Mr Whitehead is the Men's Health Clinical Nurse Consultant at St Vincent's Hospital Sydney, and recently presented at the Global Action on Men's Health and the World Congress of Public Health.

This week is Men's Health Week and features the theme; "building healthy environments for men and boys", and he says dealing with loneliness is one part of the solution.

"Cardiovascular disease is heightened in men who are lonely, as well as mental health conditions such as depression and anxiety

"Loneliness is not something we typically screen for in hospitals. A person can be seen with a health complaint and we'll treat the symptoms, but the social drivers that are affecting this are often ¬- almost exclusively - missed."

Most Australians will experience loneliness at some point in their lives and about 33% reported an episode of loneliness between 2001 and 2009, with 40% experiencing more than one episode.

Living alone and not being in a relationship are substantial risk factors for social isolation and loneliness, yet the 2016 Census found 25% of Australians live alone.

Living alone does not necessarily mean you are lonely, but many people, particularly men who do live in solo households, can report lower social connections.

Mr Whitehead says it is widely acknowledged that as men age, their close friendship circle reduces in size, which is not the same (and often the opposite) for women.

Those who don't have social connections, can at times, fall into depressive states and find it difficult to navigate their way out or seek help.

Activities such as volunteering, joining an interest group or even a dog park are simple ways men can begin to broaden their social circle.

"For men, often the longest mile is from their front door to another door," he says. "We need to strengthen the ability for men make that short journey across the loneliness divide and reap the rewards that social connection brings."

"Our society is improved when we begin to develop connections that lead to friendship, and which then add additional meaning into our lives," he says. Continue reading

Meaningful social connection—especially with people we can be ourselves around, people we can call on in times of need—is a basic human need.

But just like these other needs, if left unmet for long periods of time, there are serious social, emotional, and health consequences.

Prolonged loneliness, for example, is associated with an increased risk of depression, addiction, anxiety, heart disease, dementia, sleep disturbances, and even premature death.

We might assume this mostly affects older New Zealanders, but research shows it is our youth that are feeling the most disconnected.

They are up to four-and-a-half times more likely to experience prolonged loneliness than older New Zealanders.

Sole parents and unemployed people also have relatively higher rates of loneliness.

Loneliness is no different to hunger or thirst; a signal from our bodies that we need something

Job losses, physical distancing, and general emotional uncertainty surrounding COVID-19 have only made things worse.

Before the lockdown last year, around 3.5 percent of New Zealanders were feeling lonely—a small but significant minority.

During the lockdown this rate rose to around 11 percent, settling to about 9 percent afterwards.

Youth rates are higher: around 20 percent felt lonely during lockdown, only dropping to 17 percent afterwards.

There has clearly been a post-pandemic relational toll; the new normal is lonelier than before.

Other countries have put loneliness squarely on the policy table.

In 2018, the United Kingdom government led the way, recognising this as a policy issue years ago with a Minister of Loneliness working on a "Loneliness Strategy" aimed at increasing data collection, front-line mental health workers, and funding community projects to name a few responses.

Earlier this year the Japanese Government appointed a new Minister responsible for alleviating loneliness and social isolation.

Whether we appoint a Minister or not, we must follow suit.

We cannot afford to ignore the cost of loneliness and isolation on society.

But it's not easy area to make ground. Years in, the UK Government is only just getting the measures and strategies bedded in.

Governments are great at many things, but relational connection is not one of them.

Just because loneliness is of policy interest doesn't mean Government can alleviate it alone.

We all have a role to play in pursuing a New Zealand where we all belong.

In a recently-released book by the U.S Surgeon General Dr. Vivek Murthy on loneliness, his recommendations had surprisingly little to do with policy settings.

Simple things like devoting time to spend with loved ones, focusing attention and avoiding multi-tasking when relating, and serving others wherever we can form the foundation of a response.

Policy-wise, keeping the economy afloat with people in jobs and supporting those out of work will make a difference here, but above and beyond this economic response, this is a policy area where the Government is best set to coordinate an overarching strategy and to fund, support and protect community organisations with human faces and open arms for those struggling with loneliness.

We all have a role to play in pursuing a New Zealand where we all belong.

• Kieran Madden is Maxim Institute's Research Manager, leading and guiding our research programme.
• First published by the Maxim Institute. Republished with permission.

This is especially so as Melburnians entered the strictest lockdown to date.

Meanwhile, the rest of Australia braces for the possibility of a second wave and people are adapting to new habits and restrictions.

This has disrupted our social routines, and in many cases has reduced the number of people we interact with. This makes it harder to maintain meaningful social connections, resulting in loneliness.

But sometimes it can be difficult to tell if you're feeling lonely or feeling something else. And many people are reluctant to admit they're lonely for fear it makes them seem deficient in some way.

So what are the signs of loneliness? And how can we recognise these signs and therefore manage them?

I'm not lonely…

Loneliness is complex. Some people can feel lonely despite having extensive networks, while some others might not, even if they live alone. There are many factors behind this, and the COVID-19 pandemic is another significant one.

Social restrictions during the pandemic mean we are more reliant on existing relationships. People who enjoy brief but multiple social interactions in their daily routine, or simply like being around others, may now find it harder to keep loneliness at bay.

When researchers ask people whether they're lonely, some deny or reject the idea. But when asked in a different way, like whether they want some company, some of those same people would say yes, they would like company.

This is because there's a social stigma to loneliness. We often think it is somehow our own fault or that it reveals some personal shortcoming. Loneliness evokes a particularly vulnerable image, of someone living alone with no one around them.

One survey also found men are less likely to say they're feeling lonely, although this research was published before COVID-19.

"Max", aged 21, was interviewed as part of an upcoming project being done by Ending Loneliness Together, an organisation that addresses loneliness in Australia. He has experienced periods of loneliness and said:

Because of these misconceptions, many who are lonely will overlook their own emerging signs of loneliness in the hope these feelings will go away once they are around people.

But seemingly logical solutions like making more friends or knowing more people may not help, if you perceive these relationships to be unhelpful, neutral, ambivalent, or even sources of conflict.

Nevertheless, ignoring growing levels of loneliness will increase our risk of developing poorer physical and mental health.

Signs you might be lonely

Loneliness is a normal signal to connect with others, so it's unlikely you'll be able to rid yourself completely of lonely feelings during this time. Instead, we should aim to manage our loneliness so it doesn't become severely distressing.

More often than not, we might not be willing to admit even to ourselves that we're feeling lonely. The COVID-19 pandemic may be a trigger, but there is a range of factors that can lead you to feel lonely, sometimes without even realising.

This can make it hard to be consciously aware of any loneliness you might be experiencing, particularly if the pandemic has left you feeling busier and more stressed than usual.

Here are some signs you might be feeling lonely. To a certain extent, you feel that:

• you are not "in tune" with others
• your relationships are not meaningful
• you do not belong
• you do not have a group of friends
• no one understands you
• you do not have shared interests with others
• there is no one you can turn to.

It's important to remember, though, not all of these may relate to you and you may experience these in varying degrees.

How to manage your loneliness

Because of the complexity of loneliness, there is no one-size-fits-all solution. To find the best solution for you, reflect on your personal preferences, previous experience, and your capacity to reach out to your social networks.

During the pandemic, the solutions you select will differ depending on the social restrictions in your state.

Even under the strictest social restrictions (in Melbourne), some of us have been fortunate to have a friend or a neighbour in our area with whom we can walk and chat while still adhering to public health directives.

For others, getting in touch via Zoom or a phone call may be the only option.

For those who can, establishing shared goals or activities with friends, family, or colleagues can be helpful.

These provide positive social support and facilitate a sense of achievement when meeting those goals. This might include setting self-care goals such as exercise, meditation, cooking, hobbies, or learning new skills. But equally, it's not a sign of "failure" if you don't do these things.

Friendships are good for our health, but making a new friend can be taxing for some people.

Instead, perhaps think about how you can work on existing relationships.

Pick what feels right and is feasible for you.

If improving the ties you already hold is all you can do, focus on this. And if you are reaching out to people outside your familiar network, it doesn't have to be confronting. A simple hello is a small step towards more meaningful interactions in the future.

Social restrictions including isolation, quarantining, and social distancing are public health measures we've become acquainted with since the onset of COVID-19.

Although these restrictions modify our social interactions physically, they don't mean we can't stay meaningfully connected to each other. This is why many prefer the alternative term "physical distancing".

We can, and should, stay socially connected while being physically apart.

• Michelle H Lim is a Senior Lecturer and Clinical Psychologist, Swinburne University of Technology.
• Originally published on The Conversation. Republished with permission.

For youth aged 15-24 years (General Social Survey) or aged 18-24 years (other surveys), the incidence of prolonged loneliness increased from 5.8% of youth before lockdown to about 20.8% during the lockdown.

It fell slightly to 17.0% post-lockdown.

These are the findings of the Loneliness New Zealand Charitable Trust's report written by Dr Spencer Scoular.

Put another way, before lockdown 1 in 17 youth experienced prolonged loneliness, whereas during lockdown this increased to 1 in 5 youth and post-lockdown 1 in 6 youth.

Solo parents and the unemployed are among other groups most affected by loneliness brought on by Covid-19.

Overall prolonged loneliness increased from 3.5 percent of the New Zealand adult population before lockdown to about 10.6 percent during the lockdown, before slightly falling to 8.7 percent post-lockdown.

While the country grappled with higher unemployment, lower incomes, border restrictions, and working from home, meaningful connections would have been even harder to develop and sustain, Socular said.

This would increase people's risk of prolonged loneliness and poor wellbeing.

Youth Unemployment
Young people have been hit hardest by job losses in that time, with the number of people aged 18 to 24 on Jobseeker Support increasing by 66 per cent, a Salvation Army report found.

Maori and Pasifika workers have been generally more affected by job losses, with more than half of those households left in financial difficulty during the lockdown period.

The Salvation Army has called for "coherent and fair welfare support" based on "real measures on income adequacy" after saying the COVID-19 Income Relief Payment had highlighted "inadequate benefit levels."

The Salvation Army is calling for coherent and fair welfare support that is based on real measures of income adequacy and a focus on keeping people and especially children out of poverty.

• Source
  stuff.co.nz
• loneliness.org.nz
• stuff.co.nz
• salvationarmy.org.nz
• Image: loneliness.org.nz

Survey results were released by Cigna, a global health service company, based on the UCLA loneliness scale, an instrument that measures and assesses subjective feelings of loneliness, as well as social isolation, by using a 20-item questionnaire.

Four significant patterns related to feelings of loneliness and social isolation emerged from the survey of more than 20,000 U.S. adults, age 18 years and older:

Nearly half of the respondents reported feeling alone, occasionally or continuously (46 percent), or left out (47 percent).

• One in four rarely or never feel as if there are people who truly understand them.
• Two in five feel that their relationships are inconsequential (43 percent) and that they are isolated from others (43 percent).
• One in five report they rarely or never feel close to other people (20 percent) or that there is anyone they can talk to (18 percent).

Bob Dylan once said that New York is the only place where you can freeze to death on a busy street and no one will even notice.

Although urban centres are incredibly dense and swarming with people, the density only seems to compound the loneliness.

Thus, the confluence of urbanization and globalization is creating an expanding mission field for the church, given most of the global population continues to migrate steadily into urban centres.

What then can we do? Continue reading

Earlier this year, Tracey Crouch was appointed the United Kingdom's first minister for loneliness.

While it may seem unusual to some to have government take a role in improving our social connections, it makes sense when you consider the negative impact of loneliness not only on the individual, but also the wider community.

But with increasing investment from government, how do we ensure programs intended to address loneliness are well-targeted and successful?

What is loneliness?

Loneliness is a negative feeling that arises when someone's social needs are unmet by their current social relationships.

So people can feel alone, even if they're surrounded by others, if they're not getting the right kind of company and support.

While many think of loneliness as a social issue, it also affects our health.

A person who perceives themselves as having less access to relationships, also finds physical and mental tasks more difficult.

People with less access to others can't rely on group safety or "share the load" of life's challenges.

This can result in stress.

Researchers found hand-holding with a spouse (as opposed to a stranger) can significantly reduce stress during difficult tasks.

And these effects were even larger with couples that reported the highest quality relationship.

These emotional and psychological effects translate into physiological effects.

Loneliness negatively impacts brain processes, ability to handle cognitive tasks, control of inflammation in the body, ability to regulate stress, and severity of mental health symptoms, just to name a few.

Loneliness has been found to be a risk factor for all causes of early death and feeling lonely increases our likelihood of earlier death by 26%.

This is greater than the risk for obesity.

How to reduce loneliness

Reducing loneliness has obvious health benefits.

But the solution isn't as simple as connecting lonely people with other people; rather, it involves the establishment of meaningful connections.

Many social initiatives rely heavily on connecting lonely people with strangers and a rotating cast of volunteers.

Most of these programs designed to address loneliness are being implemented without testing their effectiveness.

The following should be considered when addressing loneliness.

First, loneliness provides a signal for us to seek out others.

The aim should be to reduce distressing levels of loneliness, rather than getting rid of loneliness per se.

And we should be mindful of risk factors that are less amenable to change, such as genetics, which can make people more predisposed to feeling lonely.

Second, loneliness can be transmitted from person to person.

Research shows loneliness can be passed on up to three degrees of separation from the lonely individual.

Exactly how this occurs is yet to be fully understood - we have yet to explain whether loneliness is relayed via negative thoughts, behaviours, or feelings within relationships.

Not understanding the transmission process may lead some to experience loneliness after interacting with the lonely.

Third, unhelpful thoughts and negative beliefs about others and the social world are thought to underpin loneliness.

Researchers have found programs that provide social opportunities as well as helping the lonely person learn how to interact better with others are the most useful.

Last, the predictors of loneliness differ depending on demographics.

We know, for instance, there are two risk periods for loneliness: in adolescents and young people under 25, and adults over the age of 65.

How we tackle loneliness should vary for both groups.

For example, an older adult may need grief counselling from a bereavement, whereas a younger person may need help coping with social anxiety.

A public health campaign in Australia could play a large role in destigmatising loneliness and addressing its health implications.

A successful campaign could recast misconceptions of loneliness as a sign of vulnerability, fragility, or weakness, occurring only in people who are physically isolated or old.

Similar campaigns have been introduced in Denmark and the UK, with a national initiative gathering momentum here in Australia.

Australian doctors and health professionals would benefit from an assessment tool to identify the risks for loneliness.

Australians would also benefit from the introduction of guidelines for good social health, as well as education around positive social relationships, which could start in schools.

With targeted solutions, we could improve feelings of loneliness across all ages.

Sources

• Michelle H Lim Senior Lecturer and Clinical Psychologist, Swinburne University of Technology. First published in The Conversation.
• Image: Sander Troelstra