How do “social relationships” affect your health?

As Aristotle first noted, humans are social animals.  Social relationships are inherent, but not unique to the human species.  We are genetically designed to operate inside a framework of a group of familiar faces.  That does not mean, however, that individuals automatically love others they don’t know, just because they are humans.  We are picky about who we develop relationships with – relationships, outside of the family unit, come from the perfect recipe of similar interests, confidence, communication styles, and timing.

Certainly, both the quality and quantity of our social relationships have an affect on us. We have seen many real-world examples of how social isolation can lead to harrowing outcomes. Just look at the the bullied teenager who commits suicide, or prisoner of war who is psychologically tortured by use of social isolation. Social isolation of otherwise healthy, well-functioning individuals eventually results in psychological and physical decay, and possibly death.

In less extreme situations, our day-to-day social relationships still have a large effect on our mental health, health behavior, physical health, and risk of death. Studies show that social relationships, from childhood to adulthood, have short term and long term effects on wellness and can cause advantages or disadvantages in health. Over the past few decades, social scientists have demonstrated a clear link between social relationships and health in the general population. Adults who are more socially connected are healthier and live longer than their more isolated peers.

What exactly is a “social” or interpersonal relationship?

A social relationship is a broad term used to describe how we interact and behave with other people, and how they interact or behave with us. This can include friendships, romantic relationships, relationships with coworkers, or even just acquaintances!

Social scientists have studied several distinct features of social connection offered by relationships.

Social Isolation – the relative absence of social relationships

Social Integration – the overall level of involvement with informal social relationships, such as having a spouse, and with formal social relationships, such as those with religious institutions and volunteer organizations

Quality of Relationshipsincludes positive aspects of relationships, such as emotional support provided by significant others, and strained aspects of relationships, such as conflict and stress. 

Social Networks – the web of social relationships surrounding an individual, in particular, structural features, such as the type and strength of each social relationship. This is particularly interesting with the rise of social media.

How do social relationships benefit health?

Many types of scientific evidence show that involvement in social relationships benefits health in many ways. To name a few,

  • Individuals with the lowest level involvement in social relationships are more likely to die than those with greater involvement (and this holds true even when socioeconomic status, health behaviors, and other variables that may influence mortality are taken into account).
  • Social connection reduces mortality risk in adults with documented medical conditions (such as in this study, where they found that, among adults with coronary artery disease, the socially isolated had a risk of subsequent cardiac death 2.4 times greater than their more socially connected peers).
  • Low quantity or quality of social can lead to a variety of conditions, including development and progression of cardiovascular disease, recurrent myocardial infarction, atherosclerosis, autonomic dysregulation, high blood pressure, cancer and delayed cancer recovery, and slower wound healing.
  • Inadequate social relationship quality can lead to impaired immune function.

Once the clear link between social relationships and health was established, scientists and sociologists worked hard to figure out the why and the how. Basically, there are three broad ways that social ties work to influence health: behavioral, cognitive, and physical.

Behavioral Explanations

Good “health behaviors”, such as exercise, consuming nutritionally balanced diets, and adherence to medical regiment, tend to promote health and prevent illness. Poor “health behaviors”, such as smoking, excessive weight gain, drug abuse, and heavy alcohol consumption, tend to lead to poorer health outcomes.

Social ties can provide a sense of responsibility to engage in healthier behaviors – to protect their own health, as well as the health of others. Social ties provide information and create norms that further influence health habits. For example, if your roommate works out constantly, then you are more likely to hit the gym! Social relationships may influence health habits that in turn affect physical health and mortality. Being married, having children, and ties to religious organizations have all been linked to positive health behaviors

Of note: relationships can also have a cost… marriage and parenthood have also been associated with behaviors that are not beneficial to health – including physical inactivity and weight gain.

Psychosocial Explanations

Research shows that relationships impact your psyche – through social support, personal control, symbolic meanings and norms, and mental health. Relationships provide social support, and give people the sense that they are loved, listened to, and important. Healthy relationships may reduce blood pressure, lower heart rate, and lead to decreased stress hormones – leading to better health and less risky behaviors.

Relationships can also help provide a feeling of personal control, a feeling that you can control the outcome of your life through actions. Social connection may enhance that feeling of personal control, perhaps leading to better health habits, mental health, and physical health

There is also research to suggest that there is a symbolic meaning of particular social ties, and health habits explains why they are linked. For example, the symbolic meaning attached to marriage and your children may lead to a greater sense of responsibility to stay healthy, which promotes healthier lifestyles. Another example is young kids who start smoking or drinking. There is research that explains that the meaning attached to peer groups (aka being popular), explains the influence on alcohol, tobacco, and drug use with high school aged kids. We definitely also see this on social media and the internet – many groups have formed to promote health and well being. There’s also a huge market for lifestyle and fitness bloggers, who are almost selling the symbolic meaning of health and wellness. Fundamentally, greater social connection may lead to a sense of meaning and purpose in life, which, in turn, enhances mental health, physiological processes, and physical health.

Physiological Explanations

Quality social relationships can benefit immune, endocrine, and cardiovascular functions. It also can reduce the wear and tear on the body that stress causes. This effect on health happens throughout the entire lifespan. Emotionally supportive childhood environments promote healthy development of regulatory systems, including immune, metabolic, and autonomic nervous systems. Social support in adulthood reduces physiological responses such as cardiovascular reactivity to both anticipated and existing stressors. Also, adults in a healthy marriage experience a lower risk of cardiovascular disease compared with those who have experienced a marital loss – partly due to the psychosocial supports we talked to related to marriage.

Is there a “dark side” to social relationships?

While social relationships are the central source of emotional support for many people, social relationships can also have a cost.

Let’s take, for example, marriage. Marriage can be the most important source of support for many people, but it can also be a huge stressor… and it can get worse with age. Poor marriage quality has been associated with:

  • decreased immunity
  • more volatile hormones
  • depression
  • poorer physical health and fitness

Friendships are also important social relationships – but, they too can lead to stress, in childhood, adolescence, and adulthood. Stress in relationships contributes to

  • poor health habits (food consumption, heavy drinking, smoking, etc.) in order to cope with stress
  • increased psychological distress and physiological arousal (e.g., increased heart rate and blood pressure) that can lead to unhealthy behaviors
  • loss of sense of control, leading to difficulties with mental health
  • stress is associated with more alcohol consumption in young adulthood and greater weight gain in mid-life

Of course, strained relationships can affect health – but social ties may have other types of unintended negative effects on your health and well-being. Among other examples,

This “social contagion” of negative health behaviors can happen because of social norms, unsupportive social ties, or negative social environments. is social norms.

Having social relationships can also come with a sense of obligation. The obligation, for example, to serve as a caregiver for a sick or impaired spouse increases the risk of poor health outcomes for the caregiver and can even lead to death. Middle-aged adults, particularly women, often experience exceptionally high caregiving demands as they contend with the challenge of simultaneously rearing children, caring for spouses, and looking after aging parents. This will likely only continue to get worse, with a higher average age and fairly recent phenomenon of smaller family units.

What are the implications for you?

Research shows that social ties influence multiple and interrelated health outcomes, including health behaviors, mental health, physical health, and mortality risk. Anything that can strengthen and support your social ties has the potential to enhance the health of others connected to you – your friends, followers, family, spouses, or children.

Poor mental, physical health, and unhealthy behaviors can wreck a huge toll on you, your families, and society as a whole. This is because social ties affect mental health, physical health, health behaviors, and mortality risk. We can use this knowledge, though, to improve the health of everyone around us. Social ties are a potential resource that can be harnessed to promote population health. They can benefit health beyond target individuals by influencing the health of others throughout social networks. Social connection has both immediate (mental health, health behaviors) and long-term effects on health (e.g., physical health, mortality).

What can you do to improve the social connections, and health, of you and your loved ones?

You can contribute by being a good partner in your relationships. Effective communication is, obviously, crucial in factor in that pursuit. Educating your family and friends about the potential health effects of different social ties – the good and the bad! – can also be important. Remember, knowledge is power! If you notice that a loved one (this can be a friend, parent, or elderly family member) is at risk of social isolation, reach out for resources to help them. It is also important to prevent and alleviate negative features of social ties, both with yourself and with others. If you notice your significant other gaining weight, encourage them to reinstall healthy habits and be careful to not fall into unhealthy habits. You can work to reduce strains for those who provide care to sick family members by providing them a home-cooked meal.

Solid scientific evidence shows that social relationships affect a range of health outcomes, including mental health, physical health, health habits, and mortality risk. Do what you can to ensure your social relationships stay healthy!

Umberson D, Montez JK. Social relationships and health: a flashpoint for health policy. J Health Soc Behav. 2010;51 Suppl(Suppl):S54–S66. doi:10.1177/0022146510383501

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