From lifelong health and well being to thriving communities: How relationships impact our health and longevity (Relationships part I)
Table of content:
Sociality in evolution and our lifespan: relationships are part of our blueprint.
The interplay of sociality with brain function
The toxicity of loneliness.
How the quality of our relationships influences our health.
The lifetime imprint of parenting.
The role of pair-bonding on our long term health.
The power of communities.
Conclusion.
The results of the “Harvard study of Adult development” that followed male students for 75 years, along inner city males of the same age, took the scientific community by surprise. More than social class, IQ or genes, it’s the quality of their personal relationships that predicted how long and happy the participants lived.
The loudest message from this long-term study was that the more socially connected to family, friends and community, are happier, physically healthier and live longer than those who are less well connected.
In the US, a recent survey found that half of the people responding reported feeling alone or left out always or sometimes. Two in five felt like "they lack companionship," that their "relationships aren't meaningful" and that they "are isolated from others."
Recent data from Statistics Canada shows that more than one in ten people aged 15 and older said that they always or often felt lonely.
Loneliness was an issue before the pandemic. When I see parents putting their hands on their children’s shoulders to encourage them to stay away from me, walking with my daughter and my adorable dog, I feel sad at the possibility of having trained younger generations to fear other humans.
But the beautiful thing about human bonds is that nothing is ever set. Trust and love can always be nurtured again. Just like our wounded inner child can be hugged and brought back to safety, to finally make some room for us to become who we are meant to be.
The beautiful thing about human bonds is that nothing is ever set.
Trust and love can always be nurtured again. Just like our wounded inner child can be hugged and brought back to safety, to finally make some room for us to become who we are meant to be.
For part I and part II of this focus on the way relationships contribute to our health and longevity, I wanted to look in which ways our sociality influences our health and learn more about what contributes to the quality of our relationships. This is also an opportunity for me to be vulnerable and honest, as this is an aspect of my life that I need to work on actively.
Part of the vision I have for my 80 year-old self is the desire to be surrounded with loving relationships. I dream of one of those big family portraits. Maybe not everyone in the picture would be a direct relative. But as I get older, I aspire to be someone people feel drawn to for support, comfort, help, and perspective. This to me, would be a legacy of generosity, kindness and mentorship.
In order for this picture to come to life, I need to be this person today. It’s on today’s canvas that I need to apply touches of love and attention, with my current relationships. Preparing this article greatly increased my motivation to improve my intimate relationships and it is my hope that it inspires you to invest more in this essential aspect of our lives.
Sociality in evolution and our lifespan: relationships are part of our blueprint.
As stated by Daniel Schmachtenberger “The vast majority of Homo Sapiens history is tribal. The dependency on the tribe: extended family and local community, is part of our evolutionary genetics”. Being human is being social.
Being together is a survival strategy, not exclusively used by humans but by many species and widely used by primates. We would not be here if it wasn’t for the group, for our interdependence, our ability to collaborate, trade skills and goods. Hence, sociality is part of the blueprint of humans: it shapes our individual development, it has shaped our brain and physiological responses, and it shapes our life outcomes.
Humans are wired for connection. The need to belong is such a part of our emotional makeup that it is described as a fundamental human motivation.
It is deeply linked to our biology.
The interplay of sociality with brain function
The social brain hypothesis posits that sociality has driven the evolution of specific brain features.
First, the brain of social species is bigger, relative to whole body size. Additionally, in primates, there is a correlation between the size of the social group and the relative brain size, due to the complexity of relationships involved in this group setting (1).
Indeed, existing in a matrix of relationships involves brain processing that contributes to our cognitive health (see section below for more details) and requires a larger and more complex prefrontal cortex.
For example, the human prefrontal cortex is equipped with a type of neuron, called Von Economo neurons (pictured in figure 1), that are only found in the brains of hypersocial species such as cetaceans and elephants (and have evolved in a convergent manner).
Individual differences due to sociality have also been found: the larger the size of a person’s social network, the larger the Ventro Medial-Pre Frontal Cortex (VM-PFC), orbital PFC and amygdala, and the better theory of mind skills (2).
Figure 1: Representations of Von economo neurons and of their localization in the brain. Source: New Scientist.
Creating and maintaining relationships require complicated activities that may explain these differences in the brain of hypersocial species. In their paper (3), Doctors John and Stephanie Cacioppo detail the specific demands on brain function:
learning by social observation;
recognizing the shifting status of friends and foes;
anticipating and coordinating efforts between two or more individuals;
using language to communicate, reason, teach, and deceive others;
orchestrating relationships, ranging from pair bonds and families to friends, bands, and coalitions;
navigating complex social hierarchies, social norms, and cultural developments;
subjugating self-interests to the interests of the pair bond or social group in exchange for the possibility of long-term benefits;
recruiting support to sanction individuals who violate group norms; and
doing all this across time frames that stretch from a person’s distant past to multiple possible futures.
They also add that our entire biology has evolved simultaneously to social behavior, with a strong selection pressure (through low survival and reproductive rates of lonely individuals), such that neural pathways, hormones and neurotransmitters support sociality.
In other words, being social is part of our blueprint.
Relationships also shape our individual development. Our experience of relationships in early childhood impacts our wellbeing for a lifetime (4). As an example, it is now well established that higher levels of caregivers' responsiveness create a more secure attachment, which determines sensitivity to stress throughout life (an effect mediated in part by the number of gluco-corticoid receptors created in the brain of infants in response to stressful environments) (2).
The toxicity of loneliness.
A few years ago, the claim that loneliness killed as much as smoking 15 cigarettes per day made the headlines. Numerous studies since the 60s have shown that people with social ties such as marriage, contacts with extended family and friends, employment, church membership, and other formal and informal group affiliations, are less likely to die than those with less connections (5).
Lonely people are 50% more likely to die prematurely than those with healthy social relationships.
In her now famous large-scale study (meta analysis), Julianne Holt-Lunstad confirmed that lonely people are 50% more likely to die prematurely than those with healthy social relationships (5). In this initial work, she did not differentiate between positive or negative interactions but analyzed health outcomes depending on the number of people participants were in contact with regularly.
Since then, this field of research has provided evidence that:
The presence of a supportive person — or even just thinking about them — can reduce cardiovascular and neuroendocrine responses to stress.
People who suffer from social isolation are more at risk for cognitive decline.
Researchers believe that the negative impact of loneliness on our health is an evolutionary mechanism. Isolated, the individual had low chances to survive. Being banished from the group for failing to abide by social norms has been the way in establishing ground rules in groups throughout human history.
How the quality of our relationships influences our health.
The lifetime imprint of parenting.
In the Adverse Childhood Experiences (ACE) Study, that included over 13000 adults, Doctor Felitti and colleagues found a strong association between exposure to abuse and household dysfunction during childhood and risk for a broad array of adult health outcomes (7). The more adverse events, the more predictive the score is for health problems including: heart disease, some cancers, chronic lung disease, skeletal fractures, liver disease, depressive episodes, and whether a suicide had ever been attempted.
Adverse events refer here to neglect, abuse, mental illness of a parent and traumatic experiences. For graphic representations of the correlation, as well as the simple questionnaire used to score adverse childhood events, visit https://acestoohigh.com/got-your-ace-score/
The ACE study also revealed that 64% of the population have at least one adverse event.
People with an ACE score of 5 or higher are 7 to 10 times more likely to use illegal drugs, to report addiction and to inject illegal drugs. These results point to the link between our childhood and the addiction epidemic.
I personally score 5 on the ACE questionnaire and have a history of depression, alcohol abuse and smoking. This all behind me now, thanks to changes in diet, lifestyle and personal development.
Parenting behaviors, in particular warmth versus hostility, also impact children’s development.
Figure 2: People reporting high parental warmth in childhood are more likely to have emotional, social and psychological well being and are less at risk for depression and drug use.
Source: Parental Warmth and Flourishing In Mid-Life (https://hfh.fas.harvard.edu/parental-warmth)
Parental warmth, characterized by praise and affirmations, being affectionate as well as showing empathy and support, correlates with lifelong outcomes , as shown in figure 2 (8, 9). The opposite: parental hostility, is characterized by anger, yelling, being physical with a child.
Maternal warmth has a stronger influence than paternal warmth on children’s development, and evidence suggests that maternal and paternal behavior have a different effect on a child.
A 20-year longitudinal study found that perceptions of receiving higher levels of parental warmth in childhood were related to experiencing less negative affect, more positive affect (see figure in http://www.drjihanefarrell.com/blog-posts/sense-of-purpose-to-live-a-longer-life), and higher eudaimonic well-being in adulthood (9). Eudaimonic well-being has been described as achievement toward one's fullest potential and finding meaning in life.
Executive brain functions, which make possible mentally playing with ideas, giving the considered rather than impulsive response, resisting temptations, staying focused, problem solving, and creatively meeting unanticipated challenges, emerge in the first 3 years of life and continue to develop through adolescence. The parent’s behaviors and sensitivity or hostility have been found to influence the development of executive functions, with mixed results and conclusions as to the effects, depending on the specific function assessed and the study (10,11).
These functions are also negatively impacted by stress, sadness, loneliness, and lack of physical health or fitness.
The role of pair-bonding on our long term health.
Recent analyses suggest that it may have been the particular demands of pair bonding that was the critical factor leading to the selection for larger brains in social species (1).
Research shows that people engaged in committed relationships live longer and do better through health challenges than those who are not. This is especially true for men: married men have a 250% lower mortality rate, compared to single and unmarried men. In contrast, women seek more support with friends and relatives outside of the romantic union (12)
Married men have a 250% lower mortality rate, compared to single and unmarried men.
An epidemiological study of marriage and mortality in Sweden showed that both men and women who were divorced, separated, or widowed were at increased mortality risk.
Quality of marriage, which could also be described as happiness, is defined as a “subjective evaluation of the relationship and behaviors in the relationship”. High quality is characterized by a supportive relationship, with little conflict or the ability to work through disagreement without conflict.
Those in a poor-quality marriage (unsupportive, hostile or withdrawing behaviors):
- are more likely to develop illness,
- report more symptoms,
- do worse and take longer to recover when they are ill.
Among other things, low marital quality has also been linked to:
- higher blood pressure and heart rate responses to stress,
- increased likelihood of cancer,
- adverse changes in arthritis disease,
- heightened risk of death when diagnosed with cancer,
- compromised immune and endocrine function ,
- depression.
In this case, this is especially true for women (12, 13, 14).
NOTES:
1. It’s reasonable to hypothesize that individual differences due to personality traits influence the relationship quality more so than gender (14)
2. The studies cited have been conducted in the context of marriage between men and women.
Evidence shows that same-sex marriage and union confer similar psychological, social, and health benefits to heterosexual marriage (15, 16) .
The power of communities.
Studies consistently show that individuals with the lowest level of involvement in social relationships are more likely to die than those with greater involvement.
According to Dr. Umberson and Dr. Montez: “Several review articles provide consistent and compelling evidence linking a low quantity or quality of social ties with a host of conditions, including development and progression of cardiovascular disease, recurrent myocardial infarction, atherosclerosis, autonomic dysregulation, high blood pressure, cancer and delayed cancer recovery, and slower wound healing” (13).
The more positive social support we have, the less likely we are to be sick and to die.
Interestingly, if relationships within a community are healthy, the individuals are healthy. Indeed, in a report of social contexts and health looking at the communities in Glasgow, Sara Dodds cites a study finding that health declines (with premature mortality and increased morbidity, particularly in stress related conditions) in communities where levels of interaction are low and where people feel insecure (17).
This means that indifference and criminality in our neighborhood impact our personal health.
Evidence has also shown that social fragmentation and the loss of social cohesion can be detrimental to mental and physical health (18).
On the flip side, studies have pointed to the potential health impacts of volunteering, and prosociality in general, with improved self-rated health, self-esteem and coping ability being found in volunteers over non-volunteers. A systematic review of the association between volunteering and health suggested benefits in terms of outcomes related to depression, life satisfaction, and wellbeing, with some links to lower all-cause mortality (17).
Additionally, people volunteering often report that volunteering gives them a sense of purpose and a place to demonstrate their worth to themselves and their community. A sense of purpose also participates in higher levels of well being and long term health.
Source: https://www.rttriangle.org/content-marketing/2018/2/17/volunteering-improves-health
Conclusions (Relationship part I).
Relationships have shaped our evolution and our biology. We are social beings and as such, belonging is a deep-rooted need.
Having social support supports longevity by reducing the risk of mortality and morbidity, promoting health behaviors, and providing emotional and psychological well being.
As parents, being able to show our love, be patient and show empathy makes a lifetime impact on our children. As member of the community, interacting with others with a simple hello and a smile, contributes to the health of our neighbors.
In part II you can read more about ways to foster health-giving and positive relationships, how childhood trauma shows up and you will find additional resources.
References used in this article:
Behave, by Dr. Robert M Sapolsky
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000316
https://www.ajpmonline.org/article/S0749-3797(98)00017-8/fulltext
https://www.annualreviews.org/doi/10.1146/annurev-psych-113011-143750#_i33
https://srcd.onlinelibrary.wiley.com/doi/epdf/10.1111/cdep.12095
https://www.gcph.co.uk/assets/0000/5594/Social_contexts_and_health__web_.pdf
