“Sounding the Loneliness Alarm”: Loneliness Problematized in a Nordic Welfare State

Abstract

Countries around the world are embracing loneliness reduction as a matter of public policy. Among the first countries to do so was Norway, which has included loneliness in its public health white papers since 2015. The country released its first dedicated loneliness strategy in 2019 as part of that year’s Public Health White Paper. The Norwegian context proves interesting due to the country’s unique Public Health Act, which acknowledges health inequalities and the country’s solidarity principle in policymaking. The current paper utilizes the What is the Problem Represented to Be (WPR) approach with the aim of exploring problematizations of loneliness in policy and political speech. Our findings reveal that loneliness is problematized as a threat to public health and the sustainability of the welfare state. Stigma-reducing public health campaigns and more research are among proposals at the population level to reduce loneliness stigma. While structural causes of loneliness are at times discussed, interventions address loneliness at an individual level. The authors argue a public health approach to loneliness may unintentionally increase othering and create anxiety in those experiencing it.

Plain language summary

Loneliness policy in a Nordic welfare state

Loneliness has become a policy issue in many countries. Norway was among the first to declare loneliness as an “emerging public health issue” in 2015. Findings from this analysis of policy and political speech from Norway indicate that loneliness is understood as a public health issue and a threat to the sustainability of the welfare state. The authors show how discourses about loneliness have become increasingly medicalized, using epidemiological terms. The population is split into risk groups believed to be more susceptible to loneliness. Attempts to include loneliness in the country’s Public Health Act were intended to insure municipalities are obliged to act, indicating that framing loneliness as a public health issue is more lucrative than framing it as a social policy issue. Loneliness receives cross-party support and represents a moral issue that is difficult to counter. While social and structural issues related to loneliness are described in some of the documents studied, most interventions offered are individualized and short-term in nature.

Introduction

Loneliness has arisen as a public health policy field in several countries. Norway was among the first to take on loneliness as a policy problem, having integrated loneliness into its public policy for many years (Helse- og omsorgsdepartementet, 2019). The Norwegian government committed to a dedicated effort to reduce loneliness in society when it delivered its loneliness reduction strategy as a chapter in 2019’s Public Health White Paper.

Drawing upon Carol Bacchi’s What is the Problem Represented to Be (WPR) framework, this paper presents findings from an analysis of discourses from Norwegian loneliness-centered policies and political speech. The documents studied span from 2014 to 2021. We take two documents as our starting point: the 2018 representative proposal to add loneliness to the Public Health Act and the 2019 loneliness strategy presented in the Public Health White Paper. Our findings indicate the recent wave of loneliness policy presents a public health problematization of loneliness. Loneliness in Norway is understood in epidemiological terms, approaching intervention by targeting risk groups and recognizing loneliness as a risk factor for poor health and early death.

Approaches to solving loneliness in Norwegian policy have evolved over time. Previously, the phenomenon was largely represented as a problem for older adults (Det kongelig helse- og omsorgsdepartementet, 2013; Helse- og omsorgsdepartement, 2011). From 2014, loneliness prevention took a progressively larger role in policymaking, going from a topic receiving brief mention within white papers, to a problem that receives dedicated action plans. Political attention to loneliness and its impact has only grown considering the attention it generated during the Covid-19 pandemic.

The Norwegian context is interesting given the “solidarity principle” in its welfare benefit and service regulations (Kjønstad et al., 2022). In addition, health-related welfare has seen a lift in status, while social care has seen a decline in funding. A public health understanding of loneliness then becomes productive, introducing what was previously understood as a social issue to a more prestigious (and better funded) field with a greater likelihood to be addressed.

Few studies have examined recent political discourses on loneliness. There is additionally a need for an analysis of policy from non-English language contexts. While there is a large literature base on individualized approaches to loneliness, approaches at the societal level are fewer and less-studied (Crowe et al., 2024). To fill this gap, we focus our analysis on population-level interventions in Norway. First, we open with a brief description of the Norwegian context. Thereafter, we provide an overview of loneliness as a public health issue and the use of public health campaigns in combatting stigma before detailing our methodology. We then present our findings and engage in a discussion of them before concluding.

The Context

Norway has a generous welfare state based on universalism. This means that most major benefits are available to residents regardless of income level, in contrast to welfare states across Europe where benefits are largely means tested (Sandvin et al., 2020). Perhaps because of the welfare state’s historical establishment as a project of unity, trust in both the state and one’s fellow citizens is high (Kuhnle & Ervik, 2019). One argument is that the universalized system prevents the creation of an “us” and “them” (benefit receivers) dynamic that can result in negative views of “the other” (Kuhnle & Ervik, 2019). Another argument for universalism is that it fosters social cohesion (Anttonen & Sipilä, 2012). However, the system is not strictly universal, as more generous welfare state provisions are based on a steady employment history (Gubrium & Lødemel, 2014). Needs-based social assistance, the “benefit of last resort,” often leaves recipients in relative poverty (Gubrium & Lødemel, 2014).

Rather than viewing welfare negatively as help for the poor, Norwegians attach meanings of security and the common good to welfare (Sandvin et al., 2020; Vike et al., 2002). Most Norwegians have a positive view of the welfare state and political actors strongly believe in its ability to solve the problems facing its citizens (Vike et al., 2002). Due to targeted social equalization to combat structural issues and inequalities in health, Norway is generally known as a country with a high standard of living, where social and economic inequality are low. Nevertheless, poverty and social inequality has risen in recent years (Goldblatt et al., 2023).

An increase in welfare services is typically politically supported, although concerns about the effective use of limited resources is often blamed for failure of the system to meet users’ needs (Kuhnle & Ervik, 2019; Vike et al., 2002). Preservation of the welfare state is a common goal across parties, (Sandvin et al., 2020; Vike et al., 2002), although rising costs have long been a concern taken up by conservative parties (Vike, 2004). Norway has not endured severe austerity as other countries did following the 2007 economic crisis (Vike et al., 2022). However, there has been a move toward incentivization and activation of groups such as the long-term unemployed and people with chronic illnesses (Gubrium et al., 2014; Gubrium & Lødemel, 2014). Since the 1981 OECD report The Welfare State in Crisis, discourses on individual responsibility and the increased involvement of community groups and NGOs have become part of the political effort to preserve the welfare state (Kuhnle & Ervik, 2019).

Loneliness as a public health problem is particularly interesting in the Norwegian context, given its Public Health Act. The Act on Public Health Work (hereafter Public Health Act) states in Section 3 nr. 2 that public health work should be understood as:

[…] society’s effort to affect factors that directly or indirectly promote the population’s health and well-being, prevent psychological and somatic illness, harm and suffering, or that protect against threats to health, as well as work for a more uniform distribution of factors that directly or indirectly affect health (Ministry of Health and Care Services, 2011).

This definition suggests that public health work is not confined to the health sector and that social factors have direct or indirect effects on health. Social factors are thus included in public health initiatives. Furthermore, the act states that public health work must include the promotion of “well-being,” a broader term than “health” (Ministry of Health and Care Services, 2011). This includes social well-being. Recent research ties loneliness to social inequalities (Beller, 2024), suggesting that a “multisystem approach” to prevention (Crowe et al., 2024) including social and income inequalities could be beneficial in combatting loneliness.

As the preparatory legal work for the act mandates, entities outside the healthcare sector must develop measures that support public health work. One example from this legal preparatory work is the obligation of public authorities at the municipal level to develop measures within and across sectors for health and disease prevention (Prop. 90 L (2010–2011) Lov om folkehelseearbeid (Folkehelseloven), 2011, Chapter 4.4.2 & 13). Research following the act’s implementation at the municipal level found that while municipal governments’ understanding of the social determinants of health has increased, policy measures to address root causes were not put in place. Time-restricted funding for projects at the individual level limits municipalities in dealing with overarching social issues that must ultimately be addressed at higher levels of government (Fosse et al., 2019).

Some have speculated that a stronger welfare state leads to less volunteering, but this is not the case in Norway (Ackermann et al., 2023; Kuhnle & Ervik, 2019). A high percentage of citizens engage with volunteer work each year, with studies placing the rate between 50% (Statistics Norway, 2022) and over 60% (Frivillighet Norge, 2023) of the population. Although the concept of the civil society is weaker in Norway, state and NGOs work together in a complementary fashion (Vike et al., 2022). In Norwegian policy, volunteering among older adults has been constructed as a form of “self-activation” and loneliness prevention. Volunteering is also presented as part of a sustainable social care system as the aging population grows (Ågotnes et al., 2023; Blix & Hamran, 2018; Jacobsen, 2017). Bahl et al. found Norwegian older adults believe the responsibility for well-being lies in individuals, who are expected to contribute to community life. The authors argue individualistic values are replacing communal values of the past (Bahl et al., 2017).

Norway is a long country, with a widely dispersed population. Many assume that those living in rural areas experience more loneliness. However, this seems not to be the case in Norway. A study of Norwegian rural and city-dwelling older adults found 10% of both rural and city dwellers reported feeling lonely. Most participants had strong ties to their local area, with high community involvement (Blekesaune & Haugen, 2018).

Loneliness has also been associated with living alone. The number of Norwegians living in one-person households has risen throughout the years (Sørlien, 2022). Some have speculated this could lead to an increase in loneliness. Although politicians make claims that loneliness is on the rise in Norway, others have discounted this claim, pointing to findings that loneliness is comparatively low in Norway (Barstad, 2021a; Rapolienė & Aartsen, 2022; Svendsen, 2018). Indeed, the phenomenon seems to have increased only among young people (Barstad, 2021a) and during the Covid-19 pandemic (Barstad, 2021a; Hansen et al., 2022), albeit less than in other pandemic contexts (Geirdal et al., 2021).

Although the arrow of direction is unclear, some research suggests loneliness correlates with levels of trust in society (Aartsen & Rapolienė, 2020; Langenkamp, 2023; Rapolienė & Aartsen, 2022; van Tilburg et al., 2021). Trust, along with a strong welfare state, has been argued to protect Norway from higher levels of loneliness (Svendsen, 2018). Recent research finds that loneliness is less common in countries with strong welfare states, in part due to their support for social infrastructure (Swader & Moraru, 2023).

Loneliness as a Public Health Issue

Loneliness is increasingly framed as a public health issue. Previously, loneliness research was primarily taken up by the fields of psychology and medicine, contributing to this phenomenon (Victor et al., 2009). Studies commonly cited by policymakers indicate that loneliness is associated with a greater risk of coronary heart disease, stroke (Abdellaoui et al., 2019; Petitte et al., 2015; Valtorta et al., 2016), metabolic disease, obesity, mental health disorders (Abdellaoui et al., 2019; Petitte et al., 2015), and early mortality (Holt-Lunstad et al., 2010, 2015). With such findings taking prominence in the research literature, it’s not difficult to see how public health policymakers would take notice. However, some of the studies behind these findings have been criticized for methodological and design flaws, for example, for only drawing upon clinical subjects (Das, 2019). These studies nonetheless tend to be cited in policy, media and research discourses uncritically.

In addition to Norway, several other countries have adopted public health policy approaches to loneliness. The United Kingdom (UK), from which Norway has drawn inspiration (Helse- og omsorgsdepartementet, 2019), has released several dedicated strategies from the national government to municipal level, aiming to minimize loneliness health risks (Jentoft et al., 2024). Responding to an increase in suicide rates, Japan appointed a loneliness minister in 2021 (Ryall, 2021). In 2023, U.S. Surgeon General Vivek H. Murthy released an advisory for the country, titled Our Epidemic of Loneliness and Isolation (U.S. Department of Health and Human Services, 2023). That same year, Denmark published its comprehensive strategy stressing the health consequences of loneliness (Det Nationale Partnerskab mod Ensomhed, 2023). Given this continuing trend of addressing loneliness under the public health umbrella, the Norwegian case represents a front runner in loneliness policymaking.

Stigma and Public Health Campaigns

Loneliness is said to be a stigmatized experience by actors in the political sphere. Research findings on stigma and loneliness paint an unclear picture, however. A UK study found older people and women were less likely to see loneliness as a controllable experience. Younger people and men expressed more stigmatizing views of lonely people, accompanied by beliefs that individuals have control over their loneliness. People who were lonely also reported shame and hiding their loneliness from others (Barreto et al., 2022). A study of university students by Lau & Gruen (1992)found lonely people were perceived as less competent and attractive. Researchers have been critical of the methodology used in their study due to the vignettes used, which implied lonely people are unskilled socially, a claim which has been disproven (Kerr & Stanley, 2021). Kerr and Stanley’s attempt to reproduce and expand on their findings found students bore stigmatizing views of lonely people, but the general public did not. They point out that this is a problem, as previous research has mostly used students as research participants (Kerr & Stanley, 2021).

A qualitative study of Norwegian older adults’ understandings of loneliness revealed non-lonely participants tended to hold stigmatizing beliefs, blaming loneliness on character flaws and personal choice (Hauge & Kirkevold, 2010). A similar study of Norwegian older home health care recipients and nurses found loneliness was a subject unlikely to be directly discussed (Birkeland, 2013). Qualitative research by Goll et al. (2015) discovered lonely older adults often minimize their loneliness and avoid seeking help, possibly due to stigma. There is some evidence that fears tied to identity-loss and age-related stigma can also contribute (Goll et al., 2015; Hauge & Kirkevold, 2010).

Health communication campaigns are an important tool in influencing public health. The use of such campaigns has been recommended by policymakers to reduce loneliness stigma. A recent study examined the impact of the British Campaign to End Loneliness among older adults. The findings showed no impact generally, but small changes were observed among higher-income participants (Li et al., 2024). The authors propose that any potential impact may be diminished due to a lack of focus on structural issues associated with loneliness in the campaigns (Li et al., 2024). Other researchers have speculated that anti-stigma campaigns on loneliness, as well as public discourses about the stigmatized nature of loneliness, may act as drivers of stigmatization (Barreto et al., 2022; Kirkevold et al., 2012).

The purported success of mental health stigma reduction campaigns is often used by political actors to support calls for similar campaigns against loneliness stigma. Research examining the success of such campaigns is critical, however. Three reviews found many studies documenting these projects suffered from weak methodology. While short-term shifts in knowledge and attitudes were found, long-term benefits (when studied) proved weak to insignificant (Morgan et al., 2018; Thornicroft et al., 2016; Walsh & Foster, 2021). Furthermore, some interventions may have even caused harm by increasing “othering” effects (Morgan et al., 2018; Walsh & Foster, 2021). This raises questions if loneliness awareness campaigns could increase the “othering” of those who experience loneliness. Some have also criticized public health campaigns for being paternalistic, wasting public funds with ineffective messaging, or for their use as a “red herring” that allows governments to appear as if they are working to improve health without addressing the root causes (Faden, 1987).

Materials and Methods

What is the Problem Represented to Be? (WPR)

Drawing inspiration from Foucault, WPR is a post-structural analytical framework in which policies are regarded as productive, actively constituting the problematizations they purport to solve rather than addressing problems as they exist out in the world (Bacchi & Goodwin, 2016, p. 6). Policymaking then becomes a “problematizing activity” (Bacchi, 2009, p. xi). Attention to the practices in policy as discourse is then attention to the production of knowledges which are forever in a state of flux (Bacchi, 2016).

In recent Norwegian policy, loneliness as a political problematization is typically addressed within the domain of public health. Bacchi presents several critiques of the paradigms that are common within health policy studies, including their tendency to cling to positivist understandings that treat problematizations as if they are givens, or, “readily identifiable” issues that can be solved through policy by determining “what works” (Bacchi, 2012a). Other analysts of policy have focused on “problem setting” and the framing of problems in policy. This may seem similar, but Bacchi is critical of such endeavors, for, although they may interrogate how problems are given shape, they often still cling to notions that problems can be located, measured, and tested outside of their policymaking contexts. This, she argues, limits the ability to contest them (Bacchi, 2016).

WPR differs from other forms of policy analysis in that it does not concern itself with how policy fields emerge, gain importance, are justified, and implemented. WPR is, rather, an exercise requiring the researcher to work backwards from solutions or policy measures toward an understanding of the implicit problematizations these solutions suggest (Bacchi, 2009; Bacchi & Goodwin, 2016). Bacchi (2016) maintains that what policymakers believe needs to change (the problem) is implicitly embedded in the solutions they propose. Further, she encourages consideration of silences and assumptions in policy, as well as the potential consequences of conceptualizing a “problem” in a particular way (Bacchi, 2012a). Bacchi (2009, 2012a) invites researchers to envision how the proposals might differ, given other problematizations.

Our analysis procedure was inspired by LeGreco and Tracy’s discourse tracing method. Developed specifically for policy analysis and influenced by Foucault’s project of archeology and grounded theory, LeGreco and Tracy (2009) present a four-phase structure for the analysis of discourses which offers transparency and a clear procedural method of analysis. The procedure involves starting with a “rupture,” or a turning point. This can be something as simple as a new policy. In the early phases, one engages with broad range of sources as one develops a corpus and gains insight into contextual nuances, all while taking note of potential patterns and recurrent themes. A chronological analysis of the data is key to discerning changes in patterns of discourse across time. One step of analysis for in discourse tracing entails asking questions of the data. We found this dovetails well with WPR, which provides a set of questions for researchers to explore (LeGreco & Tracy, 2009). The steps we followed in alignment with discourse tracing are illustrated in Figure 1.

Figure 1.

Analysis process merging discourse tracing (LeGreco & Tracy, 2009) and WPR Bacchi (2009).

The analysis was performed by the first author on a corpus containing a broad array of political documents ranging from white papers to amendment proposals to government reports to debate transcripts and statements made by policymakers to the press from 2014 to early 2021. Documents were procured via searches for “ensomhet” (Bokmål Norwegian) and “einsemd”/“einsam” (New Norwegian) on www.regjeringen.no and www.stortinget.no. For statements to the press, the same search terms were entered into Google News. Some documents were discovered through their mention in other documents. Documents and blogs issued by Norwegian think tanks were also included. A total of 164 documents were included in the analysis for this paper. The first author conferred with the second author continuously throughout the analysis process. The Norwegian Act on Public Health, the Norwegian Act on Social Security and accompanying preparatory works were analyzed by the second author. The analysis took its starting point in the 2019 loneliness strategy as an anchor as we became acquainted with this policy field in the Norwegian context. The corpus consists of publicly available official documents and media articles with statements from public political figures. Because of this, ethical approval was not required.

The documents were first given a primary read-through and initial observations on possible patterns of problematization and themes to pursue were noted. Documents were then imported into NVivo and coded according to prominent themes from the first round of analysis, in line with discourse tracing (LeGreco & Tracy, 2009). From these, subthemes were developed and used as a form of categorical sorting to create order and gain an overview of a large volume of texts.

As salient themes and patterns in the texts became apparent, data excerpts were compiled in a Microsoft Word document according to dominant themes. The practices and proposed interventions related to these themes were examined to explore what these interventions might reveal about the problem they are intended to solve. One relevant overarching theme for this paper included “loneliness as a public health issue,” which contained subthemes of “risk,”“physical health” and “mental health” among others. Another example is “the problem of stigma” which included subthemes of “a national conversation” and “public health campaigns.” We performed an “integrated analysis” on these excerpts, using questions from WPR as a backdrop for probing the nature of the problematizations in the text (Bacchi, 2009). Quotations presented in the results section were translated by the first author (except when official government translations existed) and are illustrative of patterns discovered in the texts.

Results

The Shift Toward a Public Health Problematization of Loneliness

Our analysis reveals that over the period studied, loneliness played a progressively larger role in Norwegian policymaking, primarily conceptualized as a public health problem. In 2015, loneliness received dedicated attention as an “emerging public health field” in the public health white paper Coping and Possibilities (Mestring og muligheter) section on mental health (Helse- og omsorgsdepartementet, 2015).

That same year, Conservative (Høyre) party member and Minister of Health and Care, Bent Høie, wrote a blog entry for the charity Mental Health (Mental Helse) titled “An Important Vaccine.” In it, he states:

There is a vaccine that protects against a number of illnesses. It has no side effects and is well-researched. Community (felleskap) is what it’s called. Loneliness must be prevented outside of the doctor’s office and hospital corridors (Høie, 2015).

The blog also presents the now common claim that loneliness is as dangerous as smoking 15 cigarettes per day. Høie (2015) counterintuitively suggests loneliness prevention has no place in healthcare settings, but rather, belongs in the civil sector, mirroring speech found in that same year’s public health white paper. Loneliness as a public health issue thus becomes a problem that should be solved by communities, taking a preventive health approach, in which behavioral change allays future harm.

In another pivotal example, Conservative party member Bente Stein Mathisen draws attention to statistics that indicate a high prevalence of loneliness among older and younger Norwegians in a parliamentary debate. She stresses, “Research says that [lonely people] risk a worse life and an earlier death, exactly as it is for smokers. That’s why it’s not so strange that the Minister of Health has sounded the loneliness alarm” (Stortinget, 2015). By utilizing the term “loneliness alarm” she evokes an emergency requiring urgent action.

An additional shift seems to have occurred within this period, in which loneliness emerges as a problem which can affect people of all ages and life circumstances from time to time. The young, the old, immigrants, disabled people and people living in poverty are said to be at increased “risk” (Helse- og omsorgsdepartementet, 2015). In the 2019 strategy, this same wide range of lonely subjects is broadened to include people living alone, the chronically ill, and victims of traumatic experiences (Helse- og omsorgsdepartementet, 2019). Thus, the number of subject positions available when it comes to loneliness has expanded to encompass many more segments of the population. The one exception is the omission of immigrants in the 2019 loneliness strategy, although they are mentioned in other public health contexts in the white paper (Helse- og omsorgsdepartementet, 2019).

In earlier documents, the primary solution for loneliness is volunteering. “Social support is the opposite of loneliness,” the opening chapter of the 2015 public health white paper says. “It’s about receiving love and care, to be respected and appreciated and to belong to a community” (Helse- og omsorgsdepartementet, 2015, p. 9). Mobilization of volunteers is constructed as building social support, stating, “Volunteering creates joy, well-being, belonging and advances health and democracy” thus creating value, not only for those on the receiving end, but for volunteers and society as a whole (Helse- og omsorgsdepartementet, 2015, p. 29). Volunteering becomes both a supplement to health and care systems and an activity which creates health and well-being. While volunteering remains an intervention, later documents call on increasingly more complex solutions. This seems to suggest that although volunteering levels among the Norwegian population remain quite high, loneliness is a problem of not enough (lonely) people volunteering.

A less common problematization arises in a 2018 parliamentary debate when Socialist Left party member Nicholas Wilkinson problematizes loneliness as arising due to cuts in home health hours and the denial of nursing home placement to older people due to capacity issues. This, he says, means that they sit alone, too sick to access social activities. He states, “It is not just the health services it’s about, it’s also about [ensuring] older people can live together, have a good time together” (Stortinget, 2018b). This conceptualization of nursing home placement as providing opportunities to alleviate loneliness diverges from other discourses in Norwegian policy which stress the importance of older people living independently (Christensen & Pilling, 2019; Jacobsen, 2015, 2017).

Also in 2018, a group of Labour party parliament members introduced a proposal with the primary objectives of adding loneliness to the Public Health Act and measuring the effectiveness of interventions (Dokument 8:133S (2017–2018), 2018). The proposal continues claims that loneliness has important health implications. Simultaneously, there is ambivalence around this problematization, as demonstrated in the following quote: “The authors of the proposal believe that it is important that one talks about loneliness without it being made into an illness (uten at det sykeliggjøres)” (Dokument 8:133S (2017–2018), 2018).

The Health and Social Care Committee’s evaluation of the proposal states that home healthcare workers and general practitioners have a “responsibility to uncover loneliness because they have extended contact with residents in the municipalities, but we all have a responsibility to include others in our social network” (Helse- og omsorgskomiteen, 2018, p. 2). There is clearly tension in the public health discourse at this stage. In some instances, loneliness is, like many diseases, depicted as something initially hidden, to be revealed by the healthcare practitioner’s expertise. In others, the importance of not treating loneliness like a disease is stressed, instead linking loneliness to inclusion in social networks.

Social determinants of health, such as income, education, inequality, and their relation to loneliness are mentioned in the proposal, as are levels of trust in society (Dokument 8:133S (2017–2018), 2018). In the debate that preceded a vote on the proposal, Center party member Kjersti Toppe reveals that codifying loneliness in the law “means that the municipalities are mandated by law that public health work must use all sectors to promote public health and not just the healthcare sector” to combat loneliness. However, she also illuminates how a national audit found that municipalities were already failing to address public health issues outside of the healthcare system (Stortinget, 2018a).

The proposal failed to pass, despite agreement on its general intent across parties (Voteringsoversikt-Innst.225S-133S, 2018). Olaug V. Bollestad of the Christian Peoples Party (Kristelig Folkeparti) defended her party’s vote against the change, stating, “This is a large field, where we politicians must work across disciplines.” She added that more than a paragraph in the public health law is required to remedy a society she claimed had “become cold,” excluding certain groups and falling out of alignment with Norwegian values. This signals that society-wide changes in Norwegian culture and values are believed to be related to the problem (Stortinget, 2018a).

Bollestad’s view seems to contradict Toppe’s understanding of the law. In accordance with Toppe’s understanding, the Norwegian Public Health Act requires broad, interdisciplinary, and cross-sector approaches. In Section 3 nr. 2, the law maintains that public health work should be understood as “society’s effort to affect factors that directly or indirectly promote the population’s health and well-being, prevent psychological and somatic illness, harm and suffering, or that protect against threats to health, as well as work for a more uniform distribution of factors that directly or indirectly affect health” (Ministry of Health and Care Services, 2011). This definition of public health work suggests it is not to be confined solely to the healthcare sector. As the preparatory legal work maintains, entities outside the healthcare sector have responsibilities and must develop measures that support public health work initiatives. One of many examples in the legal preparatory work pertains to the planning sector of municipalities. Here, the large variety of public authorities at the municipal level are legally obliged to plan for measures within and across their sector to enhance health and prevent illness (Prop. 90 L (2010–2011) Lov om folkehesearbeid (Folkehelseloven), 2011, Chapter 4.4.2 and 13).

Nevertheless, more comprehensive public health policy on loneliness would arrive soon after. An entire chapter within the following year’s public health white paper, Good Lives in a Safe Society (Gode liv i eit trygt samfunn) (Helse- og omsorgsdepartementet, 2019), was devoted to loneliness reduction, forming Norway’s first loneliness strategy. The Norwegian strategy repeats previous claims that, “[Recent studies] have found that loneliness can lead to increased mortality and must be counted as a risk factor similar to obesity, smoking and physical inactivity” (Helse- og omsorgsdepartementet, 2019). Here and elsewhere in the corpus, loneliness steadily becomes represented as a threat to health and a risk factor for non-infectious and infectious disease, and mental health. In this quote we also gain insight into how this representation of the problem emerged, namely, through exposure to epidemiological research findings that point to a correlation between loneliness and poor health.

Along with claims that certain risk groups are more likely to experience loneliness, the Norwegian strategy states that certain situations can put one at risk for loneliness:

There is a lot that indicates that loneliness is not generally an age-related problem, but that it is rather tied to different life situations and life changes that can also give a high risk for a lack of social support. The disabled and people who live in households with relatively low incomes often lack social and emotional support (Helse- og omsorgsdepartementet, 2019).

Although this seems to point to a relationship to social determinants of health, loneliness among people in low-income households and people with disabilities is here constructed as a problem of failed interpersonal relationships and support. This seemingly individualizes the problem.

An alternate problematization of loneliness as a problem of poverty, disability and cuts to unemployment/sick pay is offered by a coalition consisting of the Labor, Center and Socialist Left parties in an addendum to the 2019 Public Health White Paper:

These members point out that economic inequality and the possibility for participation are also decisive factors in the work against loneliness. […] These members point out that loneliness is prevented by creating the conditions for stronger community (felleskap) and securing the most possible access to activities and meeting places, regardless of economic or social standing (Helse- og omsorgskomiteen, 2019).

Here, ties are constructed between loneliness, economic insecurity and public health in a way which is largely silent in the strategy itself. In this formulation, loneliness becomes an issue of social exclusion due to financial insecurity. This points to an alternative discourse of loneliness as not simply a problem that impacts the poor and disabled due to weak social networks, but also due to structural issues that impede their ability to engage with society on equal footing. This implies that the reason people living in poverty are unable to participate in social life has more to do with a lack of disposable income which would permit them to engage in activities, not weak social relationships.

As may be expected from a public health construction of loneliness, a focus on population level measurements and research resulting in evidence-based solutions arise as primary objectives. For example, an appendix to the proposition to add loneliness to the public health act suggests that a “quality indicator” should be developed to measure loneliness and the effectiveness of interventions set forth. An indirect measure of loneliness frequently used in Norway is the survey question asking whether an individual has a close confidant (fortrolig venn) (Helse- og omsorgskomiteen, 2018). However, another quote from Center party member Kjersti Toppe illuminates how both the Institute of Public Health and the municipalities are uncertain of what is effective to combat loneliness. Certain interventions are favored regardless of evidence of their effect, she claims:

One has too little knowledge of the effects of different interventions, but one experiences that it’s easier to set interventions in motion that are directed toward living habits, such as physical activity, than interventions directed toward the underlying causes that lead to social inequality (Stortinget, 2018a).

Here she implies that interventions that foster individual change are more realistic in terms of implementation than more complex social change that would impact the social determinates of health said to play into loneliness.

The Problem of Loneliness Stigma: Toward a National Dialog

Construing loneliness as a public health problem necessitates raising public awareness about its harms. The Norwegian strategy calls for increased visibility for loneliness as a public health challenge as one of its primary population-level objectives (Helse- og omsorgsdepartementet, 2019). As with mental health campaigns, the proposed loneliness public health campaigns surface an additional problematization: loneliness is a stigmatized experience few talk about, and some are too ashamed to seek help for.

In this quote from a supplement accompanying a report from the Health and Care Committee on the proposal to include loneliness in the Public Health Act, we hear how loneliness is invisible in society due to stigma:

The committee believes one of the biggest challenges with loneliness is to locate those who are lonely because lonely people seldom tell others about their loneliness. To break down taboos around loneliness is therefore important work in the struggle to fight loneliness (Dokument 8:133S (2017–2018), 2018).

Here, changing the discourse on loneliness to remove taboos becomes a public health intervention. This presents an underlying problem related to stigma: that it may be difficult to determine who is lonely and thus offer assistance. Lonely individuals may not seek help because they are ashamed to confess that they are lonely.

Similarly, in a 2018 parliamentary debate, Minister of the Elderly Åse Michealsen states:

We must be clear about the taboos. The talk about it is there. But there are also many people who are lonely even when they are in a social setting; they are lonely inside. That is not often spoken of, because it’s easy to only see single people who feel loneliness. We have not spoken about precisely that psychological challenge of being lonely in the crowd (ensom i flokk)… (Stortinget, 2018a).

We see in this quote that the archetypical lonely person is discussed in public, while those who feel lonely regardless of their social situation are not present in the public discourse. The implication is that this type of loneliness is more stigmatized than other situations, where loneliness is normalized.

However, efforts to normalize loneliness can carry risk. In a 2015 parliamentary debate, member of the Conservative party Bente Stein Mathisen shares:

Several young people this spring have stepped forward and shared their stories about how it is to be lonely. One received many “likes” on Facebook for a post where she described her loneliness. Many could relate. Some said that they didn’t dare to “like” [the post] because they feared that someone would think they are also lonely. That says something about how stigmatizing loneliness is and how important it is that there is more openness about the subject (Stortinget, 2015).

Here, we see how sharing loneliness results in shows of support for young people in the form of “likes” on Facebook. Still, others were reluctant to respond. Although many could identify with the experience shared, few wanted to be perceived as lonely themselves.

As a remedy, the policy advocates for public health campaigns against loneliness. It is suggested that this tactic has worked with mental illness and will thus work with loneliness. The 2019 loneliness strategy states:

Mental illness and loneliness are often taboo and can be difficult to talk about. Throughout many years, we have tried to change this, such that it is no longer taboo to speak about mental illness. Today there is more openness about mental health and there is a lower threshold to ask for help when life is difficult. This development is going in the right direction. […] Just as there was the effort for reducing stigma with mental illness, there is a need for a similar effort against loneliness (Helse- og omsorgsdepartementet, 2019, p. 43).

Simultaneously, such campaigns are described as another way of integrating mental health issues into the public health agenda. This pattern of associating loneliness with mental illness is found throughout the corpus despite efforts to stress that loneliness should not be considered an illness. Because of this pattern, loneliness may become equated with mental health disorders, with the sufferer taking on a similar stigma.

The voluntary sector is also brought in through an emphasis on campaigns to mobilize, share information about volunteer opportunities and work together with private actors to “create good local communities” and meeting places (Helse- og omsorgsdepartementet, 2019, p. 44). The strategy recommends that the government draw from experiences from the “An open mind” (Et åpent sinn) campaign for mental health awareness and the British “Campaign to End Loneliness.” Additionally, it highlights other interventions in the UK like Men’s Sheds, a program that brings men together to build things for the local community (Helse- og omsorgsdepartementet, 2019). However, there is little indication that this intervention has been introduced in the Norwegian context.

Statements from the strategy suggest that in addition to reducing stigmatization of loneliness, the importance of social support must be emphasized. Yet again mirroring the English strategy, the 2019 Norwegian strategy states that a “national conversation” (nasjonal samtale) is required: “To reach as many as possible, but especially those who are most lonely, the government will release campaigns that shine a spotlight on loneliness and how important social support is” (Helse- og omsorgsdepartementet, 2019, p. 43). A national conversation is also envisioned as informing communities, municipalities, employers, and the private sector on how they can help. It also suggests that a broad array of actors is needed to carry out the work of loneliness reduction. This statement appears to assume that social support is not understood by the public to be of importance, and thus attention must be drawn to the value of “community” (felleskap).

In a 2020 digital address at the central board meeting of the Conservative party during the Covid-19 pandemic, Prime Minister Erna Solberg tied the stigmatization of loneliness in society to the previous problem of loneliness as a problem of public health. She stated:

When we are lonely, our immune system is weakened. We are more prone to illness. In the same way as other mental disorders, there is still much shame associated with loneliness. It takes bravery to say that you’re lonely. And it’s hard to be brave when you’re not doing well (Iversen & Tveten, 2020).

As can be insinuated from Solberg’s speech, loneliness was occasionally constructed as a problem that could compound the pandemic by weakening immune systems. Indeed, throughout the pandemic, loneliness and Covid-19 were depicted as simultaneous and related public health threats due to lockdown conditions.

Discussion

In our analysis, we utilized WPR (Bacchi, 2009, 2012a; Bacchi & Goodwin, 2016) as a tool to probe and challenge political discourses on loneliness in Norway. In the following, we discuss the effects and unintended consequences that may be produced through constructing loneliness in particular ways. We also seek to uncover that which remains unarticulated and taken for granted in the dominant Norwegian political discourses. In doing so, we must attend to the practices that forge these problematizations (Bacchi, 2012b).

One such practice is itself the induction of loneliness into the realm of public health. Zola once called attention to an expanding “medicalizing of society,” in which “medical rhetoric and evidence [can be used] in the arguments to advance any cause” (Zola, 1976, p. 221). This pattern can clearly be seen in recent discourses on loneliness. What once was constructed as a private social problem faced by older adults, has been reconceptualized as a medicalized problem that affects increasingly broader risk groups. This problematization is not entirely new. In fact, references to loneliness as a population illness (folkesykdom) in Norwegian debates can be found as far back as 2007 (Stortinget, 2007). This problematization has, however, become the dominant one. As a result, loneliness emerges as an object to be measured and controlled through “effective interventions” as a biopolitical project.

Neutralizing the threat of loneliness to health and well-being through prevention and intervention becomes paramount to both preserving the health of a nation and the viability of its welfare state. Accurate knowledge of how many citizens “suffer” is therefore critical. This enables government to recognize the scale of the interventions required and administrate a lonely sub-population that must be “controlled, taken care of, [and] made to flourish” (Dreyfus & Rabinow, 1983, p. 170). Through the public health problematization, loneliness is placed on a societal, population level, where social determinants of health are tied to the experience. The public health discourses on loneliness offer another example of how life is increasingly medicalized, “serving to monitor and administer the bodies of citizens in an effort to regulate and maintain social order as well as promoting good health and productivity” (Lupton, 1997, p. 100). Over time, public health discourses have advanced toward a prevention paradigm and an understanding of disease as arising due to individual “lifestyle choices” (Bacchi, 2009). Similarly, loneliness becomes individualized, with policymakers offering responses that encourage individual action through what Foucault terms “practices of the self” (F. Foucault, 1984). This despite calls to come together to “fight” loneliness.

Loneliness Risk Reduction as a Practice of the Self

Several forms of risk can be identified in loneliness governance. The dominant form is what has been called “epidemiological risk.” Epidemiological risk places its focus on morbidity and mortality, stemming from a rationality where risk calculation occurs at the population level. Potential threats to population health are then met with public health interventions (Dean, 1998). Epidemic thinking gives rise to “a logic of crisis which structures and justifies the regulation of social relations and social production” (Reid, 1999). Perhaps never has this been clearer than in the making of loneliness as a problem of “epidemic proportions.”

The comparison of loneliness to health risks like obesity in the corpus is interesting in this regard. Like loneliness, obesity was previously believed to be a product of personal deviance but has since become a matter of medical concern on the public health level (Sobal, 1995). Similarly, citizens are encouraged to conduct themselves in such a way that they minimize the potential for disease or early death (Lupton, 1997). In the case of loneliness, it is by being mindful of their own and others’ social needs for the sake of physical health, sustained productivity and longevity. As Lupton argues, preventative measures may help an individual avoid one form of medicalization, while simultaneously taking up another form in minding themselves through self-care (Lupton, 1997). With loneliness, self-care includes the care of one’s interpersonal relationships.

Epidemiological risk warrants medical screening and surveillance to reduce perceived looming pathologies through interventions that modify human behavior and eliminate risk factors (Castel in Dean, 1998), in this case, loneliness. Norway has longitudinal survey data on loneliness extending back several decades (Svendsen, 2018) and researchers have drawn attention to the fact that loneliness has never been particularly “prevalent” nor “on the rise” in Norway’s general population (Barstad, 2021a; Svendsen, 2018). Regardless, epidemiologists are recruited in the strategy to re-examine data on well-being in Norway, determine how many people are lonely and develop new measures for future surveys (Helse- og omsorgsdepartementet, 2019). An effect of this problematization is that it directs funding toward a problem which is already well-documented. But fighting loneliness, with its cross-party support and high profile in the media, is appealing for its moral connotations, and funding research is one way of projecting a proactive stance.

Risk associated with loneliness becomes a special kind of governmentality, it “represents events in a certain form so that they might be made governable in particular ways, with particular techniques and for particular goals” (Dean, 2010, pp. 205–206). Risk attached to loneliness produces loneliness as a governable object, and the medicalization of loneliness makes risk-attachment possible. Without some form of risk to the common good, in this case the populace’s health and well-being along with maintenance of the welfare state, governance of the loneliness object is less amenable to political solutions. Risk gives governance a rationality; indeed, risk made the welfare state possible as a “technology of solidarity” (Dean, 1998).

Public Health Campaigns

The use of communications campaigns to spread the word about health risks and the personal actions one can take to mitigate the risks is a common tool in public health management (Faden, 1987). Health education can undoubtedly be viewed through a lens of biopower (Gastaldo, 1997). Campaigns which aim to remove stigma from a health issue are less common. Although Norwegian policymakers stress that loneliness should not be considered a mental health disorder, anti-stigma campaigns for mental health are drawn upon as examples of how stigma against loneliness could be reduced via awareness campaigns. However, while these mental health campaigns are lauded as a success in loneliness policy, the true impact of mental health stigma reduction campaigns is little understood in terms of their degree of effectiveness and long-term impact (Morgan et al., 2018; Thornicroft et al., 2016; Walsh & Foster, 2021).

The design of such campaigns may have unintended consequences, like inadvertently enhancing stigma (Morgan et al., 2018) or leading to an “othering” of already stigmatized individuals (Walsh & Foster, 2021). Campaigns about loneliness often paint a dreary picture of loneliness by emphasizing negatives and the need to eradicate it (Barreto et al., 2022). Previous loneliness initiatives primarily depicting older adults as lonely may have continued a common fallacy that loneliness is an inevitable feature of aging, perpetuating ageism. Initiatives have also been criticized for their failure to address the structural causes of loneliness (Li et al., 2024), instead portraying loneliness primarily as an individualized issue.

Research from Barreto et al. suggests that young people carry more stigmatizing views against loneliness than older people. The authors suggest this may be because loneliness is normalized among older people. However, they also theorize that lonely young people may carry more loneliness-related shame because loneliness among young people is not normalized (Barreto et al., 2022). While this could be seen as an excellent argument for a normalizing campaign targeted at young people, the Facebook post example from our findings suggests that some young people might be reluctant to engage with loneliness-related content.

Epidemiological thinking additionally gives rise to a rationale in which personal disclosure of one’s carrier status is encouraged (Reid, 1999), in this case, as a bearer of loneliness. Although not as prominent as in policies and campaigns in the UK (see The Campaign to End Loneliness and #Let’s Talk Loneliness for examples), policymakers also imply that the individual should publicly profess their loneliness in the interest of increased visibility. We should all know who is lonely. Confession serves as a communication tool to “circulate knowledge” about bodies, attaching them to the “social body” (Gastaldo, 1997, p. 115). As in the case of sexuality, “bio-power spread[s] its net down to the smallest twitches of the body and the most minute stirrings of the soul,” specifically through the “confession of the individual subject,” whether that confession emerges through self-reflection or in public discourse (Dreyfus & Rabinow, 1983, p. 169). One becomes “an object of knowledge, both to himself and to others, an object who tells the truth about himself in order to know himself and be known, an object who learns to effect changes on himself” (Dreyfus & Rabinow, 1983, pp. 174–175). The result is a subjectification of the self as a lonely individual who not only dutifully seeks help to relieve their loneliness, but additionally makes a public proclamation in the interest of constituting loneliness as a less taboo subject. However, such public proclamations come at the risk of being viewed (and potentially treated) differently by one’s peers.

The construction of loneliness in terms of health risks can have other types of effects upon those who identify as lonely, such as increasing anxiety. Awareness that loneliness may impact health in negative ways could create stress as much as it could drive individuals to seek help. Reconsidering loneliness’ frequent pairing with mental illness within this discourse may also be in order. While strides have been made toward destigmatizing mental illness, much is still to be done. Tying an already stigmatized emotion to a stigmatized group of conditions is not certain to help. But also, as is the case with obesity, the discourse could individualize the problem to the extent that seeking help becomes a moral issue.

Individualizing and Dividing Practices Meet Structural Causes

Through the concept of risk, a “population whose health is endangered in a common, though individualized, way” emerges (Harding, 1997). The division of the population into “risk groups” for loneliness results in an objectivization of individuals, making individuals subjects through what Foucault calls “dividing practices” (M. Foucault, 1983). Foucault offers two definitions of the subject as: “subject to someone else by control and dependence, and tied to his own identity by a conscience or self-knowledge,” both of which become avenues for the exercise of power (M. Foucault, 1983, p. 212). While some are at higher risk, policy makes clear that anyone can experience loneliness, creating a risk that “never completely evaporates” (Dean, 1998, p. 35). This means that all must be vigilant, not only looking out for lonely people in their community but attending to one’s own loneliness. Furthermore, the constitution of lonely subjects could create what Hacking calls “looping effects,” a form of feedback loop in which subjects are impacted by and thus conform to constructed categories of human types (Hacking, 1999). In this case, it means taking on constructions of what lonely individuals are and the responsibility to act or jeopardize their health.

The public health-oriented discourse problematizes loneliness as an issue facing “vulnerable” risk groups. One unintended effect may be that some risk group categorizations individualize a societal/structural issue. Apart from the one example from the left-wing opposition parties, the financial strain that limits participation in social life, and the stigma these groups face is largely silent in the problematization of poverty, old age and disability as loneliness risk factors. That functional barriers (such as a lack of ramps for wheelchairs, accessible bathrooms, or sign language interpreters) prevent the disabled and elderly from engaging in social arenas is also missing from the discourse. As a result, a structural issue becomes an individualized concern in which a poor or disabled persons’ social networks are just inherently weak. The disabled and poor become represented as “vulnerable” solely because of their being disabled and/or poor, rather than a lack of accommodations and financial security. Additionally, there is evidence for an emerging cultural emphasis on individual responsibility and control over ones’ own health and well-being in Norway (Bahl et al., 2017; Bringedal & Feiring, 2011; Hervik & Thurston, 2016). This may result in less support for programs that help those who are expected to be able to help themselves.

Loneliness has been tied to social inequality in more recent research (Aasan et al., 2024; Beller, 2024) and authors advocating for a public health approach to loneliness call for robust solutions that tackle socioeconomic and systemic issues at play (Crowe et al., 2024). However, solutions to structural barriers and stigma are more difficult to enact than short-term programs that provide opportunities, but do not counter the causes of social exclusion at their root. Examples from the strategy include a vacation program to fight social exclusion that ensures young people from low-income households can go on vacation and collaboration with charities to ensure all children can participate in at least one free-time activity (Helse- og omsorgsdepartementet, 2019, p. 45). Short-term projects such as these do little to reduce the core issue of increasing levels of poverty in Norway. Rather than reinstating previous levels of income and support for these groups, the loneliness strategy opts for funding short-term solutions (Helse- og omsorgsdepartementet, 2019). This type of policymaking represents what Scott-Samuel and Smith call “an impossible dream in which the long-established social gradient in health is gradually flattened via a series of downstream interventions and policies” (Scott-Samuel & Smith, 2015). As other research has shown, when government seeks to ameliorate public health issues rooted in “wicked problems,” individualized approaches focused on behavioral change and short-term projects are frequently implemented over necessary broader societal changes (Fjellfeldt, 2023; Fosse et al., 2019; Mackenzie et al., 2020). We also see this in continued efforts to mobilize volunteers, generate public awareness and create intergenerational meeting places.

Norway’s Public Health Act is unique in Europe because of its broad understanding of social determinants of health and the mandate it creates for government to act across sectors (Fosse et al., 2019). Financial insecurity leading to social exclusion is also indirectly recognized by the Norwegian Law on Social Security section 1-1 (Arbeids- og inkluderingsdepartementet, 2023). One stated aim of social security benefits is to equalize living conditions throughout the individual’s life course and between groups of people. The idea is that financial security counteracts harmful living conditions. Though not explicitly stated, this also includes harmful living conditions that lead to social exclusion and loneliness.

The preparatory legal work on the Norwegian Act on Social Security states that the Norwegian social security scheme is based on mutual insurance and social distribution (Sosial- og helsedepartementet, 1995 chapter C section 1-1). The aim of social distribution expresses principles of solidarity and re-distribution; values that the social security scheme, and the Norwegian welfare state, are based upon (Kjønstad et al., 2022). Although legal norms in Norway express these principles, workfare policy and low benefits indirectly lead to a challenging living situation for recipients (Gubrium & Lødemel, 2014). Workfare policy programs support another aim described in Section 1-1 of the Norwegian Act on Social Security: the aim of “help to self-help” (Arbeids- og inkluderingsdepartementet, 2023). Increasingly, more weight is given to the individual’s responsibility to engage in self-help, than community and solidarity. This could be because translation of policy from national to regional levels has demonstrated that regional government cannot fix structural issues. They are thus forced to rely upon more easily-implemented individualized interventions (Fjellfeldt, 2023; Fosse et al., 2019). Additionally, by ensuring social assistance remains uncomfortably low, an effort believed to incentivize return to the workforce, some individuals will struggle to have the means to become reintegrated into their communities. We suggest that the Norwegian society’s values of solidarity and re-distribution of wealth seem to have lost some of their impact compared to the value of being self-sufficient.

Immigrants in Norway report more loneliness than the general population (Barstad, 2021a, 2021b; Madsen et al., 2016). Yet, loneliness among immigrants is only problematized in a section on improving the health and quality of life of older adults in the 2019 public health white paper, not within the loneliness strategy itself (Helse- og omsorgsdepartementet, 2019, p. 76). Elsewhere it is specified that immigrants are among those with the lowest income levels and employment in Norway, along with worse overall health (Helse- og omsorgsdepartementet, 2019, pp. 54, 59, 71), factors said to contribute to loneliness in the strategy. Specific interventions to help immigrants with their loneliness are not detailed. Given that language barriers are often related to loneliness in immigrants (Bruland et al., 2023; Kirova, 2001; Nortvedt et al., 2016), language cafes could double as loneliness interventions. Social determinants of health and economic strain may also contribute to social exclusion in this group (Bruland et al., 2023; Nortvedt et al., 2016). Additionally, immigrants in Norway have reported less trust in their fellow citizens than native Norwegians (Støren, 2019), something which is said to correlate with loneliness (Aartsen & Rapolienė, 2020; Langenkamp, 2023; Rapolienė & Aartsen, 2022; van Tilburg et al., 2021;). While there is a push toward integration in broader Norwegian society, and identification with the host culture is of importance, the value of immigrant communities should not be underestimated in loneliness prevention (Madsen et al., 2016).

Another group that is said to experience more loneliness than the general Norwegian population is LGBTQ+ people (Anderssen et al., 2020; Eggebø et al., 2015; Gram, 2021), yet they are absent from the loneliness strategy. The sole mentions of this demographic in the 2019 public health white paper are in sections regarding sexual health and mental health, and only in the context of loneliness in those with a “non-western” background. This is unfortunate, considering that research has demonstrated how loneliness may be correlated with sexual risk taking in this population, suggesting that loneliness prevention could be understood in relation to sexual health (DeLonga et al., 2011; Peterson et al., 2020). Social determinants of health and economic strain are also a well-documented issue with this group (Gram, 2021). Some may feel unable to connect with their communities or to be their true selves (Fardghassemi & Joffe, 2022), potentially limiting social participation and enhancing loneliness. The government’s plan against discrimination due to sexual orientation and gender identity was released after the strategy. It acknowledges loneliness in the general LGBTQ+ population, but it too offers only one intervention against loneliness: to enable LGBTQ+ asylum seekers to be located in areas with a larger queer community (Solberg Government, 2021, p. 84). Research shows that LGBTQ+ people may require different kinds of interventions for loneliness due to unique factors such as the experience of minority stress, shame or internalized homo(or trans)phobia (DeLonga et al., 2011; Elmer et al., 2022; Mereish & Poteat, 2015). Additionally, many of the barriers to social inclusion LBGBTQ+ people face are structural in nature or due to stigma (Eggebø et al., 2015; Elmer et al., 2022; Perone et al., 2019). This means that more targeted interventions may be needed.

Conclusion

In this article, we have utilized Carol Bacchi’s WPR approach to examine dominant discourses present in Norwegian loneliness-oriented policies. While several discourses focus on the importance of community and relationships in loneliness reduction, we point to the existence of an overarching discourse that sees loneliness as a medicalized problem. In this problematization, loneliness generates public health threats, risk groups and calls for community and solidarity. The problem is simultaneously individualized. As we have also indicated, several unintended consequences, limitations and possibilities have the potential to spring from such problematizations of loneliness. Additionally, we have presented the unique qualities of the Norwegian political landscape that shape policymakers’ understandings of how best to tackle loneliness as a policy issue.

One limitation of this study lies in the brief time span studied and a lack of documents at the municipality-level. Future research might explore how loneliness was problematized in previous periods, or localities. Future research may also examine if the discourse changed or maintained the same degree of importance following the shift to a new government in 2021 and the end of pandemic restrictions.

The medicalization problematization creates urgency around solving the problem of loneliness. We can see this in the quote about the Minister of Health and Care “sounding the loneliness alarm,” signaling that immediate action must be taken. Foucault has called attention to the ways that “political technologies” at times seek to transfer a political problem to the realm of science as a technique of neutralization, naturalization (and legitimization) (in Dreyfus & Rabinow, 1983, p. 196). This may help explain why loneliness reduction is so successful as a cross-party project. As the authors of the proposition to include loneliness in the Public Health Act clearly state, its inclusion as a public health concern would obligate the state to act (Dokument 8:133S (2017–2018), 2018). Approaching loneliness from a public health perspective in the Norwegian welfare state necessitates doing something about it, thus guaranteeing funding and programs to serve those experiencing it. This suggests a primacy of public health in Norwegian policymaking that makes medicalized problematizations more likely to find a political foothold and the necessary funding.