Satisfying relationships can help prevent chronic illnesses 

by | Mar 9, 2023

A new study finds that the quality of our relationships later in life can affect our chances of developing chronic disease.
An elderly couple sitting on a bench.

Humans, by nature, are social creatures with relationships forming the fabric of our society. The recent COVID-19 pandemic highlighted the importance of connection, with the WHO reporting a 25% rise in global anxiety and depression due to the pandemic, with reduced social interactions being a significant contributor.

But what about our physical health, how is this affected by social relationships?

Research, such as the Harvard study of happiness, reveals that close relationships are key to a happier, longer life. We now know relationships are important but it’s not just having them matters. How satisfied or fulfilled we are with these relationships is a factor in maintaining longevity in later life.

“With great advances in medicine and technology, the good news is people are now living longer, the bad news is we are suffering more,” explained Xiaolin Xu from the University of Queensland and lead author of new research exploring why meaningful relationships are important for our health. ”Here, the ‘more’ indicates multimorbidity, the co-existence of two or more long-term conditions in one person. So, tackling multimorbidity is one of the key challenges facing governments and health systems globally.”

Social connection and our long-term health

Worldwide, social connections have not yet been recognized as a risk factor for developing chronic illnesses or even just poor health, and therefore no interventions to improve them have been put in place.

To explore this important topic, Xu and colleagues had a rare opportunity to follow over 7,000 middle aged women for 20 years in the ongoing Australian Longitudinal Study on Women’s Health.

The team showed satisfaction levels with each relationship type, whether it be with family, partner, friends, or work colleagues, correlated with developing chronic conditions known as multimorbidity in later life. They demonstrated for the first time that women who are not satisfied with their social relationships in middle age have a higher risk of developing multiple chronic conditions compared to those who were highly satisfied.

Despite these significant findings, this research does not prove low relationship satisfaction levels in midlife causes multimorbidity but does indicate social satisfaction is a factor that should be considered.   

Genetic risk, lifestyle, and socioeconomic factors may all contribute to developing multiple chronic conditions . However, even when other risk factors were considered, the researchers still found low social satisfaction was associated with developing chronic diseases. In fact, the association or risk was similar to or even greater than other risk factors such as obesity or level of physical activity.

“These findings suggest that engagement in diverse social relationships might be a promising approach for preventing or slowing the accumulation of multimorbidity,” wrote the team in their published article.

Managing chronic diseases

Limitations exist with the study done only in Australian women and therefore these findings may not reflect societies elsewhere in the world or may not apply to men. Larger studies are needed to strengthen our knowledge of this key topic.  

However, the researchers argue that even this limited data set can have significant implications for managing chronic diseases. Recognizing and talking about social relationships in clinical practice could start at the individual level, explained Xu in an email. “These implications may help counsel women regarding the benefits of starting or maintaining high-quality and diverse social relationships throughout middle to early old age,” he added.

Highlighting the value of social relationships within communities and creating interventions that help improve social relationships could therefore have real benefits. Looking at the bigger picture, the team say social connections should be a nationwide priority in public health to prevent chronic diseases.

“For example, the UK appointed the first ever (in the history and across the world) minister of loneliness to tackle the ‘sad reality of modern life’ in 2018, and then Japan in 2021,” wrote the researchers.

Developing better policies

But promoting social connections is one thing, and having them put into practice and going a step further to develop policy around this idea comes with its own set of challenges.

“When we think of using this type of research for developing policies and interventions, we need to consider multiple approaches to get the most benefit,” said Jennifer Bethell, assistant professor at the University of Toronto who was not affiliated with the current study. “It is important that we use this knowledge to not only develop and tailor policies and interventions for people who might be lonely or socially isolated, but we also need to use a ‘population approach’ to prevention – that is, apply strategies that are applicable across the population.”  

This study, and a growing body of evidence, suggests we should no longer ignore the importance of meaningful social relationships throughout our lives. These findings are a stark reminder that we are a social species and there are both mental and physical benefits to having fulfilling social connections.

Reference: Xu, X, et al., Social relationship satisfaction and accumulation of chronic conditions and multimorbidity: a national cohort of Australian women, General Psychiatry (2023). DOI: 10.1136/gpsych-2022-100925

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