Social connections are shown to produce many benefits.

While genetics and environmental influences play a critical role in our health and psychological outcomes, our physical and emotional wellbeing is also intimately linked with the social connections and networks that we make with others. Not only do our social connections shape who we are and how we behave, but the impact of social support on outcomes for chronic disease, depression, anxiety, adherence to treatment and mortality are now well documented.

What is the impact wellbeing?

Evidence of the importance of social connections to our wellbeing can be seen across many different aspects of our lives.

Social isolation is a predictor of poorer prognosis and increased mortality for heart disease, diabetes, arthritis, liver disease, breast cancer and stroke.^1-6

Those who are divorced, widowed or single are often found to be more depressed than those in relationships that are supportive

We also know that emotions can be catchy; being with a depressed partner over a period of time can increase the risk of depression in the other partner. Suicide is another example of the contagion theory. 

Further, researchers also believe there is a cluster effect of the connections and networks we belong to, both good and bad. For example, whether someone is happy depends on the happiness of those people in one's social network to which they are directly connected. Both obesity and smoking are also found to be more prevalent if those you are close to are also obese and smoke.⁹87

How does this happen?

It has been suggested that lack of social support may inhibit the immune system, promote inflammation and bring about disease changes.

Stress through isolation may also hamper recovery from illness. Perhaps supportive social networks provide meaningfulness in our lives which then has a direct impact on our nervous and endocrine systems increasing our resistance to disease and improving disease prognosis.

Attachment theory proposes that from the beginning of our life as humans our social, emotional development and even survival, is dependent on forming close bonds with a caregiver. When attachment and quality connections are missing, psychopathology may be more prevalent in adulthood.

It is difficult to determine causality or even directionality when it comes to social connections and isolation.

For example does social isolation cause depression, or does cardiovascular disease result in depression which impacts on social isolation?

Is there a behavioural path whereby just being in relationships with others promotes positive health behaviours?

Do our social connections provide meaningfulness perhaps just by listening or does the support of others provide extra coping skills, role modeling and a buffer from stress, and potentially ill health?

These are questions worthy of further understanding and exploration. What is important to acknowledge right now, is the importance of social connection in the health and wellbeing of the people that we see and treat.

What can we do?

• Acknowledge the importance of social connectedness to physical and emotional health and wellbeing and discuss this with our patients/clients
• Ask ‘What emotional support/s do you have?'
• Ask ‘How confident are you that you can seek support for your health condition?'
• Put connections in place if appropriate. For example, suggest local community health centres; appropriate disease support groups; encourage and reinforce the importance of rehabilitation in group form such as for cardiovascular health after Myocardial Infarction

Whether social support networks provide us with the ability to cope and adapt or whether they offer protection from chronic disease and illness, lack of social support does appear to be damaging to our health and should be discussed: positive support networks should be promoted where appropriate.

 Life-saving Connections - 10 September   138.22 Kb

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References:

1. Bunker SJ, Colquhoun DM, Esler MD, Hickie IB, Hunt D, Jelinek VM, Oldenburg BF, Peach HG, Ruth D, Tennant CC, Tonkin AM. "Stress" and coronary heart disease: psychosocial risk factors. Medical J Australia 2003;178:272276.

2. Friedman E, Thomas SA, Liu F, Morton PG, Chapa D, Gottlieb SS. Relationship of depression, anxiety and social isolation to chronic heart failure outpatient mortality. American Heart Journal 2006;152(5):940.e1-940.e8.

3. Hemingway H, Marmot M. Psychosocial factors in the aetiology and prognosis of coronary heart disease: systematic review of prospective cohort studies. BMJ 1999;318:1460-7.

4. Kroenke CH, Kubzansky LD, Schernhammer ES, Holmes MD, Kawachi I. Social networks, social support, and survival after breast cancer diagnosis. J Clin Oncology 2006;24(7):1105-1111.

5. Joynt KE, Whellan DJ, O'Connor CM. Depression and cardiovascular disease: mechanisms of interaction. Biological Psychiatry 2003;54(3):248-261.

6. Tomaka J, Thompson S, Palacios R. The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. J Aging & Health 2006;18(3):359-384.

7. Fowler JH, Christakis NA. Dynamic spread of happiness in a large social network :longitudinal analysis over 20 years in the Framingham Heart Study. BMJ 2008;337:a2338 doi:10.1136/bmj.a2338.

8. Christakis NA, Fowler JH. The spread of obesity in a large social network over 32 years. N Engl J Med 2007;357:370-9.

9. Christakis NA, Fowler JH. The collective dynamics of smoking in a large social network. N Engl J Med 2008;358:2249-58.

Content Updated September 10, 2010