Darrell Gale, Director of Public Health for East Sussex, has just published his annual report ‘Connecting People and Places: Bringing communities together in East Sussex’.

The report captures how a partnership of public health, local authorities, the NHS and the Voluntary, Community and Social Enterprise (VSCE) sector in East Sussex are developing a collaborative approach to mitigating the worst effects of loneliness across the county.

In this post, we share a bit about our work to inform this report and what we learned about loneliness along the way. 

“Humans are social creatures: in this simple and obvious fact lies both the problem and the solution to the current crisis of loneliness.”

Dr Vivek Murphy, US Surgeon General

Loneliness: whose problem is it?

Long before the pandemic introduced us all to the effects of social distancing, loneliness had been identified as a ‘defining feature of the 21st century’. 

Loneliness is a subjective experience, a ‘mismatch between the quantity and quality of the social relationships we have, and those we want.’ Most of us will experience it at some point in our lives, but usually it will pass. However, for those who suffer chronic loneliness there can be severe consequences for mental and physical health and an increased risk of early death.

Inevitably, the effects of loneliness show up in the health system, but is it something a doctor can fix? The obvious answer is no. But if doctors can’t fix it, then who or what can?

Loneliness is a complex social problem, so searching for a single solution is a mistake in itself. It’s the product of many different sets of circumstances – personal, social, societal. No one intervention or organisation can make much of a dent.

The answer lies in connection. And creating the kind of environments that enable greater quantity and quality of connection. Local government and place-based partnerships have a powerful role to play in shaping the places in which we live to support communities to become better connected. 

Our recent work with East Sussex County Council to develop a systems approach to loneliness helped show how that can be brought about.

In his recent report ‘Connecting People and Places. Bringing communities together in East Sussex’ Darrell Gale, Director of Public Health in East Sussex, reflects on the learning from this work, led by public health and involving a partnership of local authorities, the NHS and the Voluntary, Community and Social Enterprise (VSCE) sector in East Sussex.

Together, the partnership has committed to a joined up strategy that connects the dots, spots the gaps and ensures that all departments, sectors and communities are playing a part in strengthening connections – connections within communities, between communities, and between communities and the organisations that serve them. The key learning is that to be able to do this, the system needs to be better connected within itself.

Creating connections

Understanding the different types of connections enables us to identify appropriate and possible interventions.

Connections between people can be understood based on how closely associated people are with each other. At the top are partner relationships, intimate and close relationships between people who share a mutual bond and trust for each other. 

At the next level are family and close friends. Generally these are the people who we can turn to when things are hard.

Lastly, is the wider community. There are many people in this category, who may be only acquaintances but provide a sense of recognition and belonging – on the way to the shops, when out walking the dog or sharing a cultural experience. These people enrich our lives, even if the individual bonds are not close.

The challenge of creating connections

There are limitations to what is possible or appropriate for organisations and professionals to try to do in terms of creating connections. We can’t and wouldn’t want to force people into relationships and we can’t create families and friends for each other. And, as the experience of loneliness is subjective, the lack of these relationships is not a problem for everyone. However, we can work to improve the quality of people’s relationships through education, family support and counselling services, and understand how it supports the drive to prevent loneliness. Service providers can centre relationships in their practice. 

And we can find ways to put people ‘in the way’ of each other, in the knowledge that thin ties have a value in their own right, and some may develop over time into closer bonds.

Providing or supporting places and spaces where people gather, and activities that help them connect, provides fertile ground for the development of connection. We heard for instance of the value of the seafront in Hastings during the pandemic – the flat ground and availability of places to sit (and provision of public toilets) made it an attractive place for regular walks, enabling people to start to recognise and greet each other. For some this was their only social interaction in a day. 

Alleviating loneliness requires there to be the social infrastructure that enables people to connect with others in a way that works for them. 

Creating a more connected East Sussex

To create a more connected county, where the conditions are in place for residents to be better able to connect with each other, the different parts of the system need to be better connected. To explore what this might mean in practice we developed the model below, illustrating the different layers and roles within the system. It provides a starting point to help us understand the system as a whole.

As with any model, it’s a simplification. In reality not everything fits neatly into layers, the boundaries between layers are more blurred and there are some actors and activities that will work across multiple layers. The model can be seen as a lens through which to view the system and identify a way forward, rather than a definitive analysis.

We’re really proud that this work has influenced the DPH’s report so significantly and look forward to seeing the impact of the partnership’s move into system stewardship as it evolves.

“People who are more socially connected to family, to friends, to community, are happier, they’re physically healthier, and they live longer than people who are less well connected.

Professor Bob Waldinger, Head of Harvard University Study of Adult Development

If you work for a local authority and you’d like to explore this topic further then please join the Relational Councils Network session on October 10th when we’ll be discussing ‘Taking a stewardship approach to tackling loneliness’.