The social dimension of health

If asked, “are you healthy?”, what factors determine your response? Some would simply consider physical medical conditions or diagnoses. For example, if you don't have a chronic health condition, acute illness or injury, then you are in good health. . .or not? There is increasing awareness of the impact of mental health, so if your mental health is in check and you have no physical illness, does that make you healthy? The World Health Organisation would suggest possibly not, defining health as “a state of complete physical, mental and social well being...1”

So, what is meant by social well being and how do we achieve this aspect of health? To help us understand more, let’s consider the following questions:

1. What are the benefits of social connections?
2. How is purpose in life linked to longevity?
3. What simple habits can improve your social well being?
4. Are you feeling alone?

What are the benefits of social connections?

We are all different. Numerous personality tests exist to decipher if you are an extrovert or introvert, which can be helpful to understand how best to recharge your batteries. But, regardless of which camp you fall into, all of us are hard wired to need connection with others. This isn’t about whether or not you thrive in crowds or feel anxious at the idea of entering a room of unknown people, it’s more about meaningful relationships and connections with others.

There is increasingly more understanding about the impact of loneliness on health. Importantly, loneliness is not simply being alone. Some might choose, at times, to be physically alone, but remain well connected, avoid isolation and therefore do not suffer from loneliness. Conversely, others might be surrounded by people, or have a huge number of social media followers, but lack meaningful connection and therefore feel lonely. Loneliness can result from feeling misunderstood, or fearful that people would no longer be there if they knew the ‘real’ you. In contrast, secure attachments and relationships, which are unconditional, allow people to feel connected.

Perhaps the easiest way to understand the benefits of being socially connected is to look at the increasingly strong body of evidence highlighting the health risks associated with loneliness, including:

• Loneliness increases the likelihood of mortality by 26% (2).
• Lack of social connection is comparable to the impact of smoking or alcohol on mortality (3).
• Social isolation increases the risk of coronary heart disease and stroke (4).
• Loneliness is linked to high blood pressure (5).
• Being socially isolated is linked to cognitive decline (6).
• Loneliness and lack of social interaction are linked to increased suicidal feelings (7) .

Compare this to social connection, which has been directly linked to happiness and longevity. An American study looked at psychosocial determinants of healthy ageing over a 75 year period. They followed a group of Harvard graduates and a group of underprivileged men from inner city Boston. Regardless of the individuals start in life, the study concluded that the single most important predictor of happiness and a long life is having meaningful social connections (8).

How is purpose in life linked to longevity?

The Greek island Ikaria, has been nicknamed ‘the island where people forget to die’, as one in three of its inhabitants make it to their 90’s9. Scientists have studied the population, in an attempt to learn the island's secrets. The major factors found to contribute to a long and healthy life included 10:

• Mediterranean diet
• Keeping physically active outdoors (not in gyms)
• Companionship
• Participation in social groups with common interests
• Maintaining an optimistic outlook
• Living simply to minimise stress
• Prioritising a good nights sleep

The list highlights not only the importance of being socially connected, but also having purpose in life, a key component of a healthy, fulfilling and long life. The point is well illustrated by the “Grandmothers of Lesvos”. This generation of older women on the Greek island of Lesvos, were nominated for the Peace Nobel Prize for welcoming refugees from Turkey and Africa. They did not let their older years put a stop to them having meaningful purpose in life, instead they remained ‘young’ by taking care of these people (11). The point is, having purpose and something meaningful to look forward to when you wake up in the morning is directly linked to longer, more enjoyable lives. Sometimes, circumstances might mean your purpose in life doesn’t or cannot look the way you’d imagined. Life throws curveballs, sometimes we need to adapt to our situation, even if this means a change in purpose. The key is doing activities that are meaningful, which positively impact our emotional well being. If you find yourself without a purpose, it is important to find one.

What simple actions can improve your social and emotional well being?

Even when life is very full, we benefit from making time for social connection. This will look different for each of us, but regardless of whether social connection happens in the workplace, in a parent-child group, in a caring role, a shared hobby or a support group, it plays a critical role in social wellness. “Social wellness may be defined as maintaining healthy relationships, enjoying being with others, developing friendships and intimate relations, caring about and being cared for by others, and contributing to the needs of a community” (12). Below are four ways to build social connection into your every day.

1. Gratitude - being thankful improves our well being. Being thankful to others during our daily routines can also positively impact those around you. It doesn’t take much to smile and say thank you, but this simple habit can help us feel more connected.
2. Acts of kindness - regularly doing things for those around you helps to build connection, supports others and at the same time gives you a sense of purpose.
3. Shared interests - engaging in activities you enjoy with others is a great way to increase social interaction, this might be singing, dancing, being in nature, arts and crafts, team sports, place of worship, travel...the list is endless.
4. Volunteer - volunteering is a great way to connect with others, have purpose and do something meaningful. The volunteer can benefit as much as those being supported.

Are you feeling alone? Ideas of places to connect.

Depending on many factors, your age, time available and location to name a few, the right option will vary from individual to individual. This section aims to provide some low or no cost ideas, food for thought that might inspire you to seek out further opportunities to connect meaningfully, face to face, with others.

Parkrun

If physical activity or being in nature is for you the Parkrun initiative is a brilliant place to meet others. Whether you choose to complete the 5km course (running, jogging or walking), or you opt to support the team making it all possible, for example marking the route, there is something for everyone. There are currently 1,162 Parkrun events around the country so regardless of where you are located you’re never far from a friendly group of Parkrunners.

Goodgym

Goodgym’s motto is ‘do good, get fit’, combining physical activity with good deeds in the local community. There are currently nearing 21,000 people helping others in 59 locations around the country. There is no minimum fitness required, it’s about taking part and it’s easy to get involved.

Volunteering

If you like the idea of volunteering in your local area but don’t know where to start, Do It allows you to search by postcode. You might be surprised by opportunities that you wouldn’t have known existed, for example you can become a local tree warden.

Creativity

Whether it's singing, dancing, painting, knitting or something else that taps into your creative side there are likely to be others nearby who share your passion. Meet Up is a great website which allows you to connect with others who have shared interests.

Spirituality

Whether you have a faith, follow a religion or aren’t sure, places of worship are welcoming and inclusive. It is possible to search for nearby churches, mosques, temples, synagogues or gurdwara online.

Are you keen to look holistically at your health?

To get a deeper understanding of your own health, with consideration of physical, mental and social well being, book a Well Woman or Well Man check today for a holistic health check with a lifestyle plan personalised to your results.

References

1. Constitution of the World Health Organization (no date) World Health Organization. World Health Organization. Available at: https://www.who.int/about/governance/constitution (Accessed: December 29, 2022).
2. Holt-Lunstad, J. et al. (2015) “Loneliness and social isolation as risk factors for mortality,” Perspectives on Psychological Science, 10(2), pp. 227–237. Available at: https://doi.org/10.1177/1745691614568352
3. Holt-Lunstad, J., Smith, T.B. and Layton, J.B. (2010) “Social relationships and mortality risk: A meta-analytic review,” PLoS Medicine, 7(7). Available at: https://doi.org/10.1371/journal.pmed.1000316.
4. Valtorta, N.K. et al. (2016) “Loneliness and social isolation as risk factors for coronary heart disease and stroke: Systematic review and meta-analysis of longitudinal observational studies,” Heart, 102(13), pp. 1009–1016. Available at: https://doi.org/10.1136/heartjnl-2015-308790
5. Hawkley, L.C. et al. (2010) “Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults.,” Psychology and Aging, 25(1), pp. 132–141. Available at: https://doi.org/10.1037/a0017805.
6. Cacioppo, J.T. and Cacioppo, S. (2013) “Older adults reporting social isolation or loneliness show poorer cognitive function 4 years later,” Evidence Based Nursing, 17(2), pp. 59–60. Available at: https://doi.org/10.1136/eb-2013-101379.
7. O'Connell, H. et al. (2004) “Recent developments: Suicide in older people,” BMJ, 329(7471), pp. 895–899. Available at: https://doi.org/10.1136/bmj.329.7471.895.
8. Kelly, J. and Shull, J. (2019) The Lifestyle Medicine Board Review Manual. 2nd edn. Chesterfield: American College of Lifestyle Medicine.
9. Ikaria, Greece (2021) Blue Zones. Available at: https://www.bluezones.com/explorations/ikaria-greece/ (Accessed: January 17, 2023).
10. Gourtsilidou, M. (2022) Greek island of Ikaria reveals top 10 secrets to live longer, CEOWORLD magazine. Available at: https://ceoworld.biz/2022/08/05/greek-island-of-ikaria-reveals-top-10-secrets-to-live-longer/ (Accessed: January 17, 2023).
11. Sidossis, L. (2022) “Traditional Mediterranean Lifestyle: Millenia in the making and as healthy as it gets?,” British Society of Lifestyle Medicine Conference. London: Tottenham Hotspur Stadium, 24 November.
12. Sidossis, L.S. and Kales, S.N. (2022) Textbook of Lifestyle Medicine. Hoboken, NJ, USA: Wiley Blackwell.