The Impact of Social Connections on Health

Relationships are vital for both physical health and psychosocial well-being.
Key concepts for understanding relationships:
- Social cohesion: The strength of relationships and solidarity within a community.
- Social capital: Shared group resources.
- Social networks: Webs of social relationships.
- Social support: Various forms of assistance (emotional, instrumental, etc.).

Social cohesion is indicated by the amount of social capital in a community.
Social capital: Shared group resources. Example: knowing about a job opening through a friend.
Social networks provide access to social capital and different kinds of social support.
- Emotional support.
- Instrumental support.

A study examined the link between social capital, income inequality, and mortality.
- Measures of social capital: perceived fairness, perceived helpfulness, group membership, and trust.
Findings:
- All four measures of social capital were associated with mortality.
- The relationship between income inequality and mortality may be partially explained by reductions in social capital as income inequality increases.

Collective efficacy: An aspect of social capital and social cohesion based on mutual trust.
- It describes a community’s ability to create change and exercise informal social control (influence behavior through social norms).
Associations with collective efficacy:
- Better self-rated health.
- Lower rates of neighborhood violence.
- Better access to health-enhancing resources.

Social institutions (religion, family) are sources of social capital, control, networks, and support.
Social networks can spread behaviors and outcomes (social contagion).
- Examples: obesity, smoking, and drinking.
High social support can improve health outcomes.
- Behavioral pathways: adherence to healthier diets.
- Psychological pathways: reduced emotional stress.
These pathways can affect biological functioning (cardiovascular, neuroendocrine, and immune systems).
Social support can directly benefit people and buffer them from risk factors.
Study on atherosclerosis: social support contributed to lower levels.

Social support can protect populations from discrimination.
- Study on first-generation immigrants: social support acted as a barrier against the harmful effects of discrimination on mental and physical health.

Social ties can sometimes transmit negative health behaviors or add stress.
Social isolation is generally detrimental to health and increases mortality.
Social isolation is a major concern for older adults due to decreased contact with friends.
Social isolation and loneliness resulting from the COVID-19 pandemic are likely to become major risk factors impacting health outcomes of older adults.
Younger adults report more social isolation than older adults during physical distancing.

Older individuals in long-term care facilities or with conditions that interfere with daily activities, like arthritis, may suffer from loneliness and a lack of social cohesion, which may negatively impact health.
Reduced neighborhood social cohesion is associated with a heightened likelihood of insomnia among older adults.
During natural disasters like heat waves, elderly individuals living in neighborhoods with low social cohesion may lack social support and access to safe communal areas.

Social interventions designed to improve health vary significantly and occur at multiple levels.
Cross-sector collaboration is sometimes required.
Further research is needed to better understand how social cohesion affects health and how it can be used to reduce health disparities.
This evidence will facilitate public health efforts to address social cohesion as a social determinant of health.