All of us have heard guidelines about how to be physically healthy—eat well, exercise, wash your hands, get plenty of rest. But how many of us have thought seriously about our social lives—the strength of our relationships and our sense of belonging in a community—as key to staying healthy?

Five friends holding hands walking in a park

We may have some vague idea that relationships are important to our well-being. But we often don’t act like that’s the case, taking social connections for granted in the name of work or other pursuits.

Kasley Killam, author of the new book The Art and Science of Connection, sees this as a problem. Killam, a social scientist who’s been disseminating the science of social connection for more than a decade, argues that social health matters as much to our well-being as mental and physical health—and, in fact, is interrelated to each and necessary for keeping us fit. Through her book and her organization, Social Health Labs, she tries to encourage more people to prioritize their relationships with others.

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“If you nourish your body and mind but neglect your relationships, your overall health may be compromised. In contrast, prioritizing your connection—in addition to habits that support your physical and mental health—can help you live longer, healthier, and happier,” she writes.

How social health affects everything else

What does Killam mean by “social health?” For her, it refers to “deeper connection, mutual support, and a good relationship with yourself” and “having the support you need and feeling cared for, understood, valued, and like you belong.”

This may seem like a strange marker of good health. But, as Killam argues, it’s a critical one—and researchers and health professionals, including the U.S. Surgeon General, are taking note.

For example, in one 1979 study of almost 7,000 adults, researchers found that people without social or community ties were more than twice as likely to die within nine years, regardless of their health habits (including smoking, drinking, or exercising regularly). Since then, decades of research have corroborated the connection between social ties and longevity, including a 2021 analysis of many prior studies.

Strong social connections also matter for disease prevention, Killam writes. For example, one study highlighted in the book found that people who had stronger relationships were much less likely to get cardiovascular disease or have a stroke. Another found that people who felt supported and received more hugs were less likely to develop a cold after being exposed to a virus. Something about our relationships not only makes us feel less vulnerable, but makes us literally less vulnerable, she says.

“When you spend time with family or friends, invite a coworker to lunch, or strike up a conversation with a neighbor, do you realize the interaction influences whether or not you—and they—will develop heart disease, diabetes, depression, or dementia?” she says. “Health is not only physical or mental. Health is also social.”

Of course, it’s hard with studies like these to prove cause and effect, and Killam recognizes that. But researchers can’t actually deprive people of social contact in an experiment to see what happens; they must rely on survey data. Still, the same is true of other potential health risks, like smoking, she argues; yet we accept that smoking causes cancer. Similarly, at least some researchers conclude that poor social connection causes poor physical health, making it an urgent matter for us all.

Killam is concerned that people don’t recognize how strong the link actually is—or they dismiss the importance of social ties as something relevant only to their emotional lives.

While social health is certainly important for mental health, she hopes that focusing more on how it affects physical health will elevate the issue in people’s minds.

“The wide-reaching significance of relationships is overlooked and underappreciated because it has been buried in the conversation on mental health. This is a huge problem,” she writes. “Human connection is so important, so influential for our overall health and longevity, that it deserves to rise from the shadows and stand tall in the spotlight.”

How to work on improving social health

To that end, much of Killam’s book is devoted to helping individuals improve their social health. But first, she believes people should assess the current health of their relationships and networks—just like you might do an assessment of your physical health.

To do that, she suggests looking closely at the relationships in your life—with loved ones, friends, work colleagues, neighbors, and your larger communities—as well as your individual needs for social contact (for example, if you’re more of an introvert or extrovert). By reflecting on the quality and quantity of relationships you currently have, you can decide if adjustments are needed (or not) and which of four basic strategies Killam outlines would be best for you.

Book cover of 'The Art and Science of Connection' The Art and Science of Connection: Why Social Health Is the Missing Key to Living Longer, Healthier, and Happier(HarperOne, 2024, 288 pages)

1. “Stretch if the quantity is low.” If you have fewer social ties than you want, you may need to expand the places where you are looking to connect with people. For example, if you move to a new town and don’t know anyone, you may need to join a local club or introduce yourself to your neighbors. Even if you have been living in the same place for years, you could expand your circle by going to new places or just being friendlier with the people around you. Peripheral ties can lead to closer ties and are also valuable for well-being on their own merit, says Killam.

2. “Rest if the quantity is high.” Some people feel they have too many social ties and become overwhelmed by their social responsibilities—particularly if they are more introverted and need time alone to rejuvenate. If this is you, you may want to pull back some from your wider social network and focus more on the people closest to you—your near and dear friends—while saying “no” to multiple social events.

3. “Tone if the quality is low.” Sometimes we have lots of social connection, but we’re still lonely, because we don’t feel close to anyone. In this case, you may need to take more risks to increase intimacy with the people you already know, perhaps by sharing a personal struggle and asking for advice, or by expressing gratitude for that person, says Killam. She points to the importance of having meaningful connections in one’s life and to authors like Marisa Franco, whose book, Platonic, sheds light on how to increase intimacy within friendships.

4. “Flex if the quality is high.” When the quality of your relationships is high, you may not need to do much but general maintenance—continuing to do whatever is working in nurturing your relationships. “For social health, flex your social muscles to enjoy the benefits of mutual, meaningful connection in your life,” writes Killam.

Of course, we may need different strategies at different times. But Killam also encourages people to go beyond their comfort zones on occasion—especially when it comes to connecting with strangers. While you may be reluctant to do that, one study found that both introverts and extroverts benefitted in their daily lives from having more frequent and deeper conversations with other people, even though you might not expect that for introverts.

For those who want something more specific, Canadian researchers created numeric guidelines on how much socialization you need, based on mass surveys. Partly inspired by that, Killam gives her own shorthand “prescription” for social health: “First, connect with five different people every week. Second, maintain at least three close relationships in general. And, third, dedicate at least one hour each day to social interaction.”

Like other health guidelines, these don’t need to be followed to the letter. But aiming to follow them could result in better social health.

“Just like we’re told to walk 10,000 steps, get eight hours of sleep, or drink eight glasses of water per day, guidelines can be helpful,” she says.

What gets in the way of greater social health

Not everyone is at ease reaching out to others, perhaps fearing rejection or embarrassment. But maybe you’re being more cautious than you need to be, writes Killam, as research suggests people tend to enjoy social connection more than they think they will and underestimate how much others will like them or appreciate them if they reach out.

Some tips for connecting that Killam promotes include things like volunteering in your community, being vulnerable and self-disclosing (selectively) with others, expressing gratitude, or doing good deeds—all of which have been found to improve relationships. And, while many of these strategies will benefit you, they’ll also benefit the people around you, helping to create a warmer, more inviting social milieu for everyone.

Still, social health shouldn’t be left up to individuals alone, Killam argues. We need to make our neighborhoods, workplaces, urban spaces, and governments more conducive to inviting social interaction and connection. To that end, she describes projects happening around the world that are aimed at improving social health, from creating neighborhood gathering places (like public parks) to planning community events to supporting organizations that bring together people with shared hobbies to fostering intergenerational connection—and more.

While these programs may start as the brainchild of an individual, they are often supported by communities and government agencies that recognize the need for greater social interaction for all. And that, writes Killam, is good for everyone.

“Better access to gathering places is linked to more familiarity among neighbors, higher trust, and greater community cohesion—factors which serve society as a whole,” she writes. “And we know that all of these factors should improve social health—contributing to longer, healthier, and happier lives.”

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