Loneliness is a public health crisis and neighbourisms should be part of the cure

This Housing LIN Viewpoint (no. 111) was published to coincide with the 2nd All Party Parliamentary Grounp inquiry evidence session on Creating Intergenerational Communities

As published by the Housing Learning and Improvement Network

Introduction: Housing, Health, and the Loneliness Crisis

When we think about public health crises, we often focus on pandemics, obesity, or mental health. But loneliness - when our desire for social connection is not matched by our reality - is a public health emergency. Studies have suggested it can increase the risk of premature death as much as smoking 15 cigarettes a day, with links to cognitive decline and conditions such as heart disease, depression, and malnutrition. Despite these well-documented dangers, loneliness is often treated as an afterthought in health policy. While many solutions focus on clinical interventions, the way we design our living spaces can either exacerbate or alleviate this crisis. Indeed, our health and care system is largely reactive.

Services tend to step in when malnutrition leads to hospitalisation, when depression requires medication, or when isolation has already contributed to severe cognitive decline. Across a range of sectors, thinkers and practitioners are pushing for systems which invest in preventing these issues before they take hold.

‘Neighbourisms’ and the Preventative Power of Social Connection

In my view, we rarely consider housing as a public health intervention, despite its profound influence on health outcomes. But beyond bricks and mortar, everyday interactions — what I call ‘neighbourisms’ — can shape whether a housing environment supports or erodes our health. Neighbourisms are a term I’ve started using to refer to the informal, mutual acts of care which emerge naturally in intentional, intergenerational communities. In many places, health and housing departments remain siloed, missing opportunities to create environments that support wellbeing. Intergenerational communal living - where people of different ages live together, share some spaces, and form mutual support networks - offers a compelling way to address these gaps, tackling loneliness and its associated health risks before they escalate into crises and creating a culture of ‘neighbourisms’. Alongside social connection, these housing models also offer a range of benefits such as reduced polarisation, cognitive engagement, skill sharing, reduction of consumption and waste through sharing, and cultural enrichment.

Through my Churchill Fellowship I visited 54 communal housing models (the output, Beyond the White Picket Fence: a companion for communal living, is now available), which are not assisted living or medical facilities, but intentional, relationship-centred housing models that encourage natural social interactions: people care about each other, not for each other. Organic connections, such as bumping into a neighbour while doing laundry, having someone notice if you haven’t been outside in a while, or having a friend do your shopping or cooking after an injury, can have immense preventative health benefits.

Intergenerational communal housing models - such as cohousing neighbourhoods, community-orientated apartment blocks with shared spaces, or homeshare cooperatives - create the kind of social infrastructure that keeps people healthier for longer. Informal social networks naturally emerge: neighbours providing pet or child care to overworked single parents, a teenager who helps an older resident set up a video call with their grandkids, and routine of cooking for one another. ‘Neighbourisms’ - as I outlined in my recent presentation at the Housing LIN’s HAPPI Hour.

A prescription of connectedness

One example of loneliness as a precursor to poor health is malnutrition, which is often framed as a problem of poverty, but there is an overlooked link with isolation. Eating alone reduces appetite and motivation, leading to skipped meals and poor nutrition. Many older adults, especially those living alone, experience malnourishment not because they lack access to food, but because they lack the social structures that make eating a meaningful, routine part of daily life. Communal living settings, where meals can be shared and food culture is valued, can organically counterbalance

this issue.

Studies have mapped the connection between loneliness and poor health in many more areas, for instance, chronic loneliness or social isolation can increase the risk of developing dementia by 50% in older adults, and poor social relationships has been associated with a 29% increase in the risk of heart disease and a 32% increase in the risk of stroke.

Not only are strong relationships one of the main predictors of longevity, but older residents of intergenerational communities consistently told me about the positive impacts of being around younger people on their physical and mental health, describing having young people around as “enlivening and invigorating”, “changing the energy dramatically”, “necessary”, “keeping me young”, and a “tonic”. This is supported by Blue Zones research where strong intergenerational bonds are a recurring feature of places with exceptionally high rates of longevity like Okinawa, Sardinia, and Nicoya. Social environments that include people across generations help to keep older adults physically active, mentally engaged, and emotionally connected. For young people,

growing up in intergenerational spaces can foster a deeper sense of belonging and community, improving mental health and resilience, and broadening webs of support beyond their nuclear family (which increasingly consists of single parent households). Yet, our housing and urban planning systems often separate generations, missing opportunities for these mutual benefits.

Instead of asking about social networks in medical appointments, our health system tends to focus on individual behaviour change, for instance around food and exercise, which is important but often fails to consider the extent to which behaviour is shaped by environment and relationships. Intergenerational living is a structural intervention which can bring long lasting benefits to our health and wellbeing. Connected to this is potential economic benefit. Many people are reliant on professionals for any form of social contact, and without a social safety net, find themselves using public services. According to a poll by the Campaign to End Loneliness, 76% of GPs reported that between one and five patients a day attend their surgery primarily because they are lonely. Investing in social connection is a vital step in reducing pressure on public services through preventing unnecessary escalation of health challenges.

Breaking Down Silos Between Health and Housing

A core problem in public health is that solutions remain siloed. Health departments concentrate on clinical services, while housing teams focus on bricks and mortar. But housing is health. The environments we live in shape how we age, how connected we feel, our exposure to chronic stress, and whether we experience social support or isolation. Housing conditions also directly affect health outcomes, from respiratory illnesses caused by damp and mould to the physical and mental health impacts of cold homes.

As a staff member at Los Angeles’ Anita Rosenstein Campus - which provides housing for LGBTQ+ seniors and youth alongside wraparound support - said to me,

“So often the biggest failure is treating isolated things - housing, mental health, food insecurity. These things are intuitively tie to one another. Looking holistically at health and wellness allows this to work.”

I therefore believe policymakers have a critical opportunity to improve population health while delivering better value for public money by taking a more integrated, preventative approach. Investing in housing models that prioritise social connection and wellbeing is not a luxury - it’s essential public health infrastructure. Recognising housing as preventative medicine could reduce demand on health services, improve quality of life, and address a root cause of health inequalities.

Intergenerational Communal Housing as a Public Health Strategy

So, if we are serious about tackling loneliness, malnutrition, mental health and a variety of other health and care challenges, we should be looking toward creative, cross-sector solutions. From shared meals that prevent malnutrition to shared gardens that encourage social physical activity, communal housing spaces help residents build meaningful relationships that sustain them through life’s challenges. They do not replace formal care services, but serve as a preventative layer that reduces unnecessary health escalations.

Intergenerational communal housing is not a silver bullet, but it is an exciting opportunity area: an intervention that makes people less likely to reach crisis points, and one that can be designed into urban and rural landscapes, as showcased through many case studies in Beyond the White Picket Fence.

Designing for connection should be as fundamental as designing for accessibility or sustainability. By breaking down silos between health and housing, we can create neighbourhoods that don’t just house people, but help them thrive. The places we live shape the way we live, and how long and well we live. It’s time to reignite the lost art of neighbouring, and take intergenerational communal housing seriously as a public health strategy.