We have counted loneliness. Now we need to change it.
Our new research examines loneliness and social capital in more than 135,000 adults. The challenge now is to turn those findings into better questions – and interventions worth investing in.
A loneliness score can tell us something important about someone’s life, but it cannot tell us what would make that life less lonely. That gap is where I believe the next chapter of loneliness research belongs. In our new paper in BMC Global and Public Health, we analysed data from 135,725 adults participating in the INTERACT study in England. We examined factors associated with loneliness using two established measures, alongside a separate analysis of social capital: people’s perceptions of neighbourhood trust, cohesion and reciprocity.
Among respondents, younger age, being single, unemployment and disability were consistently associated with greater loneliness. Larger friendship networks were associated with lower loneliness. Older, married and retired respondents more frequently reported high social capital, while people with disability or long-term conditions had lower adjusted odds of reporting it. These findings give us questions to pursue but they do not give us a ready-made intervention.
That distinction should shape everything we do next. The study used a volunteer sample and measured people’s circumstances at one point in time. It cannot establish what causes loneliness, estimate how common it is across England, or tell us which intervention would work. A large sample does not remove those limitations.
For me, this is the starting point for a more demanding research agenda: what would we actually change, for whom, and how would we know it helped? Consider the association between friendship networks and loneliness. It would be tempting to translate it into a simple instruction: help people make more friends. But an association cannot tell us whether expanding someone’s network will reduce their loneliness, whether loneliness makes relationships harder to sustain, or how other circumstances influence both. “More friends” is also an outcome to aspire to, rather than a sufficiently specified intervention. Who makes the introduction? Where does the first meeting happen? What helps someone return? What makes an encounter develop into a relationship that matters? Those are intervention-development questions. They deserve the same intellectual attention as the statistical models that bring them into view.
Imagine, as a design exercise, a community programme offering weekly group activities. Before commissioning it, I would want to ask what problem it is intended to address. A shortage of opportunities to meet people? Difficulty entering unfamiliar social settings? The loss of a close relationship? Practical barriers to leaving home?
Each answer points towards a different proposition to test. For someone who wants to attend but cannot reach the venue, transport support could be a candidate component. For someone apprehensive about arriving alone, a familiar person accompanying them might be worth testing. For someone seeking a close, dependable relationship, attendance at a large group may be the wrong primary outcome. These are hypotheses, not findings from our study… but their value lies in making the proposed route to benefit explicit – and therefore open to challenge!
Social capital adds another set of questions. Our paper examined it as a separate outcome; it did not establish that increasing neighbourhood trust reduces loneliness. Nevertheless, I would argue that intervention development should ask what happens beyond the individual referral. What kind of community is someone being invited into? Who feels welcome there? Can participants influence what happens? Are there opportunities to contribute as well as receive support? What resources would a local organisation need to sustain relationships beyond a short funding period?
I want self-care to sit within that discussion. Any call for people to strengthen their own social connections should be accompanied by serious questions about the opportunities and support available to them. “Take action” is an incomplete offer unless we also examine what makes action possible.
The next step should be a programme of co-designed, explicitly testable interventions. People experiencing loneliness should help define the problem, choose outcomes that matter and identify features that make participation acceptable. Their involvement should extend to interpreting why an approach succeeds, disappoints or reaches only some of its intended participants. Evaluation then needs to follow the whole journey.
Counting invitations, referrals and attendance can describe delivery. To establish benefit, we need to examine changes in loneliness and wellbeing, whether those changes last, and how outcomes compare with what would have happened without the intervention. Randomised evaluations should be used where feasible, with credible alternatives where they are not. We should also examine who never takes up the offer, who leaves, and whose circumstances make participation difficult. I would want a commissioner to see those findings alongside the average outcome and the cost. An intervention’s reach is part of its practical value.
Our study also offers a reason to think carefully about measurement. Educational attainment showed different associations depending on which loneliness measure we used. That finding cautions against treating different instruments as interchangeable. Future evaluations should specify what they seek to change and combine appropriate measures with accounts of participants’ experiences.
None of this requires abandoning observational research. It requires giving its findings a purposeful next step.
For the Prevention Lab, my challenge is to researchers, funders and commissioners alike: make room for the difficult work between identifying a pattern and delivering a useful intervention. Fund development, refinement and rigorous evaluation. Specify the benefit being sought. Be willing to adapt or stop an approach when the evidence disappoints.
I want the next paper to answer a harder question: what did we change, who benefited, and was the difference worth sustaining? The people behind our data deserve that next chapter – and a meaningful role in writing it. Through our ongoing qualitative research, we are exploring personal stories and journeys to understand what connection, belonging and support mean in everyday life. These accounts will inform the co-production of interventions grounded in people’s experiences, ready to be tested for the difference they make to their lives.