Medical Matters: Loneliness of the long-distance neighbour

Loneliness can be a health risk on par with smoking and not getting enough exercise

Mon, Apr 14, 2014, 18:00

Living and working in a rural area you become very aware that the issue of loneliness is never far from the surface. And as Garda stations close, pubs reduce their opening hours and bank branches are shut down, the potential for loneliness, especially for older people, increases.

The Government’s contribution to this new reality was strongly criticised at the annual meeting of Active Retirement Ireland (ARI) in Galway last week.

“We are worried that [the Government] will just allow these rural communities to die, which will disproportionately affect older people as they are the ones left behind in the wake of mass emigration,” ARI president Mai Quaid said.

It’s a reasonable concern. A year ago I wrote of the void left in our community by the sudden death of our post mistress Mary. Thankfully, the local post office did not close as we had feared and so this lifeline at least has been preserved.

Mary was the eyes and ears of our community. So much of the informal care she gave was unplanned. No one paid her to do it.

No one organised it. But by enabling the chronically ill and older people to survive in our community, her sons now ensure this truly preventive care survives.

Research has shown how the distribution of work by unqualified people providing unpaid care to their relatives or friends is almost exactly matched to need. In other words, a “positive care law” exists in the community, one that is created and sustained by human forces – family, neighbours, community ties that have somehow resisted the socially divisive and dehumanising force of the market.

Human capital
But the human capital needed to continue this vital care is threatened by two inexorable forces: the emigration of an entire generation seeking employment; and the steady rise in the percentage of the population who are aged over 65.

Loneliness, of itself, is a risk to health. But it also influences people’s health behaviours such as smoking, drinking and poor diet.

There is evidence that loneliness makes it harder to give up excessive drinking. Being single or widowed decreases the daily variety of fruit and vegetables eaten (compared with people who live with a spouse or partner). Older adults who live alone and have infrequent contact with friends eat fewer vegetables each day.

Research has also shown that adults who are lonely are more likely to smoke and to be overweight. And lonely adults are less likely to engage in exercise and physical activity.

A poll of GPs in Britain last year suggests family doctors underestimate the health risks of loneliness. Some 36 per cent of doctors questioned didn’t think loneliness made a significant contribution to early death.

A recent paper from the Irish centre for social gerontology at NUI Galway found that older people in rural areas are more likely to become isolated and suffer from ill-health as a result.

Spatial distribution
With some 42 per cent of those aged 65 and older living in rural Ireland, the researchers make the interesting point that the spatial distribution of Ireland’s older population has more similarities with economically less-developed countries in Asia and Africa than with developed countries in Europe or North America.

The authors point out that while location is significantly associated with social participation, the interaction between health and location is not, suggesting that rurality does not exacerbate the link between poor health and social participation.

“However, the interaction between health and location does have a significant negative effect on social resources,” they note, adding that poor health has a greater negative impact on levels of social resources in rural areas compared with urban areas.

The evidence suggests that when we are feeling lonely, we are much less likely to look after ourselves.

This Easter, if you can help older neighbours maintain their social connections or make new ones, you will undoubtedly help prevent them developing medical problems in the future.

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