Social Support, Relationships, and Health

by Larry Berkelhammer
(San Rafael, California)


There are many things we can do to improve health. You probably already know about the importance of eating a nutrient-dense diet, stress-management, and getting enough daily exercise and sleep.


What you may be less aware of is the association between social connections and health. Humans are meant to be in community, and the degree of community we experience directly correlates to the degree of health we experience.

Studies of General Morbidity and Mortality

In a very famous epidemiology study, one of the most referenced of its kind because of its impressive sample size, researchers Dr. Lisa Berkman and Dr. Leonard Syme studied seven thousand residents of Alameda County, California. All seven thousand residents were observed for a nine-year period in order to discover all the common denominators among the healthiest residents. The researchers controlled for gender, race, ethnicity, socioeconomic status, alcohol, tobacco, obesity, depression, and medical care.

These were the results:
• The healthiest people were the ones with the greatest quantity and quality of social support.
• The most socially isolated people had the greatest morbidity (rate of disease) and mortality.
• A large social support network and high frequency of contact directly correlated with health and made all the difference between health and illness.

In an eight-year follow-up study with 6,848 of the initial seven thousand subjects, the researchers found results consistent with the initial study: a very strong correlation between the amount and quality of social support and reduced morbidity and mortality of all causes.

Those who lived fairly isolated lives had a mortality rate that was three times greater than that of those with family or friends. It also found a very robust inverse correlation between the quantity and quality of social support and cancer. Those who were most socially isolated had a significantly greater chance of developing cancer and dying from it.

In another famous study, epidemiology researcher James House and his team conducted a prospective study of 2,754 residents of Tecumseh, Michigan, observing their social ties and group activities for ten years. This was a very rigorous study in that residents with any medical or psychiatric condition that could possibly interfere with their ability to be active in a social community were excluded. Over time it became clear that people with the greatest participation in a social support network or group were the healthiest.

Those who initially had great support but who, because of various life circumstances, lost their connection to community were found to develop a variety of health problems. Those with the least social support were found to have four times the mortality rate of those with the most support.

Neurobiologist Robert Ornstein and physician David Sobol performed a study involving twenty-five hundred elderly men and women in order to determine the effect of social support on health. At the start of the study, the subjects were interviewed to determine the level of social support each was receiving.

The researchers observed those subjects who were admitted to the hospital following heart attacks. They had controlled for co-morbid conditions (multiple illnesses) and severity of the heart attack. Of the patients who had two or more sources of social support, mortality was 12 percent. The patients with no social support had a 38 percent mortality rate.

In a substantial study of three thousand breast cancer patients, all of whom were nurses, completed in 2006, researchers found that women without close friends had a mortality rate of four times that of women with a close circle of friends. For those reasons, I recommend taking risks, such as engaging in conversations with people wherever you go, because the more connected we feel to others, the more we begin to live a healthier, happier life. Any behaviors that provide the opportunity to be in social connection with others will serve to improve health and wellbeing; one suggestion is to do volunteer work. Doing volunteer work with a group or organization has led to many long-lasting relationships, and can sometimes provide a social community.

Group therapy is a method for learning to cultivate the skills that lead to healthy interactions with others and lasting relationships.

In a good psychotherapy group, everyone gets honest feedback from fellow group members and from the facilitator. This helps us learn how we can interact with each other in the healthiest ways. The group therapist’s job is to make sure that all group interpersonal interactions are useful, therapeutic, healthy, and provide learning experiences for the parties involved.

The group is a place where uncomfortable interactions with fellow group members can be worked with in a safe environment. In a good group, unhealthy ways of communicating are addressed in ways that lead to learning and personal growth for everyone.

Dr. Kenneth Pelletier, a world-renowned researcher at the Stanford Center for Research in Disease Prevention, sums it up well when he concludes this:

“A sense of belonging and connection to other people appears to be a basic human need, as basic as food and shelter. In fact, social support may be one of the critical elements distinguishing those who remain healthy from those who become ill.”

Suggestions for Building Social Connections and Support

• Talk to strangers. Support takes place even in casual, one-time interactions. All relationships are important opportunities for us to meet our universal need for connection.
• Ask yourself throughout the day if your need for social support is being met; if not, take some immediate action to meet that need.
• Find an appropriate group psychotherapy group to join. This can serve two functions. First, the group itself provides social support. Secondly, participation in a well-run group results in improved interpersonal relationships, which serves to improve the odds of making new friends and social connections. Participation in the group also results in improvements in existing relationships with family and friends.
• If you are experiencing any problems in any close relationships, find a couples or family counselor to help you resolve them.
• Get involved in activities that are performed in groups. Examples are book clubs, bridge clubs, and dinner or theater clubs.
• Take up a hobby or sport that involves being with other people.
• Engage in humanitarian work that involves working on a team.
• Look for opportunities at work to be engaged in team efforts.
• If you don’t already have someone in whom you can confide, find someone.
• Make sure the support you receive is genuine. Stay away from people who leave you feeling worse after the visit.

Larry Berkelhammer, PhD, runs a non-commercial website www.larryberkelhammer.com to inform those living with chronic illness how they can use mindfulness-based behavioral change to learn mastery and wellbeing, and to increase the odds of experiencing improved health.

Related Page: The Healing Power of Love

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