Personal relationships
Data, insights and analysis on the ways personal relationships shape our health
Evidence hub home | Family, friends and community | Personal relationships | Community cohesion
Why personal relationships matter for health
Having positive personal relationships is an important factor in maintaining good mental and physical health. Loneliness is associated with a range of psychiatric disorders, such as depression and personality disorders, as well as worse physical health, including cardiovascular disease and early death.
However, the quality of personal relationships also matters for health. Positive relationships can act as protectors against stress and can encourage people to adopt healthy behaviours.
The six charts in this section explore the relationship between personal relationships and health, as well as trends and inequalities in the quantity and quality of personal relationships.
Loneliness and mental health
People who often feel lonely are more than six times as likely to experience poor mental health
- This chart shows the proportion of people experiencing severe psychological distress in 2021–22 depending on whether they often feel lonely or not.
- People who say they often feel lonely are 6 times more likely to experience severe psychological distress (35.2%) than people who do not (5.6%).
The relationship between loneliness and mental health is bi-directional – feelings of loneliness can lead to poor mental health conditions, as well as mental health conditions fostering feelings of loneliness. While this chart shows the relationship between the two, it does not indicate a causal relationship.
Looking at trends over time, the prevalence of severe psychological distress among people who often feel lonely increased significantly between 2018–19 and 2020–21 and has remained at that higher level into 2021–22. Although the rate of severe psychological distress also increased for people who do not often feel lonely between 2018–19 and 2020–21, the increase was less pronounced and in 2021–22 the rate returned to pre-COVID-19 pandemic levels.
This suggests that the experience of loneliness was a contributing factor to worse mental health during the pandemic.
Loneliness and mental health over time
The significant increase in poor mental health during the COVID-19 pandemic cannot be explained by changes in loneliness
This chart shows the proportion of people experiencing severe psychological distress and people who often feel lonely over time.
- The proportion of people experiencing severe psychological distress rose from 7% in 2019 to 9% in 2020 and 10% in 2021 before declining to 9% again in 2022.
- There was no significant increase in the proportion of people who often felt lonely – although the proportion did increase from 12% in 2019 to 13% in 2021 and 2022, this change is not statistically significant.
The relationship between loneliness and mental health is bi-directional – feelings of loneliness can lead to poor mental health, as well as mental health conditions fostering feelings of loneliness.
Perhaps surprisingly, this analysis suggests that the worsening mental health observed during the COVID–19 pandemic was not driven by more people feeling lonely. However, further analysis shows that loneliness was a risk factor in experiencing poorer mental health: those who often felt lonely before the pandemic were more likely to experience severe psychological distress during the pandemic.
We also know that factors other than loneliness contributed to worsening mental health outcomes during the pandemic: eg job and financial losses, housing insecurity and quality, reduced access to mental health services.
Loneliness and social interaction
People who meet family and friends more frequently are less likely to feel lonely
This chart explores the relationship between how frequently people meet their family and friends and whether they feel lonely.
- The proportion of people who often feel lonely decreases the more frequently they come into contact with family or friends.
- People who meet their family members and friends less than once per month are twice as likely to often feel lonely (25%) as people who meet them more than once per week (12%).
- People who meet their family and friends just once per month are more likely to often feel lonely (19%) than people who meet them once per week (14%).
- The relationship between how often a person meets their friends and family and often feeling lonely is largely unchanged from before the COVID-19 pandemic.
Loneliness by gender, age, income, region and disability status
Women, younger people, people with lower incomes and disabled people are more likely to often feel lonely
This chart explores the varying proportion of different social groups that experience feelings of loneliness.
- A greater proportion of women (16%) than men (12%) often experience feelings of loneliness.
- Over a fifth of people aged 16–24 (21%) feel lonely often compared to just 10% of people aged 65+.
- People in households in the bottom fifth of incomes are twice as likely to feel lonely often than people in households in the top fifth – 18% compared to 9%.
- There is also evidence that there are regional differences in how people experience loneliness. Notably residents of Northern Ireland (10%) are less likely to feel lonely often than residents of England (14%) or Wales (16%).
- People who are disabled (23%) are more than twice as likely to often feel lonely than people who aren’t disabled (11%).
- Small sample sizes when breaking down the data by ethnic group don't allow us to draw conclusions on the relationship between ethnicity and loneliness.
Observed inequalities in loneliness existed prior to the COVID-19 pandemic.
Negative relationships and mental health
Having negative relationships with family, friends or a partner is associated with poor mental health
This chart shows the proportion of people experiencing severe psychological distress in 2019–20 according to the number of negative relationship aspects they experience. These include dependability and the presence of criticism and tension in the relationship. A thorough explanation of the aspects can be found in the technical notes. The data is presented by relationship type: partner, family and friends.
- Across all types of relationship, people with more than 3 negative relationship aspects are more likely to experience severe psychological distress than people with no negative aspects.
- Partner relationships make the largest difference – people with more than 3 negative relationship aspects are 4.3 times more likely to experience severe psychological distress than people who have none.
Negative relationships by sex, age, income, region and disability status
The quality of people's personal relationships varies depending on their sex, age, income and disability status
This chart explores the varying proportion of different social groups that have a negative relationship with a partner, family or friends. Relationships are classified as negative if there are three or more negative aspects to the relationship, including dependability and whether there is criticism and tension in the relationship.
- A greater proportion of women (3%) than men (2%) have a negative relationship with their partner. However, a greater proportion of men (2%) than women (1%) have negative relationships with friends.
- Older people aged 65+ (3%) are less likely to have negative relationships with family than people from any other age group. Young adults aged 16–24 (3%) are more likely than people aged 35+ (1%) to have a negative relationship with their friends.
- People in households in the bottom fifth of incomes are more likely than people in households in the top fifth to have negative relationships with family (6% vs 3%) and friends (2% vs 1%).
- There are no substantial differences between regions in terms of relationship quality.
- Disabled people are more likely than non-disabled people to have a negative relationship with their partner (3% vs 2%) and family (7% vs 4%).
- Small sample sizes when breaking down the data by ethnic group don't allow us to draw conclusions on the relationship between ethnicity and relationship quality.
Loneliness and mental health
- Psychological distress is measured using the GHQ-12 assessment tool – a recognised indication of a person’s mental health. It includes 12 questions relating to mood dysfunction, social dysfunction and loss of confidence. Each question has a four-point response scale. Responses are added up to give an overall distress score – people with a score of 20 or higher are classified as experiencing severe psychological distress.
- People are classified as often feeling lonely via both direct and indirect reports of loneliness.
- The direct measure asks people ‘How often do you feel lonely?’. Response options are ‘Often’, ‘Some of the time’ and ‘Hardly ever or never’. People responding ‘Often’ are classified as often feeling lonely.
- The indirect measure is established from three individual questions: ‘How often do you feel isolated from others?’; ‘How often do you feel left out?’; and ‘How often do you feel you lack companionship?’. Response options for all three questions are scored as 3 (‘Often’), 2 (‘Some of the time’) or 1 (‘Hardly ever or never’). If the sum of all three scores is greater than 7, the respondent is classified as often feeling lonely.
- We have combined the direct and indirect measures of loneliness, so people are classified as often feeling lonely if they respond as such in either the direct measure, the indirect measure, or both.
Source: Health Foundation analysis of University of Essex – Institute for Social and Economic Research, Understanding Society, UK, 2021–22
Loneliness by gender, age, income, region and disability status
- People are classified as often feeling lonely via both direct and indirect reports of loneliness.
- The direct measure asks people ‘How often do you feel lonely?’ Response options are ‘Often’, ‘Some of the time’ and ‘Hardly ever or never’. People responding ‘Often’ are classified as often feeling lonely.
- The indirect measure is established from three individual questions: ‘How often do you feel isolated from others?’; ‘How often do you feel left out?’; and ‘How often do you feel you lack companionship?’ Response options for all three questions are scored as 3 (‘Often’), 2 (‘Some of the time’) or 1 (‘Hardly ever or never’). If the sum of all three scores is greater than 7, the respondent is classified as often feeling lonely.
- The direct and indirect measures of loneliness are combined, so that people are classified as often feeling lonely if they respond as such in either the direct measure, the indirect measure, or both. Including both direct and indirect measures of loneliness allows to account for variation in understanding of the term “loneliness” and in willingness to admit loneliness directly.
- Income is defined as monthly net equivalised household income after housing costs.
- People who are disabled are defined as people who have a long-standing illness or disability that causes substantial difficulties in aspects of their daily life.
Source: Health Foundation analysis of University of Essex – Institute for Social and Economic Research, Understanding Society, UK, 2021–22
Loneliness and mental health over time
- Psychological distress is measured using the GHQ-12 assessment tool – a recognised indication of a person’s mental health. It includes 12 questions relating to mood dysfunction, social dysfunction and loss of confidence. Each question has a four-point response scale. Responses are added up to give an overall distress score – people with a score of 20 or higher are classified as experiencing severe psychological distress.
- People are classified as often feeling lonely via both direct and indirect reports of loneliness.
- The direct measure asks people ‘How often do you feel lonely?’. Response options are ‘Often’, ‘Some of the time’ and ‘Hardly ever or never’. People responding ‘Often’ are classified as often feeling lonely.
- The indirect measure is established from three individual questions: ‘How often do you feel isolated from others?’; ‘How often do you feel left out?’; and ‘How often do you feel you lack companionship?’. Response options for all three questions are scored as 3 (‘Often’), 2 (‘Some of the time’) or 1 (‘Hardly ever or never’). If the sum of all three scores is greater than 7, the respondent is classified as often feeling lonely.
- We have combined the direct and indirect measures of loneliness, so people are classified as often feeling lonely if they respond as such in either the direct measure, the indirect measure, or both.
Source: Health Foundation analysis of University of Essex – Institute for Social and Economic Research, Understanding Society, UK, 2018–22
Loneliness and social interaction
- People are classified as often feeling lonely via both direct and indirect reports of loneliness.
- The direct measure asks people 'How often do you feel lonely?' Response options are 'Often', 'Some of the time' and 'Hardly ever or never'. People responding 'Often' are classified as often feeling lonely.
- The indirect measure is established from three individual questions: 'How often do you feel isolated from others?'; 'How often do you feel left out?'; and 'How often do you feel you lack companionship?' Response options for all three questions are scored as 3 ('Often'), 2 ('Some of the time') or 1 ('Hardly ever or never'). If the sum of all three scores is greater than 7, the respondent is classified as often feeling lonely.
- The direct and indirect measures of loneliness are combined, so that people are classified as often feeling lonely if they respond as such in either the direct measure, the indirect measure, or both.
Source: Health Foundation analysis of Department for Digital, Culture, Media & Sport, Community Life Survey, England, 2020/21
Negative relationships and mental health
- Psychological distress is measured using the GHQ-12 assessment tool – a recognised indication of a person’s mental health. It includes 12 questions relating to mood dysfunction, social dysfunction and loss of confidence. Each question has a four-point response scale. Responses are added up to give an overall distress score – people with a score of 20 or higher are classified as experiencing severe psychological distress.
- A measure of relationship quality is constructed using 6 questions that capture individual aspects of relationships: ‘Do(es) your partner/family/friends let you down?’; ‘Can you rely on your partner/family/friends?’; ‘Do(es) your partner/family/friends understand you?’; ‘Do(es) your partner/family/friends get on your nerves?’; ‘Can you open up to your partner/family/friends?’; ‘Do(es) your partner/family/friends criticise you?’.
- For each question, the strongest negative answers are used to define negative relationship aspects. People were classified as experiencing negative relationships if they had 3 or more negative relationship aspects.
Source: Health Foundation analysis of University of Essex – Institute for Social and Economic Research, Understanding Society, UK, 2019–20
Negative relationships by sex, age, income, region and disability status
- A measure of relationship quality is constructed using six questions that capture individual aspects of relationships: 'Do(es) your partner/family/friends let you down?'; 'Can you rely on your partner/family/friends?'; 'Do(es) your partner/family/friends understand you?'; Do(es) your partner/family/friends get on your nerves?'; 'Can you open up to your partner/family/friends?'; 'Do(es) your partner/family/friends criticise you?'
- For each question, the strongest negative answers are used to define negative relationship aspects. Across the six relationship aspects, people are classified as experiencing negative relationships if they have three or more negative relationship aspects.
- Income is defined as monthly net equivalised household income after housing costs.
- People who are disabled are defined as those who have a long-standing illness or disability that causes substantial difficulties in aspects of their daily life.
Source: Health Foundation analysis of University of Essex – Institute for Social and Economic Research, Understanding Society, UK, 2019–20
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