Social exclusion and isolation
Social exclusion is when a person lacks access to resources (social, public economic), inability to participate (economic, social, education, political) and exclusion from a good quality of life. Social isolation is a lack of contact with society.
Social exclusion and isolation are associated with a higher risk of death and poor health; this is regardless of whether a person feels ‘lonely’. An extensive review in 2010 found a 50% increased likelihood for survival in those with strong social networks independent of sex, age, initial condition and cause of death.
Social Isolation is not exclusive to a particular population, but risk factors include older age, those suffering mental illness, physical disability and carers. The problem is likely to increase as the Bracknell Forest population is expected to have increasing numbers of people with one or more risk factors for isolation.
Facts, figures and trends
The national Adult Social Care User Experience survey was sent to a proportion of Bracknell Forest’s Service Users in 2013. One of the questions in the survey asked people whether they had as much social contact as they wanted. Figure 1 shows the response rate for those aged 65 and over, and suggests that older people in Bracknell Forest feel more isolated than the national average. Despite this, a much larger percentage of people believe that care and support services improve social contact when compared to the national average (Figure 2).
Figure 1: Response to Adult Social Care User Experience Survey about social contact (2013)
Source: National Adult Social Care Information System
Figure 2: Response to Adult Social Care User Experience Survey question – “Do care and support services help to improve your contact with people?” (2013)
Source: National Adult Social Care Information System
Planning for a social environment
The way we design our environment can have a major impact not just on environmental outcomes, but also how accessible it is for local communities can have an impact on quality of life and ease of social connectedness. This factor in health and wellbeing is to be considered in the area’s Local Plan.
Green infrastructure, for example, is a network of multifunctional green space, urban and rural, which is capable of delivering a wide range of environmental and quality of life benefits for local communities.
Green infrastructure is not simply an alternative description for conventional open space. As a network it includes parks, open spaces, playing fields, woodlands, but also street trees, allotments and private gardens. It can also include streams, canals and other water bodies and features such as green roofs and walls, some of which have already been incorporated into the redevelopment of Bracknell Town Centre.
Reducing the digital divide
Academic research funded by the RCUK Digital Economy programme (2013) found that information communication technologies (ICT) and in particular broadband can benefit areas and people experiencing economic and social disadvantage by connecting people and places, businesses and services.
Broadband and superfast broadband is now considered to be essential to the economy and should be treated as a necessary infrastructure for new and existing communities. It may also increase access to remote educational and employment opportunities and from a wellbeing perspective, education and employment are both important determinants of health.
As the “internet of things” progresses, interconnection via the Internet of computing devices embedded in everyday objects, enabling them to send and receive data will become common place, e.g. delivering live and instantaneous remote patient monitoring and health related information and education for patients and professionals and vulnerable residents will be digitally connected and monitored by health and social care professionals through internet enabled assistive technologies. It can help to reduce social isolation and loneliness in communities, supporting improved mental health and wellbeing.
National & local strategies (current best practices)
The following links give an overview of the topic:
Preventing loneliness and social isolation: interventions and outcomes – Social Care Institute for Excellence.
Isolation and loneliness toolkit - Campaign to end loneliness.
Health and Wellbeing: Planning Guidance (DCLG, 2014) - Local planning authorities should ensure that health and wellbeing, and health infrastructure are considered in local and neighbourhood plans and in planning decision making. Public health organisations, health service organisations, commissioners and providers, and local communities should use this guidance to help them work effectively with local planning authorities in order to promote healthy communities and support appropriate health infrastructure.
Local Action on Health Inequalities: Improving access to green spaces (Public Health England, 2014) - a summary of evidence about the positive impact of access to green spaces on self-rated health, wellbeing, obesity and overweight levels, reduced social isolation and independence
What is this telling us?
People are isolated and excluded from society for different reasons. Poor health can be both the outcome and cause of isolation and exclusion. Those people who are most at risk are predicted to increase and therefore we can expect isolation to increase.
What are the key inequalities?
Certain groups of people are at far higher risk than others. This includes older people, those suffering mental illness, physical disability and carers.
What are the unmet needs/ service gaps?
Early interventions are required to stop people falling into isolation, which should aim to compliment reactive services such as befriending schemes.
Recommendations for consideration by other key organisations
The collection of more robust data on the topic is encouraged.
Exploring the potential of ways to indentify and work with those at risk of isolation would be useful. To work in partnership with local voluntary/community organisation and services (such as the fire services home safety fire checks) to achieve better social outcomes for risk populations.
Reducing loneliness, isolation and exclusion will not only have physical health benefits but will also improve the quality of many people’s lives and therefore likely to reduce the mental health disease burden.
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