Meet the Solutionists, with Mark Scott

There have never been more people living on the planet than now. And yet loneliness has become a major health concern worldwide – it’s serious enough that the World Health Organisation has declared it a public health concern. Professor Melody Ding examines loneliness and social isolation – how they differ, and how they overlap. While everyone’s experience is unique, the way we organise our communities can and does contribute to these problems. This means improvements, too, are within our reach. Melody Ding explains the differences between loneliness and social isolation, examines causes, and looks at what systemic changes we can make to improve connectedness.

Mark Scott  00:00

Speaker. This podcast is recorded at the University of Sydney's Camperdown campus on the land of the Gadigal people of the Eora nation. They've been discovering and sharing knowledge here for tens of thousands of years. I pay my respects to elders past and present, and extend that respect to all Aboriginal and Torres Strait Islander people.

Ivano  00:27

Loneliness for me, comes in waves. It's definitely sort of creeping up on me. I definitely have felt lonely before, absolutely but since being here, I feel like, as time goes by, it's, sort of enveloping me in a way. There's short tempered moments, there's, you know, manic cleaning episodes where it's the only thing that I can do is, you know, scrub away the feeling, but it definitely comes in many ways. And it could be a beautiful day, enjoying myself, going on a walk like I still feel lonely. It feels great. I'm happy to be there. I love taking in the surroundings, but there is that lingering feeling of sort of emptiness and something missing.

Mark Scott  01:39

In 2023 the World Health Organisation declared an unusual threat to public health. The US Surgeon General said the mortality effects of loneliness are the equivalent of smoking 15 cigarettes a day, worse than obesity, worse than physical inactivity. Loneliness is associated with increased risk of developing dementia, incident coronary artery disease and stroke. But it's not just a physical health hazard. It can have a profound impact on all sorts of outcomes. Young people experiencing loneliness, for example, are more likely to drop out of university, and people feeling disconnected at work often report poorer job satisfaction and poorer performance. So what exactly is loneliness, and what can we do about it? Professor Melody Ding is an epidemiologist and population behavioral scientist at the University of Sydney, and she's working on improving public health literacy and addressing loneliness. So Melody, you're an expert in public health, and you research loneliness. What was your experience of being lonely? You moved from China to the United States. What did you experience there?

Melody Ding  02:49

It was tough. And I think at that time, I didn't know why it was challenging, because I, you know, I adapted American accent, I put on American clothes, I tried to behave like American I thought that would be all easy. And I was, you know, in my early 20s, I think, you know, plenty of opportunities for me to become an American. But then I realised there's something that is fundamentally different from from people around me in terms of values. And you know what, what I value was, you know, quiet time with people and building strong connections. And I was in Southern California where there was a lot of noises, and people were super confident, and they liked throwing parties, you know, for those in their early 20s and so on. And it was really tough. I thought that I had to do that in order to make friends, in order to be accepted by the American societies, and it was just horrible. I, you know, I went to parties, and I I try my best to talk to people and having awkward moment and leaving a party, replaying those awkward moments in my head and just thinking that, Oh, gosh, you're so socially awkward, and I guess you're meant to not be accepted, and then when I had that mindset going to the next social events, it will just keep on getting worse. So it becomes a vicious cycle. At that time, I didn't know that was loneliness, but now I have the vocabulary for it. I understood that that feeling of constantly being under the spotlight and magnifying every movement or facial expression on someone else's face, and try to link that to my incapability of, you know, making social connections. That was exactly what loneliness is. And I also find it really hard to just see people, because it was so car dependent where I was. I I drove everywhere, and I could go for a day without actually talking to someone, because, you know, work has a garage, home has a garage. Wherever you go, you just park your car, and then you rarely run into someone. I try to take a walk, sometimes in my neighborhood, and every time I got neighbours stopping me and asked me. Do you need help? Are you lost? Have you lost your dog? Because it's so abnormal for them to see someone walking.

Mark Scott  05:08

That’s a very big move, isn't it, when you're moving from one country to another and leaving behind friends and family and contacts and familiarity, you did it again in your career. You moved to Australia to be a researcher. How did you find that move and did the same thing happened to you again?

Melody Ding  05:25

This, this move, I would say it's actually more of a positive move in in terms of my social life. I think my biggest shock, coming from China to the US, was that, you know, I came from a culture that really values humility, and values reading books, being intellectual, and, you know, being good in school and all that. And when I went to the US, especially in California where I was, it's so much about, at least for my age group at that time, being loud, being the life of the party, being super confident about, you know who you are, you know, being a badass and not necessarily being good in schools. So I found that really challenging, because that's not really aligned with my value and the world and the values that I'm familiar with. But when I moved to Australia, I actually found a really positive experience, and possibly because I really have gone through the tough patch, transitioning from China to the US and actually learning to make friends towards the end of my time there. So moving to Australia, I find it much easier, and I think there's possibly a couple of reasons for that. For one thing, Australia really embraces multiculturalism, and I felt like when I was in the US, I was kind of trying to be American and putting aside part of my identity. And as compared to, you know, when I moved to Australia, I've never seen that many Asian faces around me for a very long time, and it's just a bit easier for me to feel part of this. And I also find that very different urban environment set up. You have opportunity to get on buses, the trains or get on your bike. You have interactions with people more incidentally, as compared with in Southern California, you just drive everywhere. You can get away with not seeing or interacting with one person for the whole entire day, because you drive from garage to garage and basically just going home.

Mark Scott  07:22

So let’s dig a little bit more on what you're you're learning through your research. We talk about loneliness, we talk about social isolation. Are they the same thing? People talk about a loneliness epidemic, but they didn't talk too much about a social isolation epidemic. What's the difference and does it matter?

Melody Ding  07:39

Loneliness and social isolation, they're both symptoms of social disconnect. We want, ideally our society to be, you know, filled with satisfying social connections. But these two are very different in terms of how we researchers define it. So loneliness is a subjective feeling of lacking that social companionship. We often define it as the gap between one's ideal social life and the social life someone has in reality. So if one person only just needs one close confidant that this person can really be at home with, then you know this person might be seen as lonely to other people, but there's no gap or feeling of lack for that person. And on the flip side, someone might, you know, have 500 friends, but not really at a very, I guess, high quality level. And you know, to the outside person that this person might look like a social butterfly, but in reality, there's still the sense of lack. So that's what we define loneliness, and a social isolation is more objectively defined of lack of social participation. So someone might be living and in the middle of nowhere, having no neighbours, don't go to churches, don't go to local community centres, and that is more social isolation. The two are connected to each other, so they're correlated in the population, but one person can definitely be lonely without being socially isolated, and vice versa.

Mark Scott  09:14

Yeah. So if you're a involved in public policy, if you're a leader in the community, if you're a leader of organisations, do you which do you focus on? Do you focus more on social isolation? Because if you fix that more effectively, people are less likely to feel lonely?

Melody Ding  09:32

That is an excellent question, and I really want to make the point that we hear a lot about loneliness in the media, but loneliness and social isolation, they're both bad. They're both bad for our mental health and physical health, and they might affect our health in different ways, but we need to tackle them both. So from the policy point of view, the interventions are more likely to be at structural level. For example, creating public open spaces, the so called ‘third place’ where people can go hang out with each other, to increase that level of incidental interactions among each other. So that is addressing more of social isolation side of the problem and loneliness, it probably will involve some level of changing the way people think so that could be a bit more individually targeted, but when we are living in a more socially connected environment through better policies, whether that's urban design, transportation, social inequality, I really want to emphasise that, we are really living in a conducive environment for social connection, and then loneliness is again, the flip side of the social connection, so we can tackle loneliness that way as well.

Ivano  10:52

My name's Ivano. I'm 23. I live in Melbourne, and I'm a graphic designer by trade. I grew up on the Sunshine Coast, moved to Brisbane in the middle of high school, and sort of spent my early, well, late teens, early 20s in Brisbane. That's where I did most of my study. There wasn't anything in particular that sort of forced me to leave or I wanted to escape from in a way, I think I just was really excited about exploring something new.

Ivano  11:38

Melbourne offers a very vast creative scene and I believe that was sort of the appealing part of coming down here. Hearing a lot of things throughout studying about the environment down here, how many studios there are, when you do that sort of research into the design scene, the creative scene, it's very appealing. Naturally it's a bigger city, so therefore you would think that would come with more opportunity. Very fortunate I do have great people around me here, and I do have a job that I love doing, but the experience of loneliness, it comes from that I feel like I'm missing a part of me through my partner, through my family, like realising that those people were such a big part of my life, it has really opened my eyes to the things that are more valuable to me I suppose. When I do feel lonely, I think it comes in many ways, but definitely there is this feeling of intense isolation. There's short tempered moments. There's, you know, manic cleaning episodes, where it's the only thing that I can do is, you know, scrub away the feeling. But it definitely comes in many ways, and it could be a beautiful day, enjoying myself, going on a walk like I still feel lonely. It feels great. I'm happy to be there. I love taking in the surroundings, but there is that lingering feeling of sort of emptiness and something missing.

Mark Scott  13:27

I was thinking about all those references in popular culture, you know, the Beatles. Look at all the lonely people. You know, where do they all belong? And all the songs that reference loneliness. But I was wondering, is it a modern phenomenon, loneliness? If you go back in history, is it a 20th century, 21st century phenomenon?

Melody Ding  13:47

It definitely isn't. Loneliness is as old as us, as human species, and in fact, loneliness has been considered as a protective mechanism as a result of evolution, because when we think about, you know, our ancestor living the hunter gatherers life and in the middle of Africa savanna, and it's much better off that we survive as a group rather than as individuals. So in a way, we have this building system a bit, you know, similar to hunger and thirst. Hunger prompts us to eat things, and thirst for us to prompt us to reach for water, and loneliness prompt us to reach out to people, because it's better off for us to survive as species. And I think that's one of the reasons why people who feel chronically lonely are less likely to have good quality sleep, because it's still our in view mechanism, the way that we have to watch out for predators. We have to watch out for dangers around us. So it is definitely not a modern phenomenon.

Mark Scott  14:49

Clearly loneliness can affect anyone, but are there particular groups who are at especially high risk of social disconnection?

Melody Ding  14:56

So we all experience loneliness, and many of us experience problematic loneliness in our life, but we know that there are certain stages, especially around young adulthood and adolescence, that loneliness seems to be a bit more problematic and the prevalence is higher. So that's in terms of our age. In terms of sex, is really fascinating, because when you ask, loneliness can be measured two ways. You can ask people whether they're lonely, or you can give them a bunch of questions to try to get to their social connection right. And then when we ask whether people are lonely, men are so much less likely to report that they're lonely, but when we actually ask the other questions, indirectly, they're at least as lonely as women and oftentimes worse. So that's quite interesting findings for us, and then that definitely points out that we probably have quite a bit of work to do in terms of destigmatising loneliness, especially to groups that don't want to admit they're lonely. And we also know that people experiencing chronic illnesses and disabilities are more likely to report higher level of loneliness, and I think that's really an opportunity for us to think about how we build our society in such inclusive ways that their health conditions don't get in the way. And we also know that there are certain populations that are probably getting better but still marginalize, you know, the LGBTQIA+ communities and people with lower socioeconomic status, you know, lower education income, they tend to feel higher level of loneliness than others. So in many ways, the level of disadvantage that we generally see at the population level is reflected by their experience of loneliness as well.

Mark Scott  16:46

I was reflecting on that Longitudinal Survey run at Harvard about what makes people happy through life, and quality of relationships, quality of friendships seems to be kind of so dominant as an indicator of happiness. If you look at those who don't think they're lonely, but the survey would suggest they are lonely. Do we need to help people be better at developing and keeping friendships, particularly men?

Melody Ding  17:10

Absolutely and I think we have a lot of work to do at the public level to think about really bringing up this concept of social connection being important, because we're talking about it now as if it's a hot new topic. But you know, the WHO has been long defining health as not an absence of illness, but a generous physical, mental and social wellbeing. So when we think about it, it's like a triangle or a stool with three legs, all three are important for the stool to stand, but we often kind of missed out on the third part. We seem to somehow think that it's less important than others. So much of our work has been focusing on eat healthier, exercise. We care so much about what's on our plate and what we do to move our bodies, but we rarely ask, Who do you have a meal with, and who do you exercise with? And all of this, I think it's so important that's being neglected. So we really need to kind of amplify the conversation at the population level, so that all of us have a little bit self-reflection in terms of, have I done enough to maintain relationships with people, and also for people to realise that, you know, if I feel lonely, that's actually a good thing. This, it's kind of reminding me to reach out to people, and I think we have more conversation with our society in a more socially inclusive and connected ways.

Ivano  18:48

Being Italian, family is paramount. It's a really big part of our lives is just each other. I suppose. My sister, she had her first child just under 11 months after I'd moved so, you know, I think not being able to be there, to experience that, to be with my family in this like in this time, accentuates those periods where I, I sort of do, feel isolated, alone, lonely. And I think being away from everyone, it has caused some some difficulties, and sense of, you know, you always get Nonna nagging, when are you coming back? When are you coming back? So that's sort of looming and weighing on your mind when you do have to sort of separate yourself, but in a way, it does allow a bit of growth for me, having to experience this time away from from them, and from what I know is really been helpful, and it's allowed me to sort of develop a sense of myself outside of my family.

Mark Scott  20:09

I think one of the reasons that people may not tick the form and say I feel lonely is that people feel surrounded by people. And you know, they know so many people through work and everything else. What is the nature of a friendship and a relationship in terms of quality that's more likely to protect people against loneliness? You know? What of those relationships? What needs to be the characteristic of them that really helps us get to a healthy state of wellbeing in terms of relationships?

Melody Ding  20:40

I can probably answer this question in reverse engineering. The typical questions we use, the so called ‘gold standard’ question we use for measuring loneliness, actually ask, do you have someone to confide with? And to me, that's really important. Someone that you can call up when you have a problem. Someone you can just be yourself 100% and share your you know, deepest and most scary vulnerabilities with. I think that's really important. And I really don't think we need 100 of those friends. And if you can have 100 that would be fantastic. But for us to at least have one of those friends that we can always rely on and we can bear ourself with and we feel a sense of belonging together. I think that's really important.

Mark Scott  21:26

And do you have a hypothesis on why this might be growing as an issue for young people, and do you look at it with a lens of technology and social media? And can connectedness also be driving loneliness?

Melody Ding  21:39

Yeah, I think when we talk about young people, we usually just, by default, go into social media. It is really hard for us to pinpoint what is causing increasing loneliness. For example, older adults, they adopt social media as well, but they're more likely to use it as a supplement to in person interactions, and that's probably why we see them actually quite resilient during the pandemic, because they find ways to stay connected with people who they have already built a strong bond with before the pandemic and the younger people, whether we're talking about the pandemic or now post pandemic time, they're more likely to use social media to replace in person interactions. And we know that loneliness is defined as the quality of social relationship, or lack of the quality of social relationships. We could probably hypothesise that, you know, there are certain level of social interactions and connections you can build virtually, but whether that's the same quality relationship as we build in person, that's something we have to question.

Mark Scott  22:47

Yeah. I also reflect on your comments on moving to the United States from China and those voices in your head about what's everyone thinking, the sense of judgment, I think, mean that's a characteristic of social media, too, that constant sense of comparison that you have with the best and the beautiful from all around the world, and in a sense of vulnerability and insecurity that can be built on the back of that too.

Melody Ding  23:10

Absolutely, I realise the readers don't see me nodding my head the whole time when you were when you were talking about that 100% and I often have this thinking that because loneliness is defined by this perceived lack, and where does the perception come from? You know, if we're living in the world, especially, imagine us being like 16 again, where, you know, people are posting about going out with friends all the time, and other people have 1000 friends on Facebook and Instagram, and then that inevitably will make a relatively vulnerable, you know, young person to think that, oh, wow, that's what being popular is like. I guess I'm really not,

Mark Scott  23:49

As we've said, there's a relationship between loneliness and ill health. Do we understand why or how loneliness can affect us in that way?

Melody Ding  23:59

Yes, we have relatively good evidence in terms of where we think the mechanisms are, so I'll give a couple of examples. One quite talked about mechanism is the behavioral pathway for example. When people are feeling chronically lonely, they might result in some type of male adaptive coping behaviors. You know, whether it's drug, alcohol or not looking after themselves. Well enough, another potential pathway I also mentioned earlier, potentially through poor sleep, as we're feeling this constant stressor of not having someone to rely on around us. And then you know, we also know that the poor sleep could potentially trigger other, you know, worse, lifestyle related behaviours. Other mechanisms might involve some physiological pathway, because we can imagine chronic loneliness as a bit of, you know, stressor in a background. So it's constantly being reminded in our head - oops, you're alone. You don't have someone around you, oops. You better watch out for threat. So when we have this chronic stressor happening, it is going to have physiological and psychological outcomes on our body as well.

Ivano  25:18

In those times that I do experience that intense, lonely feeling I think it's hard to say that you should go talk to your friends or go socialise, because it's almost the last thing that you want to do in that situation. So, I think is just remembering that you should take care of yourself in those moments, because it's it's okay to feel that, that loneliness, and yeah, it does suck, but, you know, doesn't mean you can't take care of yourself. It helps.

Mark Scott  25:57

So this can be a spiral. We feel alone, we don't feel connected. One of the things you've talked about is a third place, and rather than just specifically trying to find individuals, find a location, find a community, find a an area where we can belong and connect. A bit talk a bit more about the third place.

Melody Ding  26:14

I think the third place can means different things for different people. For me, personally, the third place I found in the US initially was dance school. Because I'm a dancer. I enjoy movement and artistry, and I, you know, found people who are quite similar to me through that process. And I think the space itself is important, but the kind of people that the space attracts is really makes what makes me feel like there's a sense of belonging, because on the flip side of loneliness, what we often lack is a sense of belonging. And sense of belonging is different from fitting in. I can force myself to enjoy a party, or at least to outside people, but that's not a sense of belonging. So I think it's really important for us to do the deep dive about who we are and what we care about, what would we really enjoy doing, and then find the right places to build that connection with people. And I think there's things that we can praise about the social media and the socially connected, virtually connected world, you know, there are websites like, you know, meetup and that type of opportunities help us to find the exact events we enjoy doing and going to events like that. You're not guaranteed to make friends, but you're probably more likely to make friends than going to random parties.

Mark Scott  27:40

On this podcast in the past, we've talked with people who are involved in in planning and developing our cities. And you know, the leaders we talk to are often planning for a future where people will live much longer, or planning for a warmer environment. As we plan our cities now, where, you know, millions and millions of people gather the things that we need to be doing in planning to create an environment where people can feel more connected, where it's easier for people to come and meet and gather and enjoy each other's company and feel less alone?

Melody Ding  28:15

I love that question as a public health researcher, because we really want to look upstream in terms of solutions. And I think before we think about what kind of places we plan, to me, the most important question is the kind of places we plan, how do we make sure that people can live there for a certain amount of time? And I'm really want to kind of point towards housing affordability in Australia, which I think is a huge problem that our society faces, because we know that social relationship is often built on repetition. When you keep on going to the same third place for repeated number of times, you're more likely to actually build connections with people. Otherwise, we're just seeing different random people every day, you might feel, you know, certain level of connections, but that's probably not enough for you to make friends. So to me, I think the number one thing is to make sure that whatever we build that is affordable enough so that people can live there for a couple of years, rather than being kicked out by landlords every year, which has, which we see a lot with younger people, particularly, and it's really not induced for social connection. So I think that's number one. And in terms of number two, I think it's really important for us to build, to plan with social connections in mind. That could include public facilities where we put the benches, what the benches look like? Do we consider areas where it is inclusive for people of different demographic and physical ability, for example, so that we don't plan out certain population segments. And in that process I think it's also important that we focus more public spaces where people can exercise outside, walk their dogs, can take public transport or get on their bike or walking without feeling unsafe, rather than getting people in their cars and have them, you know, drive around like my experience in the US. I think it really sucks.

Mark Scott  30:17

As you look at the development of cities in modern society, do you see some smart ideas, initiatives that are really going to help overcome some of the challenges we have around loneliness?

Melody Ding  30:28

That's an interesting question. And I actually very recently seeing a documentary about the type of housing, new housing arrangement in Sweden, where instead of putting older people in senior home, that can be a bit depressing. Sometimes they put them together with young people, university students or younger in the same shared housing facilities so that the young people can help older people with using their phones and using apps and social medias. And the older people love sharing their life experience their wisdom with younger people. And then they were both happy, and I thought, how brilliant is that? And isn't that something we should consider considering our own housing challenges in Australia?

Mark Scott  31:11

That's Professor Melody Ding from the University of Sydney. Thanks to Ivano for sharing his story of dealing with loneliness and if you're thinking about how to improve your own health at the moment, you'll enjoy our episode with world leading healthy nutrition expert, Professor Luigi Fontana.

Luigi Fontana  31:30

Typically, we think you know that cancer, dementia, cardiovascular disease, liver disease, kidney disease, they are separate disease, and they are if you wait them to fully develop. But you know what we found is that many of these common chronic disease, they share a common metabolic substrate.

Mark Scott  31:53

And there are plenty more solutionist episodes, both around mental and physical health, that you can listen to right now. Just scroll back in your feed and make sure you're following the podcast so you won't miss an episode. The Solutionists is a podcast from the University of Sydney, produced by Deadset Studios. This episode was recorded at the Faculty of Arts and Social Sciences media room, and our thanks to the technical staff here.

The Solutionists is podcast from the University of Sydney, produced by Deadset Studios. Keep up to date with The Solutionists by following @sydney_uni Facebook and Instagram, and @sydney.edu.au on Bluesky.

This episode was produced by Liam Riordan with sound design by Jeremy Wilmot. Supervising producer is Andrea Ho. Executive editors are Kellie Riordan, Jen Peterson-Ward, and Mark Scott. Strategist is Ann Chesterman. Thanks to the technical staff at the Faculty of Arts and Social Sciences Media Room.

This podcast was recorded on the land of the Gadigal people of the Eora nation. For thousands of years, across innumerable generations, knowledge has been taught, shared and exchanged here. We pay respect to elders past and present and extend that respect to all Aboriginal and Torres Strait Islander people.