Loneliness is a public health problem that can be largely solved in our lifetime but doing so will require the full engagement and support from a whole system approach. The evidence of the harmful effects of loneliness is growing.
The Campaign to End Loneliness was established in 2011 and have since shared research, evidence and knowledge with thousands of other organisations and the public to make a difference to people’s lives. In recent years public attention has been drawn to the widespread experience and impact of loneliness. This was largely driven by the Jo Cox Commission on Loneliness, the appointment of the first ever Minister of Loneliness in 2017 and a cross-government Strategy on Loneliness launched in October 2018. In 2020 the Government launched a programme in England to tackle loneliness and social isolation and in May 2021, the Tackling Loneliness Network launched a Tackling Loneliness Network Action Plan. In Wales, the Welsh Government is planning to further roll out social prescribing to help tackle loneliness and social isolation.
As well as being an undesirable experience in itself, chronic loneliness increases risk of mental and physical ill-health, premature mortality, increased healthcare use and societal costs, including reduced productivity at work and absenteeism. The adverse physical and mental health effects of social isolation and loneliness are speculated to have reached epidemic proportions. Loneliness is experienced across all ages, nevertheless loneliness demonstrates a U-shaped distribution, with those aged under 25 years and those aged over 65 demonstrating the highest levels of loneliness.
The causes of loneliness are often complex, multi-layered, and mutually reinforcing. Loneliness stems from a combination of personal, community, societal and geographic factors rather than being the product of one event or change in circumstances. Triggers for loneliness are also widespread, but are associated with life course transitions, such as adolescences, leaving home, becoming a parent (particularly young and new mums), retirement, people recently divorced, separated or bereaved. Moreover, persons of higher risk of experiencing loneliness include people with mobility issues or health issues, people from marginalised groups, including ethnic minority backgrounds, LGBTQ+, people with disabilities, mental health problems or caring responsibilities .
The Covid-19 pandemic has served to amplify the conversation around loneliness, and, in turn, has exacerbated it for some groups. The evidence demonstrated a complex picture of “lockdown” loneliness. Overall loneliness levels were similar to those previously observed, but during the pandemic loneliness was particularly noted in groups not previously lonely, such as younger people and in people living in deprived urban locations. A significant number reported that their wellbeing was impacted by loneliness during lockdown. It is important to address some of the critical needs that have emerged during the Covid-19 crisis as the pandemic continues, and beyond into the recovery.
The evidence base around what works in tackling loneliness continues to act as a barrier to investment in loneliness interventions. Research into the effectiveness of interventions to reduce loneliness has by large been small scale and short term, nonetheless this does not mean that interventions are not effective and systematic reviews consistently states that new longer-term, large-scale research is needed to prove which interventions work best to reduce loneliness.
The Public Health Research (PHR) Programme wishes to commission research on interventions aimed at reducing loneliness. Although social isolation and loneliness often come together, they are conceptually and empirically distinct from each other. This call is primarily interested in intervention aimed at reducing loneliness. The PHR programme is predominantly interested in interventions that are likely to have impact on populations at scale, addressing health inequalities and the underlying wider determinants of health
PHR recognises that this call is broad and invites researchers to be targeted in their research area. Suggested research areas of interest could include (but are not limited to):
- Evaluations of cross system multi-level interventions to tackle loneliness
- Evaluations of interventions that aim to tackle loneliness in ethnic minority populations, including the recognition of the intersection with age, gender, sexuality, and geographical location (rural vs urban)
- Evaluations of interventions designed to combat loneliness among people at increased risk of loneliness, for example older people, bereaved, new mums, adolescence, students, people from marginalised groups, including LGBTQ+, people with disabilities, mental health problems or caring responsibilities
- Evaluations of interventions designed to gain skill and build resilience in people to prevent loneliness later in the life course
- Interventions utilising neighbourhood and place based approaches to reduce loneliness
- Asset based community development (ABCD) intervention, including working with existing resources and capacities in the area to build something with the community to reduce loneliness. This may also include transportation and lack of access to services
- Fiscal interventions to reduce loneliness
- Evaluation of services aimed at supporting and maintaining existing relationships
- Evaluation of Gateway Services, Community Navigators and social prescribing, which helps people to think about their social connections, as well as create new connections.
- Evaluations of interventions targeted at life transitions (e.g. retirement, divorce/separation, bereavement, change of school/university/work, parenthood). This could also be evaluations of how these transitions increase loneliness
- Evaluations of interventions whose primary purpose is not aimed at tackling loneliness but might have an impact on loneliness.
A range of study designs and outcome measures can be used. Researchers will need to clearly describe and justify their choice of target population group, as well as rationalise the most suitable methodological approach. Primary outcomes must be health related. Outcome measures of interest may include loneliness scores, subjective wellbeing, quality of life, depression, anxiety, sleeping problems, sense of belonging and/or identity. Indirect outcome measures will be considered for interventions aimed at longer term prevention of loneliness, researchers will need to clearly specify and justify any measures used. Researchers are encouraged to consider other outcome measures on the broader determinants of the inequalities of health, which should be specified and justified. Researchers will also need to specify key outcomes and how these will be measured in the short, medium and long term.
Understanding the value of public health interventions - whether the outcomes justify their use of resources - is integral to the PHR programme, where resources relating to different economic sectors and budgets are potentially relevant. The main outcomes for economic evaluation are expected to include health (including health-related quality of life) and the impact on health inequalities as a minimum, with consideration of broader outcomes welcomed. Different approaches to economic evaluation are encouraged as long as they assess the value and distributive impact of interventions. Applications that do not include an economic component should provide appropriate justification.
Researchers are encouraged to ensure that service users or people with lived experience from the target audience are involved in the design and planning of the intervention and/or as potential costed members of the research team. Researchers should demonstrate the relevance of their proposed research to decision-makers and they might do this through involving them as costed members of the research team. Researchers are encouraged to explain how they will share their findings with policy makers, public health officers, special interest groups, charities, community audiences and other relevant stakeholders. Researchers are expected to be aware of other studies in this area and ensure their proposed research is complementary.
For further information on submitting an application to the PHR Programme, please refer to the Stage 1 guidance notes and PHR supporting information. These can be found by clicking on the relevant commissioned call on the main funding opportunities page. This also includes closing dates and details about how to apply.