NHS HIGHLAND: Loneliness is one of the biggest issues affecting health - but is often hidden
What do we need in life? Finding out what we need and what other people need can be a difficult task. We may think that we need something, and other people may think that we just want it and don't need it.
Within the NHS we spend a lot of time thinking about what people need. The health service was set up more than 75 years ago to meet the needs of the whole population, not just people who were able to pay. This transformed the lives of millions of people, especially those who would otherwise not have been able to have access to medical care.
There was an idea that meeting the needs of the whole population would make everyone healthier and that therefore future need for care would be reduced. Health has certainly improved, but the need for healthcare has also increased.
As some diseases became rarer, others became more common and new treatments were developed to meet new needs. Fewer people now need treatment for infectious diseases such as tuberculosis, but other conditions have become much more common. For example, cancer will now affect around half the population at some time in their lives. What treatment people needed when the NHS was set up was different from what people need now and we should be aware of the constant changing needs in the population.
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As well as having needs for treatment when we are ill, we have many other needs throughout our lives. Some of these are basic needs such as for food and for somewhere to live, while others are more theoretical such as a need to understand the meaning of life.
The American psychologist Abraham Maslow came up with a hierarchy of need which is much used in management courses. This list puts the needs for basics such as food at the bottom, followed by the need for safety and security and then at the top are self-actualisation and transcendence. The idea was that these factors are the needs that motivate people to act and the lower needs have to be met first. Maslow’s hierarchy of need can be a useful way to look at things, but no framework such as this is perfect.
The need for belonging and the need for love is one area where some people have questioned Maslow’s hierarchy. In his scheme it is at the third level, but perhaps it should be a more fundamental element of human need.
We are social creatures, and we have a need to be with others and to interact, to value others and to be valued ourselves. There are few people who are completely happy just with their own company. Just the changes in the world have produced the need for new treatments, changes in society have meant that there are more people on their own and with less contact with others. Loneliness is one of the biggest issues affecting health but is often hidden. Yet we all do have the ability to make new connections, to reduce loneliness and to meet our needs and the needs of others.
Dr Tim Allison is NHS Highland’s director of public health and policy.