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Social Isolation and Loneliness in Berkshire Slough Report

November 2019

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Contents 1.0 Introduction ................................................................................................................................................... 4

1.1 Definitions of social isolation and loneliness ............................................................................................ 4

1.2 Why are social isolation and loneliness important?.................................................................................. 4

1.3 What causes social isolation and loneliness? ............................................................................................ 4

1.4 How are social isolation and loneliness measured? .................................................................................. 5

2.0 National policy context .................................................................................................................................. 6

2.1 Local Action on Health Inequalities – Reducing Social Isolation Across the Life course ........................... 6

2.2 Combatting Loneliness – A Guide for Local Authorities, 2016 .................................................................. 7

2.3 The Jo Cox Commission on Loneliness ...................................................................................................... 8

2.4 A Connected Society – A Strategy for Tackling Loneliness, 2018 .............................................................. 8

2.5 Tackling loneliness and social isolation: the role of commissioners, Social Care Institute for Excellence, 2018 ................................................................................................................................................................. 8

3.0 Prevalence of social isolation and loneliness ................................................................................................ 9

3.1 Global prevalence of social isolation and loneliness ................................................................................. 9

3.2 Social isolation and loneliness in England ................................................................................................. 9

3.3 Social isolation and loneliness in Berkshire ............................................................................................... 9

4.0 Identifying residents in Slough more likely to be at risk of social isolation or loneliness ........................... 10

4.1 Social isolation and loneliness in children and young people ................................................................. 10

4.1.1 Findings from the Community Life Survey 2016 to 2017 and Good Childhood Index Survey 2018. 10

4.2 Social isolation and loneliness in adults aged 16+ .................................................................................. 11

4.2.1 Findings from the 2016-2017 Community Life Survey ..................................................................... 11

4.2.2 Analysis of Local Authority level data in relation to findings from the 2016-17 Community Life Survey ........................................................................................................................................................ 13

4.2.3 Summary of findings from the Berkshire Data Observatory ............................................................ 26

4.2.4 Analysis of social isolation and loneliness in adults aged 16+ using CACI’s Wellbeing ACORN profiles ....................................................................................................................................................... 27

4.3 Loneliness in older adults aged over 65 – Age UK ................................................................................... 31

4.3.1 Age UK methodology ........................................................................................................................ 31

4.3.2 Age UK findings ................................................................................................................................. 31

5.0 Interventions to address social isolation and loneliness ............................................................................. 33

5.1 Findings from the research ...................................................................................................................... 33

5.2 Novel interventions addressing social isolation and loneliness in the UK .............................................. 35

5.2.1 Rotherham Social Prescribing Scheme ............................................................................................. 35

5.2.2 Age UK Exeter’s Men in Sheds .......................................................................................................... 35

5.2.3 Intergenerational care ...................................................................................................................... 35

5.2.4 First contact schemes ....................................................................................................................... 36

6.0 Examples of work to address social isolation and loneliness in Berkshire .................................................. 36

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6.1 The Bracknell Forest ‘Warm Welcome’ Programme ............................................................................... 36

6.2 University of Reading report on tackling loneliness and social isolation in Reading (August 2019) ....... 37

8.0 Suggested next steps ................................................................................................................................... 37

9.0 References ................................................................................................................................................... 38

10.0 Appendices ................................................................................................................................................ 41

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1.0 Introduction

1.1 Definitions of social isolation and loneliness

Social isolation and loneliness are different but related concepts. Social isolation is broadly defined as, “an objective measure of the number of contacts people have. It is about the quantity of relationships.” (1) Loneliness is broadly defined as: “a subjective, unwelcome feeling of lack or loss of companionship. It happens when there is a mismatch between the quantity and quality of social relationships a person has and those that they want.” (1) Social isolation and loneliness are not synonymous. People can be isolated but not feel lonely and people can feel lonely despite having social interactions with other people. Social isolation can lead to loneliness and loneliness can lead to social isolation. In practice, since the two concepts are related, they are often considered together (2).

1.2 Why are social isolation and loneliness important? Social isolation and loneliness are increasingly understood to be serious conditions which can adversely affect an individual’s mental and physical health (3). The Government’s 2018 strategy for tackling loneliness (4) summarised the risks of loneliness in the following way: “Feeling lonely frequently is linked to early deaths. Its health impact is thought to be on a par with other public health priorities like obesity or smoking. Research shows that loneliness is associated with a greater risk of inactivity, smoking and risk-taking behaviour; increased risk of coronary heart disease and stroke; an increased risk of depression, low self-esteem, reported sleep problems and increased stress response; and with cognitive decline and an increased risk of Alzheimer’s” (4)

According to research by IoT UK (5) the specific impacts of social isolation and loneliness include:

• More frequent use of public services due to a lack of support networks. Individuals who are socially isolated are: - 1.8 times more likely to visit their GP. - 1.6 times more likely to visit A&E. - 1.3 times more likely to have emergency admissions to hospital. - 3.5 times more likely to enter Local Authority funded residential care.

• Increased likelihood of developing certain health conditions. Individuals who are socially isolated or lonely are: - 3.4 times more likely to suffer depression. - 1.9 times more likely to develop dementia in the following 15 years. - 2 to 3 times more likely to be physically inactive which in turn is associated with higher risk of

diabetes and cardiovascular disease.

• Increased mortality: Loneliness has been found to increase the likelihood of mortality by 26%. The Marmot Review highlighted that “Individuals who are socially isolated are between two and five times more likely than those who have strong social ties to die prematurely.”

1.3 What causes social isolation and loneliness? Research investigating factors associated with being lonely have largely focused on elderly populations. Such studies have found a wide range of associations, including with social networks (living alone, being single,

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widowed or divorced, contact with friends and family, social participation); health (unmet social care needs, poor health, mobility limitations, cognitive impairment); individual characteristics (age, ethnicity, sexual orientation, low income, retirement); and neighbourhood characteristics (structures of environment, provision of local amenities, territorial boundaries, neighbourliness and deprivation) (1). Despite the focus on the elderly, recent research shows that loneliness extends across different populations and age groups in society. Data in Britain and the USA found that people who are deprived, unemployed, have a physical or mental disability or are from migrant populations are those most at risk of social isolation and loneliness and also those who struggle to access adequate support (6)

1.4 How are social isolation and loneliness measured? Until recently there has not been a consistent way of measuring social isolation and loneliness. Existing tools include the de Jong-Gierveld Loneliness Scale, the UCLA loneliness scale and the Social Isolation Index, used in The English Longitudinal Study of Ageing (ELSA) (3). National level surveys in the UK that yield data on loneliness and social isolation include the Life Opportunities Survey (LOS), Lifestyle and Opinion Survey, and Understanding Society – the UK Household Longitudinal Survey (3). In December 2017 the UK Government asked the Office for National Statistics (ONS) to develop a national measure of loneliness. The ONS undertook a programme of scoping work and consultation with experts on existing approaches to loneliness measurement. The ONS recommended four questions to capture different aspects of loneliness. The first three questions are from the University of California, Los Angeles (UCLA) three-item loneliness scale. The wording of the UCLA questions and response options are taken from the ELSA. The last is a direct question about how often the respondent feels lonely, currently used in the Community Life Survey. Table 1 shows the recommended measures for adults aged 16 years and above(3). Table 1: Recommended measure of loneliness in adults (Office for National Statistics)(3)

This measure of adult loneliness is due to be included within the Public Health Outcomes Framework November 2019 according to the Government response to the consultation on the Public Health Outcomes Framework 2019 to 2022 (6). It is expected that data will be collected via a national survey and accessible through the Public Health England Fingertips portal (7).

Measures Items Response categories

The three-item UCLA Loneliness scale

1. How often do you feel that you lack companionship?

Hardly ever or never, Some of the time, Often

2. How often do you feel left out?

Hardly ever or never, Some of the time, Often

3. How often do you feel isolated from others?

Hardly ever or never, Some of the time, Often

The direct measure of loneliness

How often do you feel lonely? Often/always, Some of the time, Occasionally, Hardly ever, Never

Source: Office for National Statistics

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An adapted version of the measures is recommended for use with children and young people aged 10 to 15 years(2). It is not yet clear whether loneliness measures published in the Public Health Outcomes Framework will include survey data for children and young people.

Table 2: Recommended measures of loneliness for children

2.0 National policy context In recent years the issues of loneliness and social isolation have received increased attention from health and social care, the voluntary sector, community-based organisations and local authorities. Several organisations and government departments have sought to shape the direction of policies to address and prevent social isolation and loneliness. Key publications are summarised here.

2.1 Local Action on Health Inequalities – Reducing Social Isolation Across the Life course

In 2015 Public Health England published a report aimed at informing action at the local level to tackle social isolation(8). The report highlighted that social isolation is closely related to health inequalities. Key points included:

• Certain groups of individuals are more vulnerable to loneliness and social isolation, depending on factors such as physical and mental health, migrant status, level of education, employment status, wealth, income, ethnicity, gender and age or life stage. As such, social isolation and loneliness are health inequality issues because many of the associated risk factors are more prevalent among socially disadvantaged groups than the general population.

• Social disadvantage is linked to many of the life experiences that increase risk of social isolation, including poor maternal health, teenage pregnancy, unemployment, and illness in later life.

• Characteristics of the built environment and transport also impact on social isolation and may do so at all stages of the life course. Deprived areas often lack adequate provision of good quality green and public spaces and adequate transport, creating barriers to social engagement.

Measures Items Response categories

The three item UCLA Loneliness scale for children

1. How often do you feel that you have no one to talk to?

Hardly ever or never, Some of the time, Often

2. How often do you feel left out?

Hardly ever or never, Some of the time, Often

3. How often do you feel alone?

Hardly ever or never, Some of the time, Often

The direct measure of loneliness

How often do you feel lonely? Often/always, Some of the time, Occasionally, Hardly ever, Never

Source: Office for National Statistics

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• Influences on social isolation accumulate throughout life. For example, social withdrawal in childhood is a risk factor for impairment of adolescent interpersonal interactions, which increases risk of depressive symptoms and diagnoses of depression in young adulthood. Depression in turn increases the risk of social isolation.

• Current circumstances also play a role. Events including the loss of a loved one, health conditions that precipitate disability and caring responsibilities may contribute to a reduction in social contact. The extent to which these events contribute to social isolation or loneliness depends on individual factors, such as the extent and quality of an individual’s previous social connections.

Figure 1: The impact of loneliness and social isolation across the life course.

Source: Public Health England(8)

2.2 Combatting Loneliness – A Guide for Local Authorities, 2016

This guidance for local authorities was produced jointly by the Local Government Association, Age UK and the Campaign to End Loneliness, setting out a range of evidence-based interventions for addressing loneliness (9). Suggested actions for local authorities included:

• Consider ‘addressing loneliness’ as an outcome measure of council strategies– including the Joint Strategic Needs Assessment (JSNA) and the Joint Health and Wellbeing Strategy (JHWS).

• Work at the neighbourhood level, to understand and build on existing community capacity and assets.

• Recognise and respond to individual needs and circumstances by both making sure general services are geared up to meet the needs of those who are lonely, as well as providing specific interventions as required.

• Pooling resources and intelligence across organisations and developing new partnerships may increase the benefits for those who are hard to reach or isolated.

• Conduct a local needs assessment or intelligence report.

• Use the loneliness framework from ‘Promising Approaches to Reducing Loneliness and Isolation’1 guide produced by the Campaign to End Loneliness and Age UK.

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• Use the Joseph Rowntree Foundation (JRF) Loneliness Resource Pack to inform action.

2.3 The Jo Cox Commission on Loneliness

In 2017 the Jo Cox Commission started a national conversation on loneliness, working with 13 charities including Age UK and Action for Children to establish ideas for change. The Commission published its final report in December 2017, calling for action from the Government in three areas(10).

1) A UK wide strategy for loneliness across all ages. 2) A national indicator on loneliness across all ages. 3) A fund to help scale-up and spread promising approaches to tackling loneliness. In January 2018 the first government Minister for Loneliness was appointed, responsible for leading on these recommendations.

2.4 A Connected Society – A Strategy for Tackling Loneliness, 2018

The government published its loneliness strategy in October 2018 (11). This set out the vision for the UK to be a country where everyone can have strong social relationships, where families, friends and communities support each other, especially at vulnerable points where people are at greater risk of loneliness. The government’s work on loneliness has three overarching goals:

1) To play a part in improving the evidence base so we better understand what causes loneliness, its impacts and what works to tackle it.

2) To embed loneliness as a consideration across government policy and how government can ensure social relationships are considered across wider policy-making.

3) To build a national conversation on loneliness, to raise awareness of its impacts and to help tackle stigma.

2.5 Tackling loneliness and social isolation: the role of commissioners, Social Care Institute for Excellence, 2018 This looked at work undertaken by the Social Care Institute for Excellence together with commissioners, local authorities and third sector representatives to explore the opportunities and barriers faced by commissioners in seeking to address social isolation in older people (12). The report highlighted commonly identified enablers to help commissioners overcome barriers and support different approaches to addressing social isolation and loneliness (12). Enablers included:

• Political and leadership support – where there is commitment from the top and existing structures such as Health and Wellbeing Board to support joint approaches across local authorities, the NHS and other parts of the public sector.

• Honest dialogue – co-producing services and solutions with residents to ensure that a range of interventions are in place that meet people’s needs.

• Using Better Care Funding and other financial levers to prioritise preventative approaches to loneliness and social isolation.

• Being pragmatic – accepting that some new initiatives need longer-term funding to give them time to embed.

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3.0 Prevalence of social isolation and loneliness

3.1 Global prevalence of social isolation and loneliness According to research carried out across EU member states in 2006, an average of 7.2% of the adult population reported social isolation, stating that they never meet up with friends or family. The highest levels of social isolation were found in Italy and Luxembourg, at 13%. Additionally, 13.4% EU households were composed of a single person aged 65 or over. In a study of loneliness in later life, loneliness was found to be highest in Eastern European countries, with rates of ‘quite severe’ loneliness found of 30-55%. In Western and Northern Europe, better living conditions and welfare provisions meant that rates of ‘quite severe’ loneliness were lower, at between 10-20% (13). An international survey by the Kaiser Family Foundation (KFF) found that loneliness is widespread globally, with 23% adults in the UK, 22% in the US and 9% in Japan “often or always” feeling socially isolated (13). Across Europe more countries are broadening their understanding of loneliness through research and campaigns, particularly the UK, Germany, Switzerland and Denmark (13).

3.2 Social isolation and loneliness in England The Community Life Survey 2017-18 (14) found that:

• 6% of adults aged 16+ in England to report often/always feeling lonely. 23% adults reported “never” feeling lonely.

• Loneliness does not just affect older people. 8% of 16-34 years olds reported “often/always” feeling lonely compared to 5% of 50-64 year olds and 3% of over 65 year olds. However, 16-34 year olds were less likely to say they “never” felt lonely compared to all other age groups.

• Children and young people also experience loneliness. The Community Life Survey 2016-17 and the Good Childhood Index Survey 2018 found 11.3% of children aged 10-15 said they were often lonely(13). Children and young people receiving free school meals, living in cities, and those reporting low satisfaction with their health and relationships were significantly more likely to say they were “often” lonely.

3.3 Social isolation and loneliness in Berkshire

• Based on the national figures of 6% of adults and 11.3% of children and young people being lonely, it is estimated that 42,694 adults aged 16+ and 6,738 children and young people* within Berkshire are often lonely (based on mid-year 2017 population estimates of 711,574 adults and 59,632 children and young people).

• At the 2011 census, 30% of Berkshire residents aged 65 years and older were living alone; about the same as the national average. Across all age groups 10% of Berkshire households were inhabited by one person; slightly lower than the national average of 12%.

• In Berkshire Local Authorities in 2017-18, between 41.4% and 49.7% (mean = 44.9%) of users of adult social care services in reported that they had as much social contact as they would like, against a national average of 46%. In 2016-17 between 22.7% and 44.1% (mean = 36.3%) of adult carers across Berkshire Local Authorities reported that they have as much social contact as they would like, against a national average of 35.5%.

*based on mid year population estimate of children and young people aged 10-15 not available therefore based on population estimate for children aged 10-14 years.

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4.0 Identifying residents in Slough more likely to be at risk of social isolation or loneliness This review aimed to identify characteristics of residents across Berkshire Local Authorities who are at higher risk of experiencing social isolation and/or loneliness. Until data using the ONS measure of loneliness becomes available through the Public Health Outcomes Framework, the data available at Local Authority-level in England remains piecemeal. This report has therefore looked at other sources of evidence to inform the current picture for Slough. The data sources and key findings have been described here.

4.1 Social isolation and loneliness in children and young people 4.1.1 Findings from the Community Life Survey 2016 to 2017 and Good Childhood Index Survey 2018.

The ONS have undertaken analyses focusing specifically on of children’s and young people’s views, experiences and suggestions to overcome loneliness, using in-depth interviews, the Community Life Survey 2016 to 2017 and the Good Childhood Index Survey 2018 (15). This is the first ONS report on loneliness in children and young people; part of the work to support the government loneliness strategy. The results are based on national data with insufficient sample size to provide a Local Authority-level breakdown specific to Slough. The key findings are: Children (aged 10 to 15 years)

• 11.3% of children said that they were “often” lonely; this was more common among younger children aged 10 to 12 years (14.0%) than among those aged 13 to 15 years (8.6%).

• 27.5% of children who received free school meals said they were “often” lonely, compared with 5.5% of those who did not.

• 19.5% of children living in a city reported “often” feeling lonely, compared with just over 5% of those living in either towns or rural areas.

• Children who reported “low” satisfaction with their health said they “often” felt lonely (28.3%), compared with those who had “medium, high or very high” satisfaction (about 10%).

• Children who reported “low” satisfaction with their relationships with family and friends were also more likely to say they were “often” lonely (34.8% and 41.1%, respectively).

Young people (aged 16 to 24 years)

• 9.8% of young people said that they were “often” lonely.

• Nearly half of young men reported that they “hardly ever or never” felt lonely, compared with 32.4% of young women.

• Those reporting no long-term illness or disability were much more likely to say they “hardly ever or never” felt lonely (44.8%) than those with a long-term illness or disability (19.3%).

• Young people living in a household with other adults were more likely to say that they “hardly ever or never” felt lonely than those living in single-adult households (over 40% compared with 18.2%, respectively).

Qualitative findings

• A range of predictable transitions linked to schooling and the move on from secondary education can trigger loneliness in children and young people.

• Children and young people described embarrassment about admitting to loneliness, seeing it as a possible “failing.”

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• Practical, social and emotional or mental barriers to participating fully in social life and activities can also contribute to loneliness.

• The intersection of multiple issues and triggers to loneliness, or more extreme and enduring life events such as bereavement, disability, being bullied or mental health challenges, may make it more difficult for children and young people to move out of loneliness without help.

• Their suggestions for tackling loneliness included: making it more acceptable to discuss loneliness at school and in society; preparing young people better to understand and address loneliness in themselves and others; creating opportunities for social connection; and encouraging positive uses of social media.

Children’s and young people’s suggestions for tackling loneliness Create a culture of openness about loneliness

• Talk about loneliness more openly as we do with mental health.

• Include loneliness on the school curriculum.

• Encourage young people to talk to someone about it or ask for help.

• Discuss it in schools and universities and make support available. Create opportunities to make social connections

• Organised activities and clubs.

• Community activities.

• Volunteering.

• Inter-generational initiatives. Encourage positive uses of social media to alleviate loneliness

• To meet new people or ease transitions.

• Find others with common interests. Prepare young people to understand loneliness and equip them to deal with it

• Prepare young people for life transitions and what to expect.

• Provide support to young people in developing connections, especially at important transition points.

• Share and try out good ideas for encouraging inclusiveness at schools in friendship groups, on the playground, in the selection of teams.4.2 Analysis of loneliness and social isolation in adults aged 16+ using the 2016-17 Community Life Survey (ONS)

4.2 Social isolation and loneliness in adults aged 16+

4.2.1 Findings from the 2016-2017 Community Life Survey

In April 2018 the Office for National Statistics (ONS) published analysis of the characteristics and circumstances associated with loneliness in England using the Community Life Survey, 2016 to 2018, in a report titled Loneliness – What characteristics and circumstances are associated with feeling lonely? (15)

The Community Life Survey asked people living in England: “How often do you feel lonely?” with response categories of “often/always,” “sometimes,” “occasionally,” “hardly ever” and “never.” Regression analysis was used to identify personal characteristics and circumstances that increase or reduce the likelihood of experiencing loneliness. The ONS also used cluster analysis to produce profiles of loneliness, showing collections of characteristics and circumstances that can put people at greater risk of loneliness. For the purpose of analyses, those who reported feeling lonely “often/always,” “sometimes,” or “occasionally” were classified as “more often lonely.” Those who reported “hardly ever” or “never” feeling lonely were

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classified as “hardly ever or never lonely. Further details on the methodology used by the ONS can be found in the ONS technical report. Key findings were:

• Younger adults aged 16-24 reported feeling lonely more than those in older age groups.

• Women reported feeling lonely more often than men.

• Those single or widowed were at particular risk of experiencing loneliness more often.

• People in poor health who have conditions they describe as “limiting” were at particular risk of feeling lonely more often.

• Renters reported feeling lonely more often than homeowners.

• People who feel they belong less strongly to their neighbourhood reported feeling lonely more often.

• People who have little trust of others in their local area reported feeling lonely more often. Three profiles of people at particular risk of loneliness were identified: 1. Widowed older homeowners living alone with long-term health conditions: Individuals in this group tended to be:

• Widowed

• In worse general health

• Living alone

• Homeowners

• Aged 65 or older

• Have a long-term physical or mental health condition Further analysis carried out by the ONS found that individuals in this group were predominantly:

• Female

• Not in paid work and economically inactive; given their age likely to be retired.

• Better-off financially than the sample average. As well as being home-owners, 62% of this group live in the 50% least deprived areas.

• in terms of personal wellbeing scores, mean scores for this group are similar to, though marginally worse than the average for the entire sample.

2. Unmarried, middle-agers, with long-term health conditions Analysis by the ONS showed that individuals in this group were at even greater risk of feeling lonely compared to widowed, older homeowners. Individuals in this group were characterised as:

• Single (never married), separated, or divorced.

• Living alone but more likely to be renting than owning their own home

• Reporting a long-term physical or mental health condition

• Unlikely to describe their general health as “very good” or “good” (and so have “very bad” to “fair” health) aged 35 to 64 years

Further analysis carried out by the ONS found that individuals in this group were:

• Less likely to be in paid work.

• More likely to be unemployed or economically inactive.

• Much more likely to report a long-term illness or disability described as ‘limiting.’

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• Worse-off financially than the sample average; 69% of this group live in the 50% most deprived areas.

• Mean personal wellbeing scores were substantially worse than the means for the overall sample and for other loneliness profile groups.

3. Young renters with little trust and sense of belonging to their area Individuals in this group were characterised as:

• Aged 16 to 34 years.

• Single, separated or divorced.

• Living with others.

• Renting.

• In “good” or “very good” health without any long-term health conditions or disabilities. Further analysis carried out by the ONS found that this group tended to be:

• Likely to be in paid work

• Living as a couple (53%), suggesting that although their marital status indicated being single, just over half were cohabiting.

• Without a strong sense of belonging to their neighbourhood; 55% reported feeling that they belonged to their neighbourhood “not very strongly” or “not at all”, compared with 38% in the sample overall.

• Have little trust of others living in their neighbourhood; only 25% reported feeling that “many” living in their neighbourhood can be trusted, compared with an average of 45%.

• Worse-off financially; as well as being renters, 70% of this group live in the 50% most deprived areas or neighbourhoods.

4.2.2 Analysis of Local Authority level data in relation to findings from the 2016-17 Community Life Survey Data accessed from Public Health England’s Fingertips portal(7) and the Berkshire Public Health Observatory(18)

has enabled profiling of Berkshire Local Authorities in relation to characteristics and circumstances associated with social isolation and loneliness. Used alongside local knowledge, this may enable identification of individuals at higher risk of social isolation and loneliness. The data and sources used to inform the following analyses can be found in the Appendices.

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Age and Gender

The ONS research identifies young renters as aged 16 to 34 years. LSOA mapping is available for the age category 16 to 29 years which is taken here to broadly represent the same age category. The highest proportion of young males are resident within LSOAs 007A in Central, 009G in Chalvey and 005E in Elliman. The highest proportion of young females are resident in LSOAs 014D in Colnbrook with Poyle, 007A in Central and 011A in Upton.

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Age and Gender

Although the ONS identifies the middle aged population as aged 35 – 64 years, this is the nearest population group for which LSOA-level mapping is available and has therefore been taken to broadly represent the middle aged population. Across Slough, the highest proportion of residents aged 45-64 live in LSOAs 003E, 003A and 003F in Haymill and Lynch Hill (male and female) and 012E in Upton.

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Age and Gender

Across Slough, less than 20% of the resident population are aged 65+. The LSOAs with the highest proportion of residents aged 65+ are 013C in Langley, 006E in Cippenham Green (male and female), St Mary’s, 003A in Haymill and Lynch Hill (male) and Female – 005D in Wexham Lea, 013C in Langley St Mary’s and 006F in Cippenham Green (female).

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Marital status

The highest proportion of single individuals are resident in LSOAs 010A in Langley St Mary’s, 001A in Britwell and Northborough and 014C in Colnbrook with Poyle. The highest proportion of separated individuals are resident in LSOAs 001B in Britwell and Northborough, 011B in Central and 013B in Foxborough.

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Marital status

The highest proportion of divorced individuals are in resident in LSOAs 013B in Foxborough, 003D in Haymill and Lynch Hill and 001B in Britwell and Northborough. The highest proportion of widowed individuals are resident in LSOAs 005D in Wexham Lea, 001D in Haymill and Lynch Hill and 005F in Elliman.

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Single person households

2011 Census information indicates that 10.3% households in Slough were occupied by a single person. 7.9% households in Slough were occupied by a single person aged 65 or over. In 2011, 31.3% of the Slough population aged 65+ were living alone. The neighbourhoods with the highest proportion of single-person households of all ages are 005D in Wexham Lea, 014C in Colnbrook with Poyle and 011A in Upton. The highest proportion of single-person households of residents aged 65+ were resident in 005F in Wexham Lea, 003D in Haymill and Lynch Hill and 010B in Langley St Mary’s.

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Household tenure

There are moderately high levels of home-ownership in some areas of Slough (including outright ownership and with mortgages). The LSOAs with the highest proportion of ownership are LSOAs 010E in Upton, 003E in Haymill and Lynch Hill and 011C in Upton. Rates of social renting are generally low across Slough. There are a few pockets with moderate to high proportions, notably 001B and 003G in Britwell and Northborough and 013B in Foxborough. Renting privately is most common in LSOAs 011B in Central, 009A and 009G in Chalvey.

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Health conditions

Less than 10% residents report their day-today-activities are limited a little and less than 11.6% report that they are limited a lot. The LSOAs with the highest proportions of residents reporting being limited a little are 005F in Wexham Lea, 001D in Haymill and Lynch Hill and 008B in Cippenham Meadows. The highest proportion of residents reporting being limited a lot are living in LSOAs 005D in Wexham Lea, 009F in Chalvey and 001D in Haymill and Lynch Hill.

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Health conditions

Neighbourhoods with the highest percentage of residents reporting bad health are 005D in Haymill and Lynch Hill, 013B in Foxborough and 001C in Britwell and Northborough. Neighbourhoods with the highest percentage of residents reporting very bad health are 014B in Colnbrook with Poyle, 012F in Langley Kedermister and 009B in Chalvey.

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Deprivation

The most deprived neighbourhoods are scattered across Slough. The LSOAs with the 3 highest deprivation scores are 007C in Elliman, 014B in Colnbrook with Poyle, 001B in Britwell and Northborough. Neighbourhoods that have higher proportions of residents who are economically inactive may be those with a higher proportion of retired residents or residents receiving social benefits. The LSOAs with the highest proportion of economically inactive residents are 009B in Chalvey, 004C in Baylis and Stoke, 007C in Elliman.

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Neighbourhood characteristics

The rate of reported crime per1000 population is highest in LSOAs 001B in Central (1,149), followed by 007A in Central (712) and 002A in Farnham.

In central areas of Slough, English is spoken as a main language by 50 – 60% of the population. In outer areas of Slough, English is generally spoken as the main language.

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4.2.3 Summary of findings from the Berkshire Data Observatory

The data explored here has enabled a relatively high-level analysis of the indicators of loneliness and social isolation rather than a comprehensive analysis of each neighbourhood within Slough. Due to the number of LSOAs within a Local Authority, only LSOAs with the highest 3 scores have been explicitly mentioned, which means that the descriptive analysis often excludes other areas that scored highly on a metric but did not score in the highest 3 scores. It should also be noted that several key measures have been obtained from the 2011 Census; it is possible that the local demographics may have since changed. Overall, the findings here will require corroboration with local intelligence. In relation to the findings from the ‘high risk’ population groups identified in the 2016-17 Community Life Survey(17), the data indicated the following: 1. Widowed older homeowners living alone with long-term health conditions: The cohort of the population aged 65+ makes up less than 20% of the population of Slough. Older people are resident across many different areas in Slough. Similarly, the highest proportion of individuals reporting limitations of daily activities or bad/very bad health are highly distributed. Given the higher proportions of single-person households in individuals aged 65+, neighbourhoods within Wexham Lea, Haymill and Lynch Hill and Langley St Mary’s may be those where loneliness and social isolation are more common. However, this would require further investigation. 2. Unmarried, middle-agers, with long-term health conditions: There are moderately high numbers of middle-aged residents across Slough. Haymill and Lynch Hill is an area with overlap between the highest proportion of middle-aged residents, divorced and widowed residents and residents reporting limitations of daily activities and bad health. Haymill and Lynch Hill also has the highest proportion of owned properties. Given the wide distribution of long-term health conditions, it is likely that there are multiple areas in which residents are at higher risk of loneliness and social isolation. Further analysis would be needed to identify these populations. 3. Young renters with little trust and sense of belonging to their area: Based on age, this population is most likely to be resident in Central, Chalvey, Elliman, Colnbrook with Poyle, and Upton. Colnbrook with Poyle is the ward with one of the highest proportion of single residents and single-person households (all ages) and may be of particular interest in relation to this cohort. Central and Chalvey are wards with the highest proportions of private renting. Notably Chalvey is also one of the highest scoring areas for residents reporting limitations of daily living, very bad health and economic inactivity.

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4.2.4 Analysis of social isolation and loneliness in adults aged 16+ using CACI’s Wellbeing ACORN profiles

Wellbeing ACORN is a geodemographic segmentation tool used for the UK’s population, specifically designed with health and wellbeing issues in mind (19). Wellbeing ACORN segments the population into 4 groups (Health Challenges; At Risk; Caution; Health) and 25 types describing the health and wellbeing attributes of each postcode across Britain. This approach draws on the knowledge that unhealthy behaviours tend to occur in clusters. Utilising an approach that is commonly used for commercial marketing purposes, Wellbeing ACORN can profile groups of the population to gain insight into their behaviours in lifestyle. In turn, this information can potentially be used to identify the health and wellbeing needs of the local population. This analysis draws on previous work completed in this area conducted by the Kent Public Health Observatory.

Group Description Type

Health Challenges

These areas contain the population with the greatest levels of illness and consequently, those with the greatest health challenges and risky behaviours now and in the past. They contain some of the oldest people in the most deprived neighbourhoods. This group contains some of the highest levels of smoking and the lowest levels of fruit and vegetable consumption. Issues around isolation and wellbeing are most prevalent here with many lacking a support network in their communities.

1. Limited Living

2. Poorly pensioners 3. Hardship heartlands 4. Elderly ailments 5. Countryside complacency

At Risk These neighbourhoods do not generally have high incidences of illness. However, multiple unhealthy behaviours, as a result of their lifestyles, could put their health at risk in the future. They have the highest rates of smoking in the country along with some alcohol concerns. Social issues such as unemployment, debt and dissatisfaction with life overall contribute to one of the lowest scores on the mental wellbeing scale.

6. Dangerous dependencies 7. Struggling smokers 8. Despondent diversity 9. Everyday excesses 10. Respiratory risks 11. Anxious adversity 12.Perilous futures 13. Regular revellers

Caution These are areas where the health and wellbeing of residents are generally good. Some behaviours do create health risks and may result in lifestyle related ailments in time. There are lower levels of smoking and generally below average incidence of illness. They are less likely to have high blood pressure but tend to be overweight and have high cholesterol. Whilst smoking is low, alcohol consumption can exceed the recommended limits.

14. Rooted routines 15. Borderline behaviours 16. Countryside concerns 17. Everything in moderation

18. Cultural concerns

Healthy These neighbourhoods are more affluent, often with older residents. Their health, given their age, is especially good with very low levels of illness and good lifestyle behaviours. Smoking is very low, and consumption of fruit and vegetables are extremely high. There are, however, issues with alcohol intake, particularly for women.

19. Relishing retirement 20. Perky pensioners 21. Sensible seniors 22. Gym & juices 23. Happy families 24. Five-a-day greys 25. Healthy, wealthy & wine

Table 3: Wellbeing ACORN segments for the UK population, showing 4 groups and 25 types (19).

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A two-stage process has been used to identify groups of residents in Slough with a higher propensity to be experiencing social isolation and loneliness. Stage 1: A composite score for social isolation and loneliness was generated for each ACORN Wellbeing profile by incorporating data from several features within the Wellbeing ACORN profiles. The features relate to factors associated with loneliness identified by the ONS (15). This included data on the factors of Health and Housing. Additional factors relating to Social Capital, Isolation and Support from Family and Friends were also incorporated since these factors relate specifically to loneliness and social isolation. This replicates the approach taken by the Kent Public Health Observatory. The composite score assigned to each Wellbeing ACORN profile has allowed identification of the profiles at greatest risk of social isolation and loneliness. This in turn has enabled identification of the postcodes with the population at highest risk. Stage 2: The ACORN Wellbeing profiles have been crossed-referenced with demographic data from the Connected Care dataset (the integrated digital records for people registered with a GP in Berkshire). Cross-referencing this data has enabled insight based on the number of residents within ward and Local Authority. Maps have been produced to show the population segmented by social isolation and loneliness risk score for all Wellbeing ACORN profiles and, separately, for the 5 profiles at highest risk of social isolation and loneliness.

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Map of Slough showing the population segmented by social isolation & loneliness risk score for all ACORN Wellbeing profiles

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Map of Slough showing the population segmented by social isolation & loneliness risk score for the 5 highest risk profiles

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4.3 Loneliness in older adults aged over 65 – Age UK 4.3.1 Age UK methodology In 2017 Age UK produced the “Age UK Loneliness Heat Maps”(20) showing the relative risk of loneliness among older people across neighbourhoods in England. The maps are intended to be used alongside local knowledge of neighbourhoods. The maps have been constructed based on results of a study investigating factors associated with an older person “often being lonely” using a sample of 6,773 people aged 65 years and older from Wave 5 of the English Longitudinal Study of Ageing (ELSA). The study identified six factors that were statistically associated with being lonely. Reporting poor health, having one or more eye conditions, a small household size, having a mortgage (compared to outright ownership and renting), reporting difficulty with one or more activity of daily living (ADL) and being divorced, widowed or separated (compared to being married or otherwise coupled) were factors associated with an increased risk of loneliness. The results of the study were applied to individual records from the 2011 Census. This produced the relative likelihood of loneliness among those aged 65 and older at Lower Layer Super Output Area (LSOA), ward area and Local Authority area. Further details on the methodology can be found in the Age UK report (21). 4.3.2 Age UK findings Age UK have used two systems to categorise the loneliness risk level for the 32,844 neighbourhoods (at LSOA level) in England. The first ranking system reflects a neighbourhood’s level of risk in relation to the level of risk for other neighbourhoods within the Local Authority. This is indicated using the colour coding system shown below.

The second system enables a comparison of a neighbourhood’s level of loneliness risk compared to all other neighbourhoods nationally. Risk scores have been categorised into five quartiles of risk where 1 = the neighbourhood with the highest risk of loneliness in England and 32,844 = the neighbourhood with the lowest risk of loneliness in England. This is indicated in the pie chart and scatterplot. The two systems of categorising loneliness risk level mean that a neighbourhood appearing high risk for loneliness within a Local Authority (based on colour coding) may not necessarily be high risk when compared to all other neighbourhoods nationally. Data from the Age UK loneliness risk profile(20) for Slough is shown on the following pages.

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Slough

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5.0 Interventions to address social isolation and loneliness

5.1 Findings from the research

Conclusions from research studies on “what works” have often been inconclusive or contradictory on the basis that evidence has been weak or studies methodologically flawed. However, the grey literature has offered insights into the conditions required for interventions to be successful (22)l.

• There is not a “one size fits all” approach to tackling social isolation and loneliness. Interventions that are tailored to the needs of diverse groups of individuals are more likely to be effective.

• It is important to reduce stigma attached to being lonely or socially isolated by avoiding use of these words and instead promoting messages around building meaningful relationships.

• Increasing participation in group activities appears to achieve good outcomes, particularly when the activities have an arts, educational or social focus.

• One-to-one activities such as befriending only appear to be successful in certain circumstances and require careful management.

• The impact of using technologies as the key intervention is inconclusive.

• Earlier interventions across the life course could help prevent some of the negative effects of social isolation and loneliness from accumulating later in life.

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Age UK and The Campaign to End Loneliness have developed a framework for providing a comprehensive system of local services (9).

Figure 2: The Campaign to End Loneliness and Age UK’s framework to tackle loneliness (9)

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5.2 Novel interventions addressing social isolation and loneliness in the UK

There are many existing interventions in existence across communities in England. A selection of novel initiatives are described here. 5.2.1 Rotherham Social Prescribing Scheme

Social prescribing has potential to reduce social isolation and loneliness, alongside a range of other health-related issues (9, 23). In Rotherham, Voluntary Action Rotherham (VAR) deliver a social prescribing programme on behalf of Rotherham CCG. VAR employ a Social Prescribing project team made up of a manager and five advisors. GP practices use a risk stratification tool to identify eligible patients (mainly older people with a long-term condition). Patients identified as needing non-clinical means of support to improve their health and wellbeing are referred to the social prescribing scheme. Social prescribing link workers visit the patients referred to undertake a needs assessment and link patients into appropriate services in the community and voluntary sector (23). VAR also support sustainability of the community and voluntary sector to deliver options and solutions to people’s needs, such as through helping to secure additional funding and volunteers (23). During the pilot phase of the project between April 2012 to March 2014, 83% patients experienced a positive change in at least one social outcome area. There were also significant benefits to the NHS; Emergency Department attendances reduced by 20%, inpatient admissions and outpatient attendances reduced by 21% among those referred (23). The pilot phase cost £1.1m. An independent assessment estimated that return on investment could reach £3.38 per pound spent, if the benefits achieved in the pilot were sustained over a five-year period (23). 5.2.2 Age UK Exeter’s Men in Sheds

Men’s Sheds initiatives are run across the UK, promoted by the Men’s Sheds Association. There are a number of Men’s Sheds running or in development across Berkshire (a map can be accessed at Find a Shed) (24). One example of this initiative is the Age UK Exeter’s Men in Sheds(9), which was established to offer a facility for men aged over 50 to meet for a few hours a week in the familiar environment of a shed or a workshop. The men socialise over projects to refurbish tools and garden equipment to be donated to charities and organisations in the UK and Africa or to be sold to raise money for Age UK. The scheme is open four days a week. Two days a week the scheme is open to men who can manage the work independently. On two other days the Shed offers a more managed environment so that men with physical or mental health needs can safely participate. This is called Tools Company. Regular Shed attendees act as buddies for those who would not otherwise be able to participate. The scheme is widely advertised through local media. Referrals to the Sheds are made by Mental Health teams, Social Services, Age UK Exeter and local NHS services. Self-referrals are also accepted (9). The project costs £32,000 per annum. The scheme was initially funded for six months by a £10,000 grant from Nesta. Ongoing funding has been obtained from several other trusts and foundations and donations of tools and training from corporate supporters (9). Evaluation of the six month period funded by Nesta showed that participation resulted in a reduction in feelings of loneliness and isolation among all people attending the Shed, increased social contact and lasting friendships between older men and an increase in the amount of time in which older men were engaged in meaningful activities each week (9). 5.2.3 Intergenerational care

Intergenerational care is the practice of bringing the young and elderly together by introducing nurseries and care homes to each other. Intergenerational care homes are found worldwide, although it is not mainstream practice.

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Research studies have found intergenerational care to be an effective intervention for decreasing loneliness, delaying mental decline and reducing blood pressure among the elderly. A useful summary of the evidence has been compiled by Age UK (25).

Apples & Honey, the first example of an integrated nursery and care home in the UK, was established in South London in 2017. Although the model has not been formally evaluated, there is strong anecdotal evidence for the benefits to residents (25). 5.2.4 First contact schemes

First contact schemes train individuals who people at risk of loneliness are most likely to come into contact with, on engaging people experiencing loneliness and making referrals to relevant services. Individuals who are trained include staff in post offices and libraries as well as community volunteers who are recruited specifically to identify the needs of excluded or vulnerable people in their local area (9). There are 35 schemes in the UK. Most are funded by Local Authorities who work in partnership with local organisations such as Rural Community Councils, Fire & Rescue Services, Police, faith groups, Age UK branches and other charity organisations. Some schemes have been developing integrated relationships with healthcare services. For example, Leicestershire FirstCare contact works closely with GPs so that preventative services can be accessed more quickly (9).

6.0 Examples of work to address social isolation and loneliness in Berkshire Initial internet searches found a high number of services, clubs and resources in existence across Berkshire, provided by the voluntary and community sector. This report has not set out to provide a list of all services that support vulnerable population groups. Instead, examples of specific work undertaken by Local Authorities in Berkshire to tackle social isolation and loneliness have been summarised.

6.1 The Bracknell Forest ‘Warm Welcome’ Programme

The Bracknell Forest ‘Warm Welcome’ programme, which launched in 2015, aims to reduce rates of social isolation through community development (26). It is a rolling programme that is part of the core business of Bracknell Forest Council. The programme consists of three ongoing elements that are integrated into the core business of Bracknell Forest Council:

1. Community Asset Mapping: involves a regular search for local groups that are run by residents for residents and offer opportunities to improve health, mental well-being and social contact. An important feature of this work is that it goes beyond the ‘established’ voluntary sector and seeks out groups that may not be listed in any official directory. The community map(27) now includes over 400 groups, including everything from walking groups through to woodwork, knitting, reading, chess and singing groups. The map is promoted to residents via social media. Training has also been delivered to local health, social and voluntary groups so they can use the map to support people in finding a suitable group.

2. Warm Welcome Assessments: ensure that every group on the map is willing and able to accommodate new members. A member of the Bracknell Forest Public Health team carries out the Warm Welcome Assessment to establish whether new members would be likely to have a positive experience. These assessments are often utilised by the community groups as a chance to learn about how they can do to widen the accessibility of the group and make their welcome a ‘warmer’ one to a wider range of people.

3. Community Group Support: support to local groups to build their capacity is offered by the Public Health team, in liaison with other experts where required. The support offered includes advertising, promotion, advice on accommodating particular needs or skills training. In some cases, support is in the form of small financial grants to purchase IT equipment or run promotional events.

Evaluation of the programme was undertaken using results from the Adult Social Care survey of residents receiving health and social care services, on the basis that they often experience the greatest barriers against social

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participation. When this work began in 2015, the number of people reporting that they have as much social contact as they would like was significantly lower than the national and regional averages at 38.4%. Since the Warm Welcome programme began, this figure has risen to 49%, exceeding regional and national averages (26).

6.2 University of Reading report on tackling loneliness and social isolation in Reading (August 2019)

Research on loneliness and social isolation in Reading was funded by the Health and Wellbeing Team at Reading Borough Council and the Participation Lab at The University of Reading (2). The aim of the study was to provide an in-depth understanding of the dynamics of loneliness and social isolation in Reading and to identify best practices which may prevent and address it. An in-depth qualitative methodology was used to explore the perspectives of different groups of service users, volunteers and community members. Groups included Deaf and hearing impaired people, older carers, peer support volunteers with experience of mental health issues, people at risk of homelessness, mothers and refugees and asylum-seekers (2). The research found a complex interaction between societal, situational and personal risk factors and barriers that prevent people in Reading from developing good social connections and networks. The research also identified a number of best practices in alleviating and preventing loneliness and social isolation among statutory and third sector organisations working with vulnerable groups and community members in Reading. These included

• Specialist support and safe spaces

• Focused group activities

• Making services and activities accessible

• Peer support, befriending and volunteering. The report made a number of recommendations for action. These are set out in the full report (2). A multi-agency Loneliness and Social Isolation Steering Group has been established in Reading which reports to the Health and Wellbeing Board. An action plan has been developed to put in place recommendations.

8.0 Suggested next steps The data in this report should be used together with local knowledge within Public Health teams and from relevant stakeholders, in order to establish the populations at greatest risk of experiencing social isolation and loneliness and to agree next steps. In many areas in England, Local Authorities have developed a strategy or action plan for addressing social isolation and loneliness. The following general recommendations are taken from the Combatting Loneliness: A guide for Local Authorities report (Local Government Association, 2018) (9).

1) Consider ‘addressing loneliness’ as an outcome measure of council strategies – including the Joint Strategic Needs Assessment (JSNA) and the Joint Health and Wellbeing Strategy (JHWS).

2) Work at the neighbourhood level, to understand and build on existing community capacity and assets.

3) Recognise and respond to individual needs and circumstances by both making sure general services are geared

up to meet the needs of those who are lonely, as well as providing specific interventions as required.

4) Pooling resources, and intelligence across organisations and developing new partnerships may increase the benefits for those who are hard to reach or isolated.

5) Carry out a local needs assessment (building on the findings of this intelligence report).

6) Use the loneliness framework from ‘Promising Approaches to Reducing Loneliness and Isolation’ guide produced by the Campaign to End Loneliness and Age UK (30).

7) Consider using the Joseph Rowntree Foundation (JRF) Loneliness Resource Pack (29) to inform action.

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The general recommendations from the LGA together with the information provided in this report could be used by Local Authority Public Health teams and their partners to identify actions that will make a difference locally.

9.0 References

1. Care Connect and Age UK (2018). Loneliness and social isolation – understanding the difference and why it matters. Available at: https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/loneliness/rb_feb2018_180208_careconnect_ageuk_loneliness_research_article_isolation.pdf [Accessed 17/09/19] 2. Bridger, O. and Evans, R. (2019) Tackling Loneliness and Social Isolation in Reading, Research Report, Participation Lab, University of Reading, Reading, UK. Available at: https://research.reading.ac.uk/participation-lab/wp-content/uploads/sites/131/Unorganized/Bridger-and-Evans-2019-Tackling-Loneliness-in-Reading-report.pdf [Accessed 29/10/19] 3. The Office for National Statistics (2018). Measuring loneliness: guidance for the use of national indicators on surveys. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/methodologies/measuringlonelinessguidanceforuseofthenationalindicatorsonsurveys [Accessed 17/09/2019] 4. HM Government. Department for Digital, Culture, Media and Sport (2018). A connected society. A strategy for tackling loneliness – laying the foundations for change. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/750909/6.4882_DCMS_Loneliness_Strategy_web_Update.pdf [Accessed 17/09/2019] 5. Griffiths, H. (2017). Social Isolation and Loneliness in the UK: With a focus on the use of technology to tackle these conditions, IOTUK. Available at: https://iotuk.org.uk/wp-content/uploads/2017/04/Social-Isolation-and-Loneliness-Landscape-UK.pdf [Accessed 23/10/19] 6. Public Health England (2019). Public Health Outcomes Framework 2019/20: a consultation. Government response. Available at: https://www.gov.uk/government/consultations/public-health-outcomes-framework-proposed-changes-2019-to-2020 [Accessed 23/10/2019] 7. Public Health England. Public Health Profiles. Available at: https://fingertips.phe.org.uk/ [Accessed 29/10/2019] 8. Public Health England (2015). Local action on health inequalities: reducing social isolation across the lifecourse. Available at https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/461120/3a_Social_isolation-Full-revised.pdf [Accessed 17/09/2019] 9. Local Government Association, Age UK, Campaign to End Loneliness (2016). Combatting Loneliness – A Guide for Local Authorities. Available at: https://www.local.gov.uk/sites/default/files/documents/combating-loneliness-guid-24e_march_2018.pdf [Accessed 17/09/2019] 10. Jo Cox Commission Final Report. Age UK (2017). A Connected Society – A Strategy for Tackling Loneliness – Laying the Foundations for Change. Available at: https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/active-communities/rb_dec17_jocox_commission_finalreport.pdf [Accessed 17/09/2019] 11. Jo Cox Commission Final Report. Age UK (2017). A Connected Society – A Strategy for Tackling Loneliness – Laying the Foundations for Change. Available at: https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/active-communities/rb_dec17_jocox_commission_finalreport.pdf

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12. Jo Cox Commission Final Report. Age UK (2017). A Connected Society – A Strategy for Tackling Loneliness – Laying the Foundations for Change. Available at: https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/active-communities/rb_dec17_jocox_commission_finalreport.pdf [Accessed 17/09/2019] 13. Social Care Institute for Excellence (2018). Tackling loneliness and social isolation: the role of commissioners. SCIE Highlights No 3. Available at: https://www.scie.org.uk/prevention/connecting/loneliness-social-isolation [Accessed 17/09/2019] 14. No Isolation. (2017). The prevalence of social isolation in Europe. Retrieved here: www.noisolation.com/global/research/the-prevalence-of-social-isolation-in-europe/ 15. HM Government. Department for Digital, Culture, Media and Sport (2019). Community Life Survey: Focus on Loneliness Report. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/771482/Community_Life_Survey_Focus_on_Loneliness_201718.pdf [Accessed 17/09/2019] 16. Office for National Statistics (2018). Children and young people’s experiences of loneliness: 2018. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/childrensandyoungpeoplesexperiencesofloneliness/2018 [Accessed 23/10/2019] 17. Office for National Statistics (2018). What characteristics and circumstances are associated with feeling lonely? Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/lonelinesswhatcharacteristicsandcircumstancesareassociatedwithfeelinglonely/2018-04-10 [Accessed 23/10/2019] 18. Public Health for Berkshire. The Berkshire Data Observatory. Available at: https://berkshireobservatory.co.uk/ [Accessed 29/10/2019] 19. CACI (2013). The Wellbeing ACORN user guide. The health and wellbeing classification. London, UK. Available at: http://www.caci.co.uk/sites/default/files/resources/Wellbeing_Acorn_User_Guide.pdf [Accessed 30/10/2019] 20. Age UK (2016). Loneliness heat maps. Available at: http://data.ageuk.org.uk/loneliness-maps/england-2016/ [Accessed 17/09/2019] 21. Iparraguire, J. Predicting the prevalence of loneliness at older ages. Age UK. 2016; 1-20. Available at: https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/health--wellbeing/predicting_the_prevalence_of_loneliness_at_older_ages.pdf [Accessed 29/10/2019] 22. Victor, C. et al. (2018). An overview of reviews: the effectiveness of interventions to address loneliness at all stages of the life-course. What Works Centre for Wellbeing. Available at: https://whatworkswellbeing.org/wp/wp-content/uploads/woocommerce_uploads/2018/10/Full-report-Tackling-loneliness-Oct-2018.pdf [Accessed 29/10/2019] 23. British Red Cross, Co-op, Kaleidoscope Health and Care (2019). Fulfilling the promise. How social prescribing can most effectively tackle loneliness. Shared learning report 2. Available at: https://www.redcross.org.uk/-/media/Documents/About-us/Research-publications/Health-social-care-and-support/Fulfilling-the-promise-social-prescribing-and-loneliness [Accessed 23/10/2019] 24. UK Men’s Shed’s Association. Find a Shed. Available at: https://menssheds.org.uk/find-a-shed/ [Accessed 23/10/2019]. 25. Age UK (2018). How care homes and nurseries are coming together for good. News article. Available online at: https://www.ageukmobility.co.uk/mobility-news/article/intergenerational-care [Accessed 23/10/2019].

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26. Bracknell Forest Council (2018). Bracknell Forest Warm Welcome Community Partnership Programme Report. 27. Bracknell Forest Council (2018). Public Health Portal: Bracknell Forest Community map. Available at: http://health.bracknell-forest.gov.uk/online-services/community-map/ [Accessed 23/10/2019] 28. British Red Cross (2016). Isolation and Loneliness: An overview of the literature. Available at: https://www.redcross.org.uk/-/media/documents/about-us/research-publications/health-social-care-and-support/co-op-isolation-loneliness-overview.pdf [Accessed 29/10/2019] 29. Robbins, T. & Allen, S. (2013). Loneliness resource pack. Joseph Rowntree Foundation. Available at: https://www.jrf.org.uk/report/loneliness-resource-pack [Accessed 30/10/2019] 30. Age UK and The Campaign to End Loneliness. (2015). Promising approaches to reducing isolation and loneliness in later life. Available at: https://www.campaigntoendloneliness.org/wp-content/uploads/Promising-approaches-to-reducing-loneliness-and-isolation-in-later-life.pdf [Accessed 30/10/2019]

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10.0 Appendices

Indicator Period Source SloughSouth East

regionEngland

Age

Percentage of the resident population aged 16 - 24 9.9 - -

Percentage of the resident population aged 35 - 64 38.9 - -

Percentage of the resident population aged 65 and over 9.8 19.1 18

Gender

Percentage of population who are male 50.5 - -

Percentage of population who are female 49.5 - -

Marital status

Percentage of adults who are separated or divorced 2011 Census 11.2 11.6 11.6

Health

Healthy life expectancy at birth (male) 59.4 66.1 63.4

Healthy life expectancy at birth (female) 59.2 66.2 63.8

Disability-free life expectancy at 65 (male) 7.4 11.2 9.9

Disability-free life expectancy at 65 (female) 9.1 10.9 9.8

Percentage of respondants reporting a low happiness

score10.5 7.6 8.2

Long term health conditions

Estimated prevalence of common mental disorders (%

of population aged 16 and over)19.3 14.8 16.9

Estimated prevalence of common mental disorders (%

of population aged 65 and over)11.8 9.2 10.2

Percentage of people who reported having a limiting

long-term illness or disability2011 Census 13.4 15.7 17.6

Percentage of people reporting at least two long-term

conditions, at least one of which is MSK related.2017/18 GP Patient Survey (GPPS) 7.9 11.2 12.1

Estimated prevalence of physical disability (estimated

% of population aged 16-64)2015

Health Survey for England and

ONS population9.9 11.3 11.1

Excess under 75 mortality rate in adults with serious

mental illness2017 NHS Digital 348.3 347.5 370

Proportion of adults in the population in contact with

secondary mental health services.2017 HSCIC Indicators Portal 4.5 4.5 5.4

Contact with mental health or learning disability service:

rate per 1,000 patients on GP practice lists aged 18+2017

Mental Health and Learning

Disabilities Data Set (MHLDDS)32 34.2 38.7

Percentage population with a long-term illness, disability

or medical condition diagnosed by a doctor at age 15.2016

What About YOUth (WAY)

survey, 2014/1514.8 15.2 14.1

Percentage of population living with sight loss 2018

RNIB sight loss data tool -

accessed via JSNA for

preventable sight loss

2 - 3.1

Percentage of population living with some hearing loss 16,549 - -

Percentage of population living with severe hearing

impairment1,650 - -

Percentage of population living with moderate or severe

visual impairment1,332 - -

Percentage of population receiving Disability Living

Allowance2018

Office for National Statistics

(2018); NOMIS Official Labour

Market Statistics - Benefit

Claimants - Disability Living

Allowance

3,570 (2.4%) - 3.2

2017

2018

2015-17

Adult Psychiatric Morbidity

Survey (NatCen & NHS Digital)2017

ONS Small area population

estimates, England and Wales:

mid-2017

ONS and Annual Population

Survey

Berkshire Observatory

2018Projecting Adult Needs and

Service Information (2018)

Key

Better than average for England

Worse than average for England

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Indicator Period Source SloughSouth East

regionEngland

Social isolation

Percentage of population aged 65 and over living alone 31.3 30.4 31.5

Percentage of households occupied by a single person

aged 65 or over7.9 12.7 12.4

Percentage of all households occupied by a single

person (all ages)10.3 12.1 12.8

Social isolation: percentage of adult social care users

who have as much social contact as they would like

(18+ years)

43.8 47 46

Social isolation: percentage of adult social care users

who have as much social contact as they would like

(65+ years)

41.9 44.5 44

Social isolation: percentage of adult carers who have as

much social contact as they would like (18+ years)22.7 33.2 35.5

Social isolation: percentage of adult carers who have as

much social contact as they would like (65+ years)28.8 35.9 38.3

Sports club membership (% of population aged 16+) 2015/16Active People Survey (Sport

England)14.5 - 22

Deprivation

Index of Multiple Deprivation (rank of average rank out of

151 Local Authorities)2019

English Indices of Deprivation

2019 - Summaries at Local

Authority Level

53 - -

Employment and economic indicators

Percentage of people aged 16-64 in employment. 2017/18Annual Population Survey -

Labour Force Survey75.8 78.5 75.2

Unemployment (% of the population claiming out of

work benefit)2017/18

NOMIS - Labour Force Survey -

model-based estimates of

unemployment

1.4 1.2 1.9

Employment deprivation: score 2015

The English Indices of

Deprivation 2015, Department for

Communities and Local

Government

0.103 - 0.119

Economic inactivity rate 2016/17

Data is from the Annual

Population Survey (data

produced by ONS), accessed via

nomis (www.nomisweb.co.uk).

22.3 19.2 21.8

IDAOPI (Income deprivation - older people) 2015Department for Communities and

Local Government (DCLG)23.2 - 16.2

Long-term unemployment rate per 1,000 people of

working age2017/18 NOMIS Labour Market Statistics 1.7 1.9 3.6

Percentage of older people in deprivation 2015Ministry of Housing, Communities

& Local Government23.2 11.8 16.2

Home ownership

Affordability of home ownership 2017

Data is sourced from the ONS

and based upon House Price

Statistics for Small Areas

(HPSSAs) and Annual Survey of

Hours and Earnings data.

11 9.8 7.9

Owned or shared ownership (% population) 54.1 - 64.1

Social rented (% population) 20.6 - 17.7

Private rented or living rent free (% population) 25.3 - 18.2

Neighbourhood belonging/trust indicators

People who feel they belong to their neighbourhood 2010

Ministry of Housing, Communities

and Local Government.

Discontinued from 2010.

68.5 58.3 58.7

Crime rate per 1000 residents Jul-19UK Crime Stats for Thames

Valley Police12.15 8.6 10.06

ONS (JSNA DU5)2017

Census2011

2017/18Adult Social Care Survey -

England

2016/17

Personal Social Services Survey

of Adult Carers in England (NHS

Digital)