Individual-level drivers of lonelinessHealth – Acute or chronic health concerns presented many barriers for individuals to engage Outside of the disruptive life events, participants in social connection and maintain satisfying social raised a range of challenges that started with bonds. For example, participants with health them and decreased their ability to connect with conditions noted that managing their health others – the individual-level drivers of loneliness. issues took up time and energy (e.g. getting to Figure 7 summarises these challenges.and through medical appointments, and coping with pain and discomfort). When it then came to Figure 7. Individual-level drivers of lonelinessplanning for or engaging in social activities and other enjoyment, participants found they had little time and energy left to offer. Often, links Sense with existing social connection points were also of self severed because participants found it difficult or impossible to engage with hobbies they once Changed Health enjoyed – for example, retreating from sports and habits exercise groups once symptoms became too severe to participate. Indi- “[I’m] unable to use my legs in the same way vidual as healthy people…I often need to sit down Emotions Income or go home before other people do.” (Mobility, Female, London, 35-54) Income – Our research included individuals with Confidence Energy a wide range of financial circumstances, including people experiencing poverty or otherwise affected by financial instability. Echoing the findings from the general public survey, where 24% of those surveyed noted they were often lonely as Sense of self – In the absence of positive social a result of their economic status, participants connections, confusion about who they were and experiencing loneliness said they could not afford what they had to offer could make it difficult to to connect even if they had the opportunity. In engage with others. Without a sense of where particular, they told us that ongoing financial participants were ‘starting from’ (‘I am Jim, instability makes it hard to rationalise spending and I am a postman’), connecting with others money on social or non-urgent purchases. The was more difficult. For example, participants cost of typical informal activities a participant with health issues noted that as their lives, might do with someone – eating a meal out, abilities, and habits had changed, they found it going for drinks or watching a film – were not increasingly difficult to reconcile ‘who I am’ with always financially feasible. More formal activities ‘who I used to be’. This identity transition was for establishing or strengthening connections very unsettling, making it difficult to connect – exercise classes, cookery courses, further whilst participants were getting used to their education and vocational studies – were often new way of living. also out of reach due to costs. Even for those “I don’t have a place where this new character who described themselves as ‘financially alright’, the cost of getting to and paying for activities and identity its...I’m living with and in the or services and support was sometimes seen shadow of the ghosts of my past.” as prohibitive, or, at least, as presenting a barrier (Health, Male, Aberystwyth, 55-74)to engagement. What causes loneliness, and how can it become chronic? 22