In previous blogs we have covered how lifestyle and behaviour affect our risk for developing chronic diseases of ageing and therefore affect our healthspan and lifespan. Being physically active, having a nutritious diet, getting consistently good sleep, avoiding harmful substances such as tobacco and managing our stress response are all behaviours that prevent diseases like cardiovascular disease, diabetes, obesity, Alzheimer’s disease, and poor mental health.
The sixth pillar of behaviour in lifestyle and preventive medicine is social connection and healthy relationships. Incorporating social support and connections is critical to our overall health as well as for our healthy habits to be sustainable.
Feeling connected to others - feeling welcomed, understood, close to someone or others, and part of something larger than yourself - can be life altering in that it promotes our wellbeing and good health habits. Although we often use loneliness and social isolation interchangeably, they are in fact distinct conditions, though they often coexist. Loneliness is the subjective experience of feeling alone, whereas social isolation is lack of social contact. Both conditions become more common as we age due to decreased mobility, and loss of social networks.
Humans are social animals and have lived in groups for thousands of years. Having close associations to others, feeling part of a group and not feeling lonely is essential for good mental and physical health.
Social interaction and connection have a profound effect on human development. From the moment we are born we are wired to connect. Oxytocin, sometimes referred to as the love or bonding hormone, is produced by mothers at the sound of their newborn crying, causing milk let down for breastfeeding and for parent-infant bonding. Oxytocin also plays an important role in many other human behaviours and social interactions.
Individuals who experience loneliness or social isolation are at an increased risk of cardiovascular disease, diabetes, obesity, cancer, mental health issues and have a decreased life expectancy. The mechanisms underlying the associations between these conditions and chronic diseases are complex and varied.
Physiologically, individuals who feel lonely or are socially isolated often have elevated blood pressure, higher levels of chronic inflammation, an increased chronic stress response as well as reduced sleep duration and quality. These risk factors are all linked to increased incidence of chronic health conditions.
Social isolation and loneliness both have profound effects on an individual’s mood and psychological health. As both conditions become increasingly common in our society, particularly following the pandemic, there has been an associated increase in depressive symptoms and suicide risk. Individuals who form part of groups - for example educational, political, religious or social - have a significantly reduced risk of developing depression as well reduced depression symptoms in those already diagnosed with depression. Patients with post-traumatic stress disorder who are actively involved in local support groups, for example, have milder symptoms than their patients who do not.
Additionally, loneliness is correlated to an increased rate of cognitive decline which predisposes to dementia which in turn negatively impacts many factors of an individuals ability to adhere to positive lifestyle habits and behaviours.
Harmful behaviours such as excessive alcohol consumption, tobacco and illicit drug use, poor dietary choices, reduced physical activity and non-adherence to prescribed medication are all associated with loneliness and social isolation. These factors all further increasing the risk of developing chronic diseases and conditions.
From a sociological perspective, having a sense of purpose in life and feeling part of something which is greater than oneself, also appears to be protective against mortality in lonely individuals and appears to be highest amongst those with more positive social relationships and interactions.
The 85 year long Harvard Study on Adult Development has shown that having more positive relationships is the most consistent factor in keeping us happier, healthier and living longer lives.
The relationship between social connection and chronic diseases and mortality are complex and multidirectional. Interventions to reduce social isolation and loneliness should be considered as part of a holistic approach to longevity. Close relationships help to delay physical and mental decline and is the key to healthy ageing.