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Empower clients to nurture relationships
By empowering clients and patients to nurture their relationships, there may be an untapped opportunity to support them with their health and well-being.
- Mortality is 2 to 3 times higher for people with fewer social connections.
- Lonely people are 50% more likely to die prematurely than those with healthy social relationships.
- Married men have a 250% lower mortality rate, compared to single and unmarried men.
- Social media use may be contributing to perceived loneliness.
Introduction
What and when to eat, exercise, supplements... In the field of anti-aging, we are looking for lifestyle and diet tweaks that prevent disease, delay the onset of decline, and potentially extend lifespan. However, the #1 predictor of a long and happy life is the quality of our personal relationships, an aspect often overlooked by health practitioners.
Indeed, for the vast majority of our species’ history, humans lived in tight-knit extended family groups with regular social contact. Our entire biology has evolved simultaneously to social behavior, with a strong selection pressure against loneliness (through low survival and reproductive rates), such that neural pathways, hormones, and neurotransmitters all support sociality (1). We are wired for connection.
By empowering clients and patients to nurture their relationships, there may be an untapped opportunity to support them with their health and well-being.
Image 1
Relationships: a human need
The need to belong comprises such a part of our emotional makeup that it is described as a fundamental human motivation (Maslow’s hierarchy of needs). By definition, fundamental motivation is required to be satisfied for an individual to experience health and wellbeing. As defined by Roy Baumeister and Mark Leary, humans have “a drive to form and maintain a minimum quantity of lasting, positive, and significant interpersonal relationships” (2). Being human is being social. We thrive when we are supported, in the community, and we suffer when we feel isolated and alone.
The decline of social connection in the modern life
Unfortunately, both the quantity and quality of our relationships are decreasing in the industrialized world. First, we have gone from living primarily in tribal or extended family units to living in single-family or even individual units. According to the Pew Research Center, the average American household went down from 5.8 people in 1790 to 2.6 in 2010. This decrease in size is due to fewer intergenerational families (less than 15% of people 65 and older lived with their adult children in 2000, compared to 70% in 1850), later marriage, and dual-career families. Women also become mothers later and have fewer children: in 1790, a woman would give birth, on average, 7 times in her lifetime (3). Going off to university, and relocating for work opportunities, we are now also more mobile and less likely to put down roots and create relations. Perhaps most disturbing is that the number of Americans who report having no close confidants has increased threefold in the last two decades.
Our ways to connect have also changed dramatically with online communications. Even though social media offers more opportunities to meet and interact with others, evidence suggests that social media use may be contributing to the decline in social connections. Time spent on social media is associated with anxiety, greater depression, lower self-esteem, and more loneliness (4). A study on young adults found that those who were online more frequently were three times more likely to feel socially isolated (5).
Lessons from the Blue Zones
Blue Zones are areas in the world where people live significantly longer than the average population (an extra 7 in Ikaria and 8 years in Okinawa, compared to the USA). When studying the common lifestyles in the Blue Zones, it was found that nurturing relationships was one of the life principles fostering longevity. Centenarians in the Blue Zones spend time with closed ones and nurture their relationships, in particular with spouses and children, who seem to turn to their older parents for guidance benefiting their lives. Additionally, it is common for people in the Blue Zones to belong to faith-based communities (6).
The effects of social deprivation on our health
In a large-scale study (meta-analysis), Julianne Holt-Lunstad confirmed that people who feel lonely are 50% more likely to die prematurely compared to people who have more social support (7). This led to the headlines comparing the effect of loneliness on mortality to smoking 15 cigarettes per day. In this initial work, she did not study the quality of social connections but analyzed health outcomes depending on the quantity. Since then, this field of research has provided evidence that:
- People who are socially isolated have a 30% increased risk of stroke and coronary artery disease (8).
- Compared to people who have supportive relationships, individuals with ambivalent relationships have higher blood pressure and anxiety (9).
- Cardiovascular and neuroendocrine response to stress is better regulated in the presence of a supportive person.
- People who suffer from social isolation are more at risk for cognitive decline.
- Genes overexpressed in lonely individuals include many involved in immune system activation and inflammation (10).
- Lonely individuals have increased systemic inflammation, quantified by C-Reactive Protein and Interleukin 6 (11).
These results illustrate how our sociality impacts our physiology and biological function. Loneliness, even if only perceived, has a direct impact on our immune function, cardiovascular health and cognitive abilities, hence our longevity. Loneliness can contribute to an increase in the incidence of cognitive decline and the progression of Alzheimer’s disease (11).
Correlation between mortality and social connection
The social network index quantifies social ties such as marriage, contacts with extended family and friends, employment, church membership, and other group affiliations. Numerous studies since the 60s have shown that people with high social index have lower mortality rates than those with fewer connections. People with a low social network index are twice as likely to die within the duration of the study than those with a high social network index.
In various studies, the number of social connections was found to predict mortality for up to 13 years following inclusion in the study. After adjustment to other risk factors of mortality (age and biomedical conditions), it was found that those with less social connections were 2 to 3 times as likely to die for men, and 1.5 to twice as likely to die for women, as those who had a larger social network (12).
Pair-bonding has a particularly protective effect on health outcomes. Research shows that people engaged in committed relationships live longer and do better through health challenges than those who are not. Numerous studies have shown that both men and women who were divorced, separated, or widowed were at increased mortality risk than those who are in relationships. This is especially true for men: married men have a 250% lower mortality rate, compared to single and unmarried men. In contrast, women seek more support with friends and relatives outside of the romantic union (13). The quality of marriage (or committed relationship) also impacts health outcomes. Among other things, low marital quality (unsupportive, hostile, or withdrawing behaviors) has been linked to:
- higher blood pressure and heart rate responses to stress,
- increased likelihood of cancer,
- adverse changes in arthritis disease,
- heightened risk of death when diagnosed with cancer,
- compromised immune and endocrine function,
- depression.
In this case, this is especially true for women (13).
Harnessing social connections for better health outcomes
Often overlooked by longevity experts, the quality of our personal relationships predicts a longer and happier life. There may be an opportunity to impact the health goals of your clients and patients and get better results in your program by supporting them to leverage more connections and social support in several ways:
- Increase awareness of their feeling of loneliness or belonging
- Help them be more intentional about relationship building
- Support them in creating goals to connect with others
- Empower them with resources to improve the quality of their relationships
- Be part of a community experience that you create
Numerous strategies can be involved to empower patients and clients to improve social support are:
- Developing support network
- Volunteering
- Joining groups based on common interest
- Awareness of social media use
- Improving the quality of existing relationships
- Becoming a community leader
Conclusions
Enjoying healthy relationships is essential for our mental, physical and psychological health. Without attachment, connection, and community, the risks of disease, premature death, depression, and cognitive decline increase. Sociality has changed dramatically since the Industrial revolution with a reduction in the size of families and decreased number of connections due to the modern lifestyle. People who are well connected and frequently attend community events live longer, are healthier, and have better outcomes when faced with health challenges. Coaches, with their coaching tools, are in an ideal position to empower people to create more opportunities to socialize. With their communication skills, coaches are also able to support clients in improving the quality of their relationships. Finally, by creating group experiences, coaches can step into community leadership.
References
- John T. Cacioppo and Stephanie Cacioppo. Social Relationships and Health: The Toxic Effects of Perceived Social Isolation. Soc Personal Psychol Compass. 2014 Feb 1; 8(2): 58–72. doi: 10.1111/spc3.12087
- Roy F. Baumeister & Mark Leary. The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin. 1995; 117(3): 497–529. doi: 10.1037/0033-2909.117.3.497
- https://www.pewresearch.org/fact-tank/2019/10/01/the-number-of-people-in-the-average-u-s-household-is-going-up-for-the-first-time-in-over-160-years/
- Emily B. O’Day, Richard G. Heimberg. Social media use, social anxiety, and loneliness: A systematic review. Computers in Human Behavior Reports. Volume 3, 2021;100070,ISSN 2451-9588, doi: 10.1016/j.chbr.2021.100070.
- Brian A. Primack, Ariel Shensa, Jaime E. Sidani, Erin O. Whaite, Liu yi Lin, Daniel Rosen, Jason B. Colditz, Ana Radovic, Elizabeth Miller. Social Media Use and Perceived Social Isolation Among Young Adults in the U.S. American Journal of Preventive Medicine. 2017; Volume 53(1): 1-8. doi: 10.1016/j.amepre.2017.01.010
- Roundtable on Population Health Improvement; Board on Population Health and Public Health Practice; Institute of Medicine. Business Engagement in Building Healthy Communities: Workshop Summary. Washington (DC): National Academies Press (US); 2015 May 8. 2, Lessons from the Blue Zones®. Available from: https://www.ncbi.nlm.nih.gov/books/NBK298903/
- Julianne Holt-Lunstad, Timothy B Smith, J Bradley Layton. Social Relationships and Mortality Risk: A Meta-analytic Review. PLOS Medicine. 2010; 7(7): e1000316. doi: 10.1371/journal.pmed.1000316
- Julianne Holt-Lunstad, Timothy B Smith. Loneliness and social isolation as risk factors for CVD: implications for evidence-based patient care and scientific inquiry. Heart. 2016;102:987-989.
- Julianne Holt-Lunstad, Benjamin D. Clark. Social stressors and cardiovascular response: Influence of ambivalent relationships and behavioral ambivalence. International Journal of Psychophysiology. 2014; 93(3):381-389. Doi: 10.1016/j.ijpsycho.2014.05.014.
- University of California - Los Angeles. "Loneliness Is A Molecule." ScienceDaily. ScienceDaily, 17 September 2007. <www.sciencedaily.com/releases/2007/09/070913081048.htm>
- Javier Yanguas, Sacramento Pinazo-Henandis, & Francisco Jose Tarazona-Santabalbina. The complexity of loneliness. Acta bio-medica : Atenei Parmensis. 2018;89(2): 302–314. doi: 10.23750/abm.v89i2.7404
- James S House, Karll R Landis, Debra Umberson. Social relationships and health. Science. 1988;241(4865):540-5. doi: 10.1126/science.3399889.
- Shelley E. Taylor and Gian C. Gonzaga. Evolution, Relationships, and Health: The-Social-Shaping-Hypothesis. In Evolution and social psychology. Psychology Press. June 9, 2014. ISBN 9781138006096
- Bryant PH Hui, Jacky CK Ng, Erica Berzaghi, Lauren A. Cunningham-Amos and Aleksandr Kogan. Rewards of Kindness? A Meta-Analysis of the Link Between Prosociality and Well-Being. Psychological Bulletin, 146(12), 1084–1116. doi: 10.1037/bul0000298
- Rodlescia S Sneed, Sheldon Cohen. A prospective study of volunteerism and hypertension risk in older adults. Psychol Aging. 2013 Jun;28(2):578-86. doi: 10.1037/a0032718.
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OUR partnering associations
- Mortality is 2 to 3 times higher for people with fewer social connections.
- Lonely people are 50% more likely to die prematurely than those with healthy social relationships.
- Married men have a 250% lower mortality rate, compared to single and unmarried men.
- Social media use may be contributing to perceived loneliness.
Introduction
What and when to eat, exercise, supplements... In the field of anti-aging, we are looking for lifestyle and diet tweaks that prevent disease, delay the onset of decline, and potentially extend lifespan. However, the #1 predictor of a long and happy life is the quality of our personal relationships, an aspect often overlooked by health practitioners.
Indeed, for the vast majority of our species’ history, humans lived in tight-knit extended family groups with regular social contact. Our entire biology has evolved simultaneously to social behavior, with a strong selection pressure against loneliness (through low survival and reproductive rates), such that neural pathways, hormones, and neurotransmitters all support sociality (1). We are wired for connection.
By empowering clients and patients to nurture their relationships, there may be an untapped opportunity to support them with their health and well-being.
Image 1
Relationships: a human need
The need to belong comprises such a part of our emotional makeup that it is described as a fundamental human motivation (Maslow’s hierarchy of needs). By definition, fundamental motivation is required to be satisfied for an individual to experience health and wellbeing. As defined by Roy Baumeister and Mark Leary, humans have “a drive to form and maintain a minimum quantity of lasting, positive, and significant interpersonal relationships” (2). Being human is being social. We thrive when we are supported, in the community, and we suffer when we feel isolated and alone.
The decline of social connection in the modern life
Unfortunately, both the quantity and quality of our relationships are decreasing in the industrialized world. First, we have gone from living primarily in tribal or extended family units to living in single-family or even individual units. According to the Pew Research Center, the average American household went down from 5.8 people in 1790 to 2.6 in 2010. This decrease in size is due to fewer intergenerational families (less than 15% of people 65 and older lived with their adult children in 2000, compared to 70% in 1850), later marriage, and dual-career families. Women also become mothers later and have fewer children: in 1790, a woman would give birth, on average, 7 times in her lifetime (3). Going off to university, and relocating for work opportunities, we are now also more mobile and less likely to put down roots and create relations. Perhaps most disturbing is that the number of Americans who report having no close confidants has increased threefold in the last two decades.
Our ways to connect have also changed dramatically with online communications. Even though social media offers more opportunities to meet and interact with others, evidence suggests that social media use may be contributing to the decline in social connections. Time spent on social media is associated with anxiety, greater depression, lower self-esteem, and more loneliness (4). A study on young adults found that those who were online more frequently were three times more likely to feel socially isolated (5).
Lessons from the Blue Zones
Blue Zones are areas in the world where people live significantly longer than the average population (an extra 7 in Ikaria and 8 years in Okinawa, compared to the USA). When studying the common lifestyles in the Blue Zones, it was found that nurturing relationships was one of the life principles fostering longevity. Centenarians in the Blue Zones spend time with closed ones and nurture their relationships, in particular with spouses and children, who seem to turn to their older parents for guidance benefiting their lives. Additionally, it is common for people in the Blue Zones to belong to faith-based communities (6).
The effects of social deprivation on our health
In a large-scale study (meta-analysis), Julianne Holt-Lunstad confirmed that people who feel lonely are 50% more likely to die prematurely compared to people who have more social support (7). This led to the headlines comparing the effect of loneliness on mortality to smoking 15 cigarettes per day. In this initial work, she did not study the quality of social connections but analyzed health outcomes depending on the quantity. Since then, this field of research has provided evidence that:
- People who are socially isolated have a 30% increased risk of stroke and coronary artery disease (8).
- Compared to people who have supportive relationships, individuals with ambivalent relationships have higher blood pressure and anxiety (9).
- Cardiovascular and neuroendocrine response to stress is better regulated in the presence of a supportive person.
- People who suffer from social isolation are more at risk for cognitive decline.
- Genes overexpressed in lonely individuals include many involved in immune system activation and inflammation (10).
- Lonely individuals have increased systemic inflammation, quantified by C-Reactive Protein and Interleukin 6 (11).
These results illustrate how our sociality impacts our physiology and biological function. Loneliness, even if only perceived, has a direct impact on our immune function, cardiovascular health and cognitive abilities, hence our longevity. Loneliness can contribute to an increase in the incidence of cognitive decline and the progression of Alzheimer’s disease (11).
Correlation between mortality and social connection
The social network index quantifies social ties such as marriage, contacts with extended family and friends, employment, church membership, and other group affiliations. Numerous studies since the 60s have shown that people with high social index have lower mortality rates than those with fewer connections. People with a low social network index are twice as likely to die within the duration of the study than those with a high social network index.
In various studies, the number of social connections was found to predict mortality for up to 13 years following inclusion in the study. After adjustment to other risk factors of mortality (age and biomedical conditions), it was found that those with less social connections were 2 to 3 times as likely to die for men, and 1.5 to twice as likely to die for women, as those who had a larger social network (12).
Pair-bonding has a particularly protective effect on health outcomes. Research shows that people engaged in committed relationships live longer and do better through health challenges than those who are not. Numerous studies have shown that both men and women who were divorced, separated, or widowed were at increased mortality risk than those who are in relationships. This is especially true for men: married men have a 250% lower mortality rate, compared to single and unmarried men. In contrast, women seek more support with friends and relatives outside of the romantic union (13). The quality of marriage (or committed relationship) also impacts health outcomes. Among other things, low marital quality (unsupportive, hostile, or withdrawing behaviors) has been linked to:
- higher blood pressure and heart rate responses to stress,
- increased likelihood of cancer,
- adverse changes in arthritis disease,
- heightened risk of death when diagnosed with cancer,
- compromised immune and endocrine function,
- depression.
In this case, this is especially true for women (13).
Harnessing social connections for better health outcomes
Often overlooked by longevity experts, the quality of our personal relationships predicts a longer and happier life. There may be an opportunity to impact the health goals of your clients and patients and get better results in your program by supporting them to leverage more connections and social support in several ways:
- Increase awareness of their feeling of loneliness or belonging
- Help them be more intentional about relationship building
- Support them in creating goals to connect with others
- Empower them with resources to improve the quality of their relationships
- Be part of a community experience that you create
Numerous strategies can be involved to empower patients and clients to improve social support are:
- Developing support network
- Volunteering
- Joining groups based on common interest
- Awareness of social media use
- Improving the quality of existing relationships
- Becoming a community leader
Conclusions
Enjoying healthy relationships is essential for our mental, physical and psychological health. Without attachment, connection, and community, the risks of disease, premature death, depression, and cognitive decline increase. Sociality has changed dramatically since the Industrial revolution with a reduction in the size of families and decreased number of connections due to the modern lifestyle. People who are well connected and frequently attend community events live longer, are healthier, and have better outcomes when faced with health challenges. Coaches, with their coaching tools, are in an ideal position to empower people to create more opportunities to socialize. With their communication skills, coaches are also able to support clients in improving the quality of their relationships. Finally, by creating group experiences, coaches can step into community leadership.
References
- John T. Cacioppo and Stephanie Cacioppo. Social Relationships and Health: The Toxic Effects of Perceived Social Isolation. Soc Personal Psychol Compass. 2014 Feb 1; 8(2): 58–72. doi: 10.1111/spc3.12087
- Roy F. Baumeister & Mark Leary. The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin. 1995; 117(3): 497–529. doi: 10.1037/0033-2909.117.3.497
- https://www.pewresearch.org/fact-tank/2019/10/01/the-number-of-people-in-the-average-u-s-household-is-going-up-for-the-first-time-in-over-160-years/
- Emily B. O’Day, Richard G. Heimberg. Social media use, social anxiety, and loneliness: A systematic review. Computers in Human Behavior Reports. Volume 3, 2021;100070,ISSN 2451-9588, doi: 10.1016/j.chbr.2021.100070.
- Brian A. Primack, Ariel Shensa, Jaime E. Sidani, Erin O. Whaite, Liu yi Lin, Daniel Rosen, Jason B. Colditz, Ana Radovic, Elizabeth Miller. Social Media Use and Perceived Social Isolation Among Young Adults in the U.S. American Journal of Preventive Medicine. 2017; Volume 53(1): 1-8. doi: 10.1016/j.amepre.2017.01.010
- Roundtable on Population Health Improvement; Board on Population Health and Public Health Practice; Institute of Medicine. Business Engagement in Building Healthy Communities: Workshop Summary. Washington (DC): National Academies Press (US); 2015 May 8. 2, Lessons from the Blue Zones®. Available from: https://www.ncbi.nlm.nih.gov/books/NBK298903/
- Julianne Holt-Lunstad, Timothy B Smith, J Bradley Layton. Social Relationships and Mortality Risk: A Meta-analytic Review. PLOS Medicine. 2010; 7(7): e1000316. doi: 10.1371/journal.pmed.1000316
- Julianne Holt-Lunstad, Timothy B Smith. Loneliness and social isolation as risk factors for CVD: implications for evidence-based patient care and scientific inquiry. Heart. 2016;102:987-989.
- Julianne Holt-Lunstad, Benjamin D. Clark. Social stressors and cardiovascular response: Influence of ambivalent relationships and behavioral ambivalence. International Journal of Psychophysiology. 2014; 93(3):381-389. Doi: 10.1016/j.ijpsycho.2014.05.014.
- University of California - Los Angeles. "Loneliness Is A Molecule." ScienceDaily. ScienceDaily, 17 September 2007. <www.sciencedaily.com/releases/2007/09/070913081048.htm>
- Javier Yanguas, Sacramento Pinazo-Henandis, & Francisco Jose Tarazona-Santabalbina. The complexity of loneliness. Acta bio-medica : Atenei Parmensis. 2018;89(2): 302–314. doi: 10.23750/abm.v89i2.7404
- James S House, Karll R Landis, Debra Umberson. Social relationships and health. Science. 1988;241(4865):540-5. doi: 10.1126/science.3399889.
- Shelley E. Taylor and Gian C. Gonzaga. Evolution, Relationships, and Health: The-Social-Shaping-Hypothesis. In Evolution and social psychology. Psychology Press. June 9, 2014. ISBN 9781138006096
- Bryant PH Hui, Jacky CK Ng, Erica Berzaghi, Lauren A. Cunningham-Amos and Aleksandr Kogan. Rewards of Kindness? A Meta-Analysis of the Link Between Prosociality and Well-Being. Psychological Bulletin, 146(12), 1084–1116. doi: 10.1037/bul0000298
- Rodlescia S Sneed, Sheldon Cohen. A prospective study of volunteerism and hypertension risk in older adults. Psychol Aging. 2013 Jun;28(2):578-86. doi: 10.1037/a0032718.
Article reviewed by
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Dr. Ana Baroni MD. Ph.D.
Scientific & Medical Advisor
Quality Garant
Ana has over 20 years of consultancy experience in longevity, regenerative and precision medicine. She has a multifaceted understanding of genomics, molecular biology, clinical biochemistry, nutrition, aging markers, hormones and physical training. This background allows her to bridge the gap between longevity basic sciences and evidence-based real interventions, putting them into the clinic, to enhance the healthy aging of people. She is co-founder of Origen.life, and Longevityzone. Board member at Breath of Health, BioOx and American Board of Clinical Nutrition. She is Director of International Medical Education of the American College of Integrative Medicine, Professor in IL3 Master of Longevity at Barcelona University and Professor of Nutrigenomics in Nutrition Grade in UNIR University.
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