Social Connections and Health

It's big news: the size of your social network may have as large an effect on your health and how long you live as whether you exercise, smoke or are obese. And our moods and healthy (or unhealthy) habits are contagious. They spread around the people in your network--not just your friends, but their friends and even their friends' friends!

It may seem hard to believe, and not all experts are convinced, since the evidence doesn't come from controlled experiments. You can't design an experiment that involves that many people for a long enough time, or control their relationships. But the data from observing natural social connections grows stronger all the time. And the effect is greater than anyone expected. People with many social ties may be 50% less likely to die at any given time than more isolated folks. That's a huge effect. If you could bottle and sell it, it would be the strongest medicine ever made by far.

We've known for years that social factors affect health. On average, people with good social networks:

• Get better protection from flu shots
• Heal faster from injury or illness
• Have lower blood pressure
• Have lower rates of stroke, kidney disease, and death from heart disease
• Develop fewer symptoms of Alzheimer's disease--and if they do get it, don't decline as fast
• Sleep better
• Are more active
• Are less depressed
• Are more likely to go to the doctor and take their medications
• Live longer

But a recent study that pooled the results of 148 studies found this remarkable overall 50% "survival benefit" for people with lots of social ties. Among those studies, the more types of relationships each study included, the stronger the survival benefit. They might include people you live with, relatives, friends, coworkers and all of your acquaintances.

How could my social life affect my body?
We aren't sure of all the mechanisms, but here are some:

• The immune system seems to be boosted by social and emotional stimulation. Warm social interactions decrease the stress hormone cortisol and increase the "bonding" hormone oxytocin. Both changes promote faster healing.
• There's some evidence that good relationships decrease inflammation that is linked to higher rates of heart disease, diabetes, Alzheimer's disease, cancer, and many other conditions.
• You're more motivated to take good care of yourself if you have people around who love or depend on you. They may remind you to take your pills or go to the doctor. If you're looking tired or ill, they may urge you to rest. One study found that teens who had social support had better health habits.
• Conversation improves memory and builds more robust brains.

What does it mean that health behaviors are "contagious"?
Our healthy and unhealthy behaviors spread like viruses in our social networks, not just to our friends and relatives, but also to the people they know and even to the people they know to a lesser degree. We live in a web of influences that we're barely aware of.

Nicholas Christakis and James Fowler studied the social connections between 5,124 people over 32 years. They were in the Framingham Heart Study, which has followed over 15,000 residents and their descendants in a Massachusetts community since 1948. They've collected regular, detailed data on these folks, from their weight and blood samples to lists of relatives and friends. Christakis and Fowler found:

• If your friend becomes obese, your chance of doing the same goes up 57%. If a sibling does, your odds increase 40%. If it's a spouse, 37%. And here's where it gets really weird: your odds go up 20% if it's a friend of a friend who becomes obese. But your weight isn't affected by everyone. For instance, your neighbors' weight has no effect. And you're more affected by people of your own gender than the opposite sex.
• From 1971 to 2003, whole groups quit smoking. If your spouse quit, your odds of quitting went up 67%. If it was a friend who quit, your odds went up 36%; a coworker, 34%; a sibling, 25%. On the other hand, if your friend started smoking you were 36% more apt to do the same.
• Similarly, alcohol use is affected by that of your relatives and friends (but not neighbors or coworkers).
• Happiness is contagious, too. Two important trends were found: the happiest people had the largest social networks. And happiness is more contagious than unhappiness. Happiness may spread not so much from deep intimate relationships but from little things, like seeing someone smile or laugh.

How does this happen?
It's obviously not direct influence. You don't tell your friend's friends how much to drink or eat. One simple explanation is what we see others do has a big influence on our idea of what is normal and acceptable. That happens unconsciously, without even thinking about it.

Another explanation comes from research on nerves in certain parts of the brain called mirror neurons. Scientists have found that when you see someone experience something, mirror neurons fire in the same part of your brain as would if you had experienced it yourself. When you see someone smile your brain lights up in the same area as if you were smiling, and you actually feel happier. Similarly, when you see someone in pain, you wince as if it was happening to you.

Aren't some relationships unhealthy?
Yes. Of course, that applies to physically abusive relationships. And people in lousy marriages have higher health risks. Bickering, putting your partner down, and not celebrating the good things that happen to your partner are hallmarks of relationships that are literally unhealthy.

We've said that negative trends like weight gain can spread among people. Loneliness spreads, too, especially among friends who live near each other, and among women. Again, it's not just that you become lonelier if your friends do. The effect spreads outward to their friends' friends, until the connections in the whole network unravel, and everyone gets lonelier.

My son has been shy his whole life. He avoids social situations. Is there any kind of therapy for shyness?
Many people are born shy. It's in their genes. So it's wise to have realistic expectations. Introverted people need time alone. Extroverts gain energy and positive feelings from being in groups. Being around people exhausts introverts. Your son may need "down time" after being around people.

That said, cognitive behavior therapy can help shy people think more realistically about their fears. Group therapy can be very helpful for people with social anxiety. And if anxiety is the root of the problem, some antidepressant medicines can help, too.

My daughter spends hours "talking" online in chat rooms and sites like Facebook. And my son plays online games with people he doesn't even know. Isn't it bad for their social skills to be doing that instead of socializing in person?
It depends on whether that's all they do. If they also socialize in person to a normal degree, probably not.Several studies have found that kids can benefit from socializing online.

• They're exposed to people with different worldviews, which may help them in future jobs and life.
• They practice critical thinking and debate.
• They get support from peers.
• They get help with homework.

It is important that kids learn to protect themselves from predators. But some researchers say that socializing online is much like meeting at a coffee shop, or playing cards.

What can I do to increase the quantity and quality of my social connections?

• Spend time with happy, healthy people.
• Nurture the relationships you have. Call more often. Make plans to get together. Look up people you haven't seen in too long.
• Make new friends whenever you can. When you meet someone you like, get their contact information and use it. Or join a group or class and go regularly.
• Smile! You'll make other people happy and attract happy people to you.
• If you don't have a friend at work, try to make one. It can help you cope with work stress, emotionally and physically.
• When you talk with people ask how they're doing, and really listen.
• If you have a spouse or partner, work on making your relationship more loving and less critical. Show that you're glad when something good happens to them.
• Volunteer to help others--as a Big Brother or Sister, at the animal shelter, museum, zoo, homeless shelter, local festival, church, hospital, library, nursing home, literacy program, hospice, day care center or anywhere that interests you. Check your local papers for volunteer opportunities.
• Get a pet if you don't have one. People who have pets are healthier. They love and need you unconditionally.

We are all part of social networks. Spread healthy behavior and happiness in yours!

Updated on 7/26/10 by Jennifer Johnson, BA English composition, Northwestern University. Reviewed by Steve Silverstein, MD. Published on 8/30/10.

References:
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