What do you do to be healthy? Let’s say you follow the advice of doctors, health blogs, and wellness influencers perfectly. You walk 10,000 steps a day. You get eight hours of quality sleep at night. You eat plenty of fresh vegetables and avoid processed foods. You work through challenges with a therapist. You meditate and take hot baths for self-care.
Your physical and mental health improve as a result – but only up to a point.
The problem with traditional health advice is that it overlooks one of the most important ingredients: human connection.
You can’t be fully healthy if you don’t have a name to write down as your emergency contact. If you don’t see family except for a few hours over the holidays. If you lack close friends to share experiences with. Or if you don’t have enough alone time to reconnect with yourself.
You value your romantic and platonic relationships, but do you know they determine how long you live? When you spend time with family or friends, invite a co-worker to lunch, or strike up a conversation with a neighbor, do you realize the interaction influences whether or not you – and they – will develop heart disease, diabetes, depression, or dementia?
Health is not only physical or mental. Health is also social.
Social health is the aspect of overall health and wellbeing that comes from connection – and it is vastly underappreciated. Whereas physical health is about your body and mental health is about your mind, social health is about your relationships. Being socially healthy requires cultivating bonds with family, friends and the people around you, belonging to communities, and feeling supported, valued, and loved, in the amounts and ways that feel nourishing to you.
Decades of research have proven that connection is as essential as food and water, but this knowledge hasn’t yet made its way into the mainstream understanding of health – and without it, we’re suffering.
Today, many people show signs of social health in decline. Over the past 30 years, the percentage of Americans with 10 or more close friends dropped by 20%. Over the past 20 years, the amount of time people spent alone increased by an average of 24 hours a month. Over the past 10 years, participation in communities, such as book clubs, sports leagues and neighborhood associations, fell by nearly 20%. And according to a national survey in 2019, about half of adults in the US felt as if no one knew them well.
Researchers have documented similar trends in other countries. According to Gallup, 330 million adults around the globe endure weeks at a time without speaking to a single family member or friend, and 20% of all adults worldwide don’t have anyone they can reach out to for help. These statistics stun even me, who reads statistics like these for a living.
This lack of connection is dangerous, increasing people’s risk of stroke by 32%, their risk of dementia by 50% and their risk of early death by 29%.
We undervalue the impact of connection
Most people underestimate the importance of relationships for their health.
In 2018, researchers surveyed people in the US and UK about how they perceived various factors that influence life expectancy, such as smoking, alcohol consumption, exercise, obesity and social support. They found that people perceived the relational factors as far less important for health than they actually are. This was especially true among men, younger participants, and participants with a lower level of education. Similarly, another study showed that people in the US, UK and Australia ranked physical activity and healthy weight as the biggest predictors of mortality risk, when their actual ranking was lower. In contrast, people ranked social integration and social support as low – when in fact they were the number one and number two biggest predictors of mortality risk in the researchers’ analysis. Perhaps unsurprisingly, then, in the US and UK, four in five people who often or always feel isolated, lonely, or left out, or who lack companionship do not recognize their disconnection as a major problem.
While the impact of factors like smoking and exercise are well known, we clearly have a long way to go toward a broad understanding that connection is a vital determinant of overall health, wellbeing and longevity.
This matters when thinking about the individual steps that you can take to be healthier. But it also matters when deciding what issues the government and healthcare system prioritize. When Gallup, a global analytics firm that advises employers and leaders, asked Americans what they considered the most urgent health problem in the US in 2021, nearly half said Covid-19. Other common answers were healthcare access and affordability, while some people pointed to specific conditions like obesity, cancer, mental illness and heart disease. To be sure, these are all important health problems.
But loneliness was not top of mind – despite the fact that it was deemed a public health epidemic by the US surgeon general, Vivek Murthy, in 2017. Despite 36% of all Americans, including 61% of young adults and 51% of mothers with small children, experiencing “serious loneliness” at the time of the Gallup survey. Despite the health consequences of isolation among older adults costing the federal government close to $7bn annually and lonely workers costing the US economy an estimated $406bn in lost productivity.
When I first read these findings, I wondered why people underestimate relationships so drastically. A simple Google search on “healthy habits” gave me an important clue. The top results were articles from reputable sources of health information like Harvard Medical School, the National Institutes of Health, the Cleveland Clinic and WebMD containing many useful tips: exercise regularly. Eat vegetables. Get a good night’s sleep. Don’t smoke. Drink water.
However, not one mentioned anything about relationships. People don’t realize that connection is a health habit because it’s missing from the prevailing narrative of what it means to be healthy. Even major, reputable sources of health information and experts in the health field tend to undervalue it or disregard it entirely.
At best, this is a missed opportunity. At worst, it is deadly.
When we take this all in, a few objectives become clear. One is that we need to help more people understand that human connection is necessary – not “nice to have” – for health. Another is that we need to translate that awareness into action, giving people the tools to be healthier through their relationships and setting up our society in such a way that connection and community are the norm.
That’s what social health as an idea and approach can do.
Mental health is not enough
The second reason that the language of social health is powerful is that it gives relationships the credit they deserve.
In the rare instances that connection is mentioned as a healthy habit in news outlets or expert advice, it is typically framed as benefiting emotional wellbeing – not physical health or longevity. The wide-reaching significance of relationships is overlooked and underappreciated because it has been buried in the conversation on mental health.
This is a huge problem.
People instinctively understand that quality relationships are good for mental health. Of course we feel happier and more resilient when we are supported by the people around us; that makes sense. But as we’ve just discussed, the advantages extend far beyond that to include susceptibility to disease and likelihood of dying. This fact gets lost if we keep discounting connection as just one of many factors for mental health.
By distinguishing and elevating social health, we can acknowledge how essential connection is while building on the mental model of health that we’re already familiar with – extending it from physical and mental to social.
To be clear, I’m not arguing that mental health does not matter. On the contrary, I understand the importance of mental health more than many. I began my career studying psychology and working as a research coordinator in the Cognitive and Psychotic Disorders Lab at Queen’s University in Canada. In that capacity, I got to know people whose lives had been disrupted by severe mental illnesses such as bipolar disorder, severe depression and schizophrenia. Mental health is an essential pillar alongside physical and social health that we would all benefit from strengthening.
At the same time, the conversation falls short if we talk only about physical and mental health – and we will do people a disservice if we continue to hide relationships under the umbrella of mental health. Human connection is so important, so influential for our overall health and longevity, that it deserves to rise from the shadows and stand tall in the spotlight. It should be a protagonist, not a supporting character, on the stage of health.
One way to clearly see how social health is differentiated is to break down the three dimensions by their focus, their goals and the behaviors that enhance them.
At the same time, it’s worth reiterating how interconnected these dimensions are. For example, exercise can positively affect both physical and mental health. Therapy can positively affect both mental and social health (studies have shown that overcoming social anxiety and self-limiting beliefs with a therapist helps people feel less lonely). Socializing can positively affect physical, mental and social health. Back to the Greek temple analogy: strengthening one column supports all three.
By reframing quality connection in its various forms as essential for social health and elevating it alongside physical and mental health, we can better appreciate just how much connection matters for overall health. Then the question becomes: how do we take action to optimize our relationships to live longer, healthier, and happier lives?
We need a positive framework
That brings us to the third reason why the language of social health is powerful: it is positive and asset-focused. Let me explain.
In recent years, loneliness has been getting a lot of attention because of how widespread and detrimental it is. Every single major media outlet has published numerous articles about it. Coalitions dedicated to this issue have formed in the US, Canada, Australia, Germany, the Netherlands and elsewhere. I would argue that a “loneliness economy” has emerged, with hundreds, if not thousands, of startups launched to solve the problem.
I became actively involved in this movement before it felt like a movement. I chose to focus my master’s degree in public health at Harvard on solutions for loneliness. I have written articles, given talks, partnered on initiatives across sectors and consulted for companies big and small, local and global, on the topic.
After all that, I have a confession: I’m over loneliness.
Don’t get me wrong; it’s an important issue – perhaps one of the most important of our time. But I’ve become disenchanted by the focus on fixing what’s wrong. We need to focus more on fostering what’s right. Solutions for loneliness are noble and valuable, but I want to see more approaches to cultivating social health.
That’s what social health has the potential to do for relationships: generate new ideas, new research, new programs, and new tools to help people live more meaningfully connected, healthier lives. The language of social health is powerful because it points to three key mindsets.
Social health is inclusive and inviting. Not everyone is lonely, but everyone can benefit from cultivating connection and community. We all need to move our bodies, eat nutritious foods and get restful sleep – not just people who are sick. In the same way, we all need to spend time with loved ones and feel cared for – not just people who are lonely.
Social health is positive and generative. It’s an asset to invest in, a resource to cultivate, a source of not just surviving but also thriving. You don’t want to go through your days barely scraping by, living but not enjoying life, alive but not healthy. You want to flourish. And you can’t flourish without meaningful relationships.
Social health is proactive and preventive. Just as you shouldn’t wait for a cancer diagnosis to take care of your physical health, nor neglect your mental health until you have an anxiety attack, you will benefit from strengthening your social health before loneliness even has a chance to take hold.
By redefining what it means to be healthy as taking care of not only our bodies and minds but also our relationships, and by recognizing that health is not only physical and mental but also social, we will move into the next phase of our collective understanding – and unleash new ways to maximize our potential to live long, healthy, happy lives.
Even for people who do appreciate the value of connection– even for those who recognize how essential it is for health – there has not been a clear framework for how to go about it. That changes now.
The Art and Science of Connection Why Social Health Is the Missing Key to Living Longer, Healthier, and Happier, by Kasley Killam, is out now
