 – Often 4 – Most of the time авг.12

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Campaign to End Loneliness Seminar December 2013 Source Sullivan and Victor 2013 июн.13

Back by popular request!

[email protected]

Campaign to End Loneliness Seminar December 2013