The Friendship Vitamin

In 1979, the first study demonstrating the importance of social relationships to health was published, and it was truly a bombshell report. A nine-year prospective survey of nearly 7,000 adults, it found that people who lacked social and community ties were at increased risk of mortality. What could explain this? Was it really true that relationships make a difference to health?

After the study was published, many follow-up studies replicated and confirmed the finding that people with a greater number of social ties have a lower mortality risk and are at lower risk for a variety of health problems. They are also more likely to survive a heart attack, less likely to be depressed, less susceptible to infectious disease, and less likely to have a recurrence of cancer. Meta-analyses have found that the effect of relationships on mortality is comparable to the effects of classic mortality risk factors like exercise and cigarette use.

We have every reason to believe that the quality and quantity of our connections to others impact our health as much as typically identified behaviors like being active and not smoking. Yet how many people think of improving relationships when they set health goals, or think of being lonely as a threat to health similar in magnitude to smoking cigarettes? One study found that social isolation is a risk factor for disease on par with smoking 15 cigarettes a day. It’s high time that we view supportive and meaningful relationships as a key component of healthy living.

One question is whether the association between relationships and health is due mostly to the positive benefits of good relationships, or to the negative impacts of bad relationships and loneliness. That is, do we see this association because good relationships are good for your health, or because bad relationships are bad for your health? The answer appears to be both. Good, healthy relationships appear to be protective to health. On the other hand, social isolation and dysfunctional relationships can damage our health. Therefore, we need to think about both aspects: We must consider how good relationships promote good health as well as how a lack of relationships or bad relationships can harm health.

The evidence indicates that being lonely poses the greatest risk to health, and loneliness is one of the biggest health threats facing people today. A large proportion of Americans report feeling lonely—around 25% of people surveyed—and this number is higher in older populations. People who report being lonely are at greater risk for disease and have an increased mortality risk. Fostering positive relationships will likely protect your health, but it is even more important to try and prevent loneliness. Strong feelings of loneliness should never go ignored and should serve as a red flag regarding your health.

What does it mean to be lonely? Is that just another way of saying the person has few or no social ties? Not necessarily; even people with many social ties can feel lonely. Loneliness is not a consequence of the number of people we are connected to, but rather the quality and meaning of our relationships. People who feel deeply and meaningfully connected to other people do not feel lonely. Therefore, when we reflect on our relational health, we must be honest about how meaningful our relationships are. It isn’t enough to spend time with or talk to others if it doesn’t lead to greater depth in our relationships.

Take, for example, romantic relationships. Two people may each have a romantic partner while attaching different meaning to that relationship. Person A might view their romantic partner as someone who entertains them, who they have fun with, and who helps them escape the day-to-day responsibilities that come with being an adult. Person B, on the other hand, might view their romantic partner as a life companion and someone who they can work with as a team to tackle obstacles and build a life together.

Which of these two people do you think attaches more meaning to their romantic relationship? Clearly, it is person B; it’s certainly more meaningful to have a life partner than to have a fun fling. Both kinds of relationships have value, but they are not imbued with the same level of meaning.

Unfortunately, while abundant evidence exists that relationships are important to health, there is sparse evidence for what works to decrease loneliness. We know a lot more about how strongly relationships are associated with health than we do about how to improve relationships or decrease loneliness.

Forming deep, meaningful relationships with others requires being vulnerable and showing empathy. It requires consistently showing up and listening well. Such relational skills are not easily taught or acquired. Like all things worth having in life, they take time and effort to develop. As a society, we would do well to prioritize relational health as much as we do mental health and physical health.

Relationships give our lives meaning and, as it turns out, greatly impact our health and longevity. The next time you think about your health, think about the health of your relationships. If ever you feel lonely, it should signal to you that something is amiss, and this should motivate you to find ways to connect with others and derive more meaning from your relationships. Find people you can be your authentic self with. Making the effort to improve your relationships and prevent loneliness is an important part of a healthy lifestyle.