Feeling connected to other people is important for our health and wellbeing. Yet, as we age, it can be harder to stay socially connected to others. To facilitate social connections among people, the NHS, local authorities, and third-sector organisations allocate funding for social activity services. In this blog, PhD student Alice Wreford explores the value of social connection in the region.
Alice Wreford is a PhD student in ARC East of England’s Health Economics and Prioritisation research theme and she is a Senior Research Associate at the University of East Anglia.
Social connection refers to the quantity, quality and benefits of social relationships. It can support a range of emotions, such as bringing a sense of belonging, happiness, and security. It can also encourage people to make healthier choices by influencing behaviours such as exercising more or signposting people to health and care information or support. As a result, good social connection helps improve our physical and mental health and wellbeing.
If people do not have good social connections, they can become socially isolated and lonely. This puts people at greater risk of new-onset depression and an increased risk of anxiety. It is also associated with increased risks of dementia, coronary heart disease, and stroke, which all cause mortality. These risks are particularly relevant to older adults, as the typical events of ageing, such as retirement, mobility issues, and bereavement, put them at greater risk of poor social connections.
Activities such as joining clubs or organisations, interacting with neighbours, attending community events, or volunteering can help support good social connections. Therefore, providing community services or activities focused on improving social connection among older adults is of particular importance. The NHS, local authorities, and third-sector organisations recognise this and fund services to deliver social activities, including support groups for substance abuse, walking groups, and coffee mornings. However, with limited public sector resources and funding, decision-makers must ensure they are making the best decisions on how to use their budgets. It is challenging for them to efficiently choose between activities, as it is not well known what members of the public would prefer to take part in and which services will have the greatest impact on health and well-being. Thus, my PhD project builds on the evidence gap, understanding activity preferences to maximise participation.
Equitable delivery of social activity services
The design and implementation of services to deliver social activities can be particularly complex as social connection is experienced differently by different people. In addition to demographic differences such as age, cultural identity, neighbourhood, and marital status, non-cognitive factors like personality traits, including introversion/extroversion and locus of control, can influence an individual's likelihood of being socially connected. However, it remains unclear whether these diverse groups have distinct preferences for features of social activity services or engage with them in different ways. Consequently, it is uncertain whether the needs of the community are being addressed equitably across various demographic and personality groups.
The COVID-19 pandemic placed a spotlight on the importance of social connection in our lives, with lockdown restrictions changing the way we viewed, discussed, and experienced it. The government-imposed restrictions and movement to digital services meant that the pandemic worsened feelings of social isolation and loneliness amongst those already at risk of experiencing poor social connection, such as those without access to or ability to use digital technologies, those with certain health conditions, and those with limited social contacts. It was essential that we explore how we, as a society, can equitably support improvements in social connection.
"As we began to investigate, it became apparent that people find it easy to discuss positive social connections, highlighting the importance of the good relationships in their lives. However, sharing experiences of social isolation and loneliness can be much harder."
Alice Wreford, ARC East of England PhD Student
The emotional burden associated with discussions about loneliness and social isolation often prevents individuals from fully disclosing the severity of their social disconnection and its effects. This lack of openness complicates our understanding of the needs of those most vulnerable and their desire to feel a part of the community. Capturing these experiences was crucial for this study to enhance the existing evidence base. To effectively identify, access, and engage members of the public who are typically disengaged from social interactions, we collaborated extensively with public contributors and stakeholders. We employed asset-based approaches to engage with individuals who otherwise might not have had the opportunity, or confidence, to share their experience of social connection.
Understanding social activity service preferences
Individuals experience social connection in diverse ways, complicating the ability of decision-makers to accurately measure which services are having the biggest impact on the community. This presents challenges in prioritising services effectively. To address this issue, the study employed interviews to investigate the specific challenges faced by decision-makers. The findings revealed that, rather than focusing solely on evaluating the impact and economic value of these services, a more pressing concern is understanding public preferences regarding the design of social activity services.
"I feel we need to raise awareness for people like myself, who are not just ageing without children, but who are alone in communities and in society. We need to reach out to them."
Project Public Contributor
The East of England population has unique regional needs, which include increased rurality, coastal inequalities, an ageing population, scattered infrastructure, and limited transportation links. Due to this, we conducted structured discussion groups with four diverse demographics to identify and prioritise intervention features tailored for individuals over 50. The insights gained from these discussions informed a survey aimed at assessing the relative importance of various features of social activity services and examining how preferences may be influenced by factors like cultural identity, personality type, and digital skills. By understanding these preferences and their interrelations, we aim to guide the design of social activity services that resonate with the target population. This evidence-based approach will assist decision-makers in selecting services that are most likely to be embraced by the community, thereby enhancing user engagement and optimising the use of limited resources.
Discussions with the public highlighted many features of community services that contribute to positive social connection and support participation in the community. Despite the positively framed questions we used to guide our sessions, such as “What does it look or feel like to be socially connected to you?” and “What can be done or provided in your community to enhance social connections?” respondents consistently identified barriers that hindered their ability to connect socially. The main themes that emerged included: a dislike for online service provision and digital technology; limited access to transportation; safety concerns; challenges related to functional decline; the impact of rising living costs; and anxiety surrounding participation.
"It is essential for community service planning to address concerns (e.g., challenges related to functional decline, anxiety, and the impact of rising living costs) in order to prevent the social isolation and loneliness experienced by ageing adults."
Alice Wreford, ARC East of England PhD Student
An initial analysis of the survey results has revealed that individual disability is a significant factor associated with varying preferences for service delivery. The early findings of the survey align to the concerns identified in the discussions with the public, highlighting potential for meaningful improvement in the way we deliver, or support older adults to engage with, social activities in the community. More in-depth analysis of the survey results is underway.
Next steps
The data analysis for this study is near completion and study write-up is ongoing. We look forward to disseminating the findings of this study in the near future. To stay up to date, please see our webpage:
