Social exclusion and isolation

Introduction

In simplest terms, social exclusion is when a person is prevented from participating in society by external means, and social isolation is when a person removes themselves from contact with society. People are isolated and excluded from society for different reasons and 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.

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.

Key inequalities and risk factors

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)

Social situation in those aged 65 and over

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)

Do care and support services help improve contact with people

Source: National Adult Social Care Information System

Supporting people to make connections

Think Local Act Personal, states that “support should enable people to retain or regain the benefits of community membership, including living in their own homes, maintaining or gaining employment and making a positive contribution to the communities they live in.”  

"Community capacity" describes the things people in local communities are able to do to help and support each other and building community capacity describes the process of helping a community to support itself. Research suggests that wellbeing and resilience improves and deteriorating ill health lessens when a community has strong 'social capital' (connections between people) or 'assets' (the enabling factors that help them to be connected). 

Community development is action that helps people to recognise and develop their ability and potential and organise themselves to respond to problems and needs which they share.

The LGA report “A Glass Half-Full” sets out the value and principles of the asset based approach which directly challenges traditional deficit models of service delivery.  The asset approach:

  • identifies and makes visible the health-enhancing assets in a community
  • sees citizens and communities as the co-producers of health and well-being, rather than the recipients of services
  • promotes community networks, relationships and friendships that can provide caring, mutual help and empowerment
  • values what works well in an area
  • identifies what has the potential to improve health and well-being
  • supports individuals’ health and well-being through self esteem, coping strategies, resilience skills, relationships, friendships, knowledge and personal resources
  • empowers communities to control their futures and create tangible resources such as services,  funds and buildings.

The council is working on a community development programme to overcome barriers which cause social exclusion and support individuals to overcome social isolation. It is based on the premise that people want fulfilling lives and need interesting, meaningful and fulfilling things to engage in, preferably near to where they live. A new tool will map local groups, clubs, societies, events and activities within “natural” neighbourhoods. The tool differs from traditional directories of services and support which are designed specifically around people's disabilities, conditions, illnesses or circumstances and will link them to meaningful and purposeful things to do that interest them regardless of disabilities, conditions, illnesses or circumstances or other perceived limitations.

Keeping people safe and well

Avoiding permanent placements in residential and nursing care homes is a good measure of delaying dependency.  The council has looked at the wider support enviroment and has invested in extra care housing, an independence at home service, supports a range of voluntary and community sector organisatiions to support people directly in their homes either practically or with emotional and social support, but also indirectly, through resilience building programmes including a conversation models of care focussing on early intervention and social capital development progammes that help people to connect to community to reduce social isolation and build local support networks.

Planning for a connected 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.

Sense of place

In the widest sense, a “sense of place” is a desirable planning outcome because it sets out those things that people recognise as being distinctive to that place. The implication is that this ‘specialness’ is also desirable.

Creating a sense of place can facilitate a range of planning-related outcomes, such as a positive emotional attachment to a neighbourhood and community. This can translate into better participation in community life, including planning consultation and engagement. A partnership of agencies in Scotland has published the Place Standard (also see the LGiU Scotland briefing on the standard), which is a simple question and answer tool to help evaluate the quality of a place. This includes a question on identity and belonging; housing organisations need to demonstrate that they are using the standard to engage local people as a criteria for receiving government funding.  Making sense of a ‘sense of place’: a planning perspective (LGiU, 2017) is a briefing on calls for change within the planning system to focus more on a sense of place, with the aim of achieving development that is more accepted by local communities going beyond economic vitality to wider wellbeing outcomes.

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.

In 2015, the Older People's Partnership concluded a year long research project into the digital inclusion with nearly 300 older people aged 50+ across the borough. Whilst the oldest residents aged 80+ were "offline and not interested in getting online", 65% of older people aged 50-79 were either actively online or interested in getting online with the right support.

Want to know more?

A Glass Half-Full (LGA, 2010) - proposes assessing and building on the strengths and resources in a community to increase resilience and social capital, and develop better ways of delivering health outcomes.

Preventing loneliness and social isolation: interventions and outcomes (Social Care Institute for Excellence, 2010) - A report into the continuum of possible support ranging from the most intensive 'tertiary services’ such as intermediate care or reablement, down to 'secondary’ or early intervention, and finally, 'primary prevention’ aimed at promoting wellbeing - all of which have a significant impact on social isolation and exclusion.

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

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