Michael Marmot is one of the world‘s leading experts on the so-called health determinants, that is the set of factors (social, economic, cultural, environmental and so on) that positively or negatively impact the health of the individual and the community. Among these, precisely, loneliness and social isolation.
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Professor, you write that “the quality and quantity of social relationships have an impact on lifestyle, physical and mental health and the risk of mortality”. What are you referring to?
“Human beings have two basic needs: first, free will and control over one’s life; second, human relationships and the support of others. There are very specific evolutionary reasons: without social relationships one is more vulnerable. over time, when for example humans hunted together, people needed to support each other, for reasons of protection from predators, sharing resources, accessing more substantial food sources. In this sense, at that time having social relationships was literally a matter of life or death. Today things have changed in form, but not in substance: our need for social relationships is still very strong. And above all it has practical reasons: if our partner gets sick, just to give an example, it is essential to have someone to help us with our children while we take care of our partner. Then, of course, there are also social needs i and emotional. All the evidence we have gathered shows that when we are alone our health suffers. ”
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How? Are there people more vulnerable than others?
“Physically, psychologically and in terms of mortality. The correlation between loneliness and the worst state of health is a general correlation, which applies to everyone, with some differences that we are trying to understand. We know well, for example, that mortality is higher in socially isolated men than in married men. Why? The first explanation is linked to lifestyle: lonely men, on average, consume more alcohol and eat worse than those in a relationship. In single or divorced women, on the other hand, we do not observe the same phenomenon: why? To understand it we studied the differences between the countries of Eastern Europe and those of Western Europe, in particular before and after the fall of the Berlin Wall, asking ourselves why the European Communist nations had health worse and higher mortality than the others and why this element was particularly evident in single men compared to single women. And what we observed is that when an Eastern European man who did not have a partner was really isolated, because it was the woman who tended to cultivate the “informal network” of human contacts: if it was necessary to have the roof fixed, or to buy a new refrigerator, or to repair the car, it was the woman who took care of it. So, if a man in that environment lost his female partner, with her he also lost all connection with the world and with other human beings. And he got sick more, and died before the others. Conversely, if a woman lost her male partner, she simply had one less problem to solve. She kept having to take care of the family, the house, the children, and she didn’t have another human being to look after. Therefore, it is probably true that women tend to have stronger social relationships even outside of marriage. ”
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Is poverty linked to loneliness?
“Absolutely yes. In addition to gender, the determining factor is income. A few years ago, in the English Longitudinal Study of Aging, we observed that all indicators relating to loneliness were related to wealth: in general, the poorer one is, the more you are alone. When you are poor the problems are above all practical: if you do not have the money to pay for heating or rent, it is difficult for you to think about inviting your friends home. If you live in a country where hospitality it is culturally important, and you do not have the resources to be hospitable, you feel unsuitable, you feel ashamed, and you tend to isolate yourself more and more. Then there is the psychological question: living in poverty consumes time and mental energy. thinking about where to raise the money for survival takes away energy, time and desire to be with others. And, again, it leads to isolation “.
What are the indicators you are talking about? In other words, how is loneliness measured?
“At least on two levels. The first is the individual one, which is measured by asking people, for example, how often they meet their relatives, or their friends, or their colleagues. But this indicator must be inserted in the social context: in Italy, for For example, we tend to meet friends and acquaintances much more frequently than in the United Kingdom. Therefore, the frequency of the meetings must be evaluated with respect to the average of the environment in which we live. There is also a second level, that of community, linked to the so-called “social capital”, or rather the “quality” of one’s relationships. Which is actually more difficult to measure: to do this, in our studies we ask questions such as “do you trust who lives in your neighborhood?”, or “if your child was in danger do you think your neighbors would help him? “. The answers help us assess the quality of social relationships at the community level, the so-called” spectator effect. “In this sense, the evidence is quite encouraging. ti: as Dutch historian Rutger Bregman pointed out in his book A new (non-cynical) history of humanity (2019), research suggests that humans tend to be more “good” than one might think, meaning that on average there are more examples of help and support, even towards strangers, than indifference. Living in a community where you can weld social connections even with strangers, where you help each other, can really change things “.
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How should one intervene to combat loneliness?
“We cannot simply say” love one another “. We must create the conditions for this to happen. At the community level we must act not only by reducing poverty, but also through social and urban interventions. Administrators should ask themselves, to For example, if there are enough places in the cities they govern where people can meet and be together, and if those places are safe enough. If you are afraid to go out, for example, because you live in a very violent or run-down neighborhood – and this, again, happens to the most socially and economically disadvantaged people – they will fall more easily into social isolation. The same goes for welfare and services: good kindergartens, efficient schools, pre- and after-school activities can make a difference. with regard to the youngest, there is the even broader question of the future. Youth unemployment and illiteracy are highly correlated with social isolation. being isolated, in addition to not having someone physically close, is to perceive a lack of possibility and trust in one’s future. Not feeling part of society, having no hope. Give people an expectation for the future, an involvement in society, and loneliness will also be reduced. Isolation has two sides, one individual and one social, which go hand in hand. To solve the problem you have to face both of them “.