In 2005, both CBS and ABC News reported that according to a 1985 survey done by the University of Arizona and Duke University, individuals were found to have an average of three close confidantes. Today, that average has declined from three to two, a decrease of one-third over approximately twenty years. In addition, about 25% of individuals today feel that they have no one in which they can confide. Sociologists conducting this study described this drop as “dramatic”.
Health educator Ellen White called this need for social connections the “law of mutual dependence.” Solomon expressed it this way: “Two are better than one, because they have good reward for their labor. For if they fall, one will lift up his companion; but woe to him who is alone when he falls, for he has no one to help him up. Again, if two lie down together, they will keep warm. But how can one be warm alone? Though one may be overpowered by another, two can withstand him, and a threefold cord is not quickly broken.”
As a community are we reaching out to lonely individuals who are pinned down by mental illness or limited because of some personality quirk? Perhaps they are paralyzed with fear or are in need of encouragement. Although we hesitate to admit it, we have individuals in our church, on our campus, and in our community who are as limited in their ability to reach out for help as those who have more obvious physical impairments. Gentle caring on a regular basis and in a manner they would consider acceptable and appropriate, might afford some comfort to these individuals.
In a meta-analysis study for the period 1970-1998 researchers in the UCLA School of Medicine found a growing awareness of the potential for negative health effects from social relationships that are characterized by more negative patterns of critical and/or demanding interactions, including increased risks for depression and angina. Elevated sympathetic autonomic activity, stress hormones, increased cardiovascular activity, inadequate repair, depressed immune function all contribute to the detrimental effects of negative social interactions. However, more positive, supportive social interactions, by reducing stress hormones and improving immune function, enhance health.
Social Isolation, Loneliness, and Health
Hawley and associates found that social isolation predicts morbidity and mortality from cancer, cardiovascular disease, and a host of other causes. Indeed, scientists have discovered that even perceived social isolation or loneliness predisposes individuals to diseases by increasing the body’s reactivity to stress and diminishing repair processes. According to studies, lonely individuals or those without adequate social support or companionship have less efficient sleep and poor wound healing. These young adults rated their everyday stress as more tense and coped with it more passively than those who were socially involved.
Some studies show social isolation predicts morbidity and mortality from cancer, cardiovascular disease, and a host of other causes. Canadian researchers, while controlling for age and gender, the chances of all-cause mortality were significantly higher among individuals reporting that they often feel lonely than compared to those who report that they never feel lonely. Although in this study frequent loneliness was not significantly associated with mortality from ischemic heart disease, it more than doubled the odds of mortality from other ailments of the circulatory system.
Loneliness among middle and older age adults is an independent risk factor for physical inactivity and increases the likelihood that physical activity will be discontinued over time.
Loneliness Damages the Heart
Dr. John Cacioppo from the University of Chicago also discovered in other studies that the social interactions lonely people do have are not as positive as those of other people, hence the relationships they have do not buffer them from stress as relationships normally do. Loneliness raises levels of circulating stress hormones and levels of blood pressure. It can gradually undermine regulation of the circulatory system so that the heart muscle works harder and the blood vessels are subject to damage by blood flow turbulence. Most surprising of all, in a survey Dr. Cacioppo conducted, doctors, themselves, confided that they provide better or more complete medical care to patients who have supportive families and are not socially isolated. In a later study, Hawley and associates found that loneliness was associated with elevated systolic blood independent of age, gender, race or ethnicity, cardiovascular risk factors, medications, health conditions, and the effects of depressive symptoms, social support, perceived stress, and hostility.
More recent studies indicate that higher levels of loneliness were associated with reduction of the beneficial parasympathetic effects of heart muscle from the hormone oxytocin. (Norman and cacioppo) Oxytocin also helps to protect the heart from negative effects of the “flight or fight” stress.
Social Health and the Brain
Irish researchers found that loneliness and social networks independently affect mood and well-being in the elderly and that both loneliness and lack of social support significantly increase their risk for depression. Swedish researchers found that men and women who are living alone or are divorced are at a significantly higher risk of developing Alzheimer’s disease (AD) in their later years. In his study of 1,449 individuals, professor Krister Hakansson and associates found that those living alone in mid-life were 40-50% more likely to get Alzheimer’s. People who lived alone for their entire adult lives had double the risk for dementia while those who divorced in middle age and remained single had three times the risk for dementia. Scientists at the Rush Institute for Aging found that risk of AD was more than doubled in lonely persons compared with persons who were not lonely Risk of AD was more than doubled in lonely persons compared with persons who were not lonely.
Social Support and the Immune System
Social relationships can buffer during both acute and chronic stressors, protecting against immune dysregulation. Lonelier medical students and psychiatric inpatients had poorer cellular immune function than their counterparts who reported less loneliness. In other words, their killer T-lymphocytes were less efficient in destroying viruses and cancer cells and their helper-T cells were less effective in producing-immune bolstering chemicals. In contrast, higher social support is robustly associated with higher natural killer cell responsiveness in those under stress. Natural killer cells destroy viruses and cancer cells. Greater social support, for example has been linked with better immune responses to Hepatitis B vaccine in medical students. The same holds true for other vaccines. Researchers at Carnegie Mellon University, Pittsburgh, studied the effect of loneliness on antibodies in healthy freshmen when given a flu vaccine. Antibodies are the immune system’s CIA agents, which help the white blood cells identify germs. They found that “elevated levels of loneliness throughout the semester and small social networks were independently associated with poorer antibody response to one component of the influenza vaccine. Those with high levels of both loneliness and a small social network had the lowest antibody response.” According to Janice K. Kiecolt-Glaser, “The support provided by social relationships can serve as a buffer during both acute and chronic stressors, protecting against immune dysregulation.”
Women with breast cancer who perceived they had substantial social support had greater NK cell activity than those women who also had breast cancer, but little social support. Even in women with metastatic breast cancer, studies showed that greater quality of social support was associated with “lower cortisol concentrations in women,” which indicates healthier neuroendocrine function. However, cortisol levels were higher among patients “who reported less appraisal, belonging, and tangible support.” Researchers at the University of Iowa found that this was also true in women who have ovarian cancer. The authors of this particular study concluded, “Psychosocial factors, such as social support and distress, are associated with changes in the cellular immune response, not only in peripheral blood, but also at the tumor level. These findings support the presence of stress influences in the tumor microenvironment. In other words, interpersonal relationships help to shape the responses of cancer cells to the immune system’s attack.
Isolation & Loneliness Promote Inflammation
Animal studies show that social isolation produces significant inflammatory response, especially in females. Isolation, perceived or otherwise, increases pro-inflammatory agents in human beings, as well as decreasing certain anti-inflammatory agent. On the other hand, studies show that those individuals who are socially integrated have fewer inflammatory markers. This is important because inflammation fuels most chronic and autoimmune diseases. Rodent studies also show that social interaction in rodents reduces the actual size of an infarct after a stroke. In contrast, loneliness increases inflammation even more after a stroke.
Cole and associates of UCLA showed that even the genome in individuals who subjectively experience chronic and high levels of social isolation changed so that inflammation within the body was promoted. Relationship conflict and lower social support can directly cause inflammation (via CNS/neural/endocrine/immune biobehavioral pathways), and indirectly, by promoting depression, emotional stress responses, and detrimental health behaviors.
Social Support Helps the Cardiovascular System
Researchers at the University of Pittsburg followed men and women for 19 years. Among women, high loneliness was associated with increased risk of incident coronary heart disease even when controlling for age, race, education, income, marital status, hypertension, diabetes, cholesterol, physical activity, smoking, alcohol use, systolic and diastolic blood pressures, and body mass index. In contrast to university students who were lonely, other students with good social support experience less of detrimental effects from the nervous and hormonal system on their blood pressure when exposed to acute psychological stress.
Research from the University of California suggests that loneliness or lack of social support could triple the odds of being diagnosed with a heart condition. Redford Williams and his colleagues at Duke University directed a study in 1992 on heart patients and their relationships. They discovered that 50% of patients with heart disease who did not have a spouse or someone to confide in died within five years, while only 17% of those who did have a confidante died in the same time period.
The Mayo Clinic found that a low social support network is equivalent to many of the classic risk factors of one-year mortality from a heart attack (i.e. elevated cholesterol levels, tobacco use, and hypertension). In other words, a lack of friendships increases the risk of dying from a heart attack within one year, and the value of meaningful relationships is as important as lowering cholesterol, controlling high blood pressure, and smoking cessation in preventing a heart attack. Another study showed that after a heart attack, even having a perception of low social support predicted death or another reoccurring heart attack. In Japan, low social support was associated with a higher risk of stroke mortality in men.
h2. Friendships Reduce Risk for Periodontitis
Researchers from Harvard School of Health examined the association between social support, anger expression, and periodontitis in 42,523 male, U.S.-based, health professionals. Interestingly, in this study more than half of the men were dentists. They were free of a diagnosis of periodontitis at the start of the follow-up in 1996. Subjects who reported having at least one close friend had a 30% lower risk of developing periodontitis compared with those who did not have a close friend. Men who participated in religious meetings or services had a 27% lower risk of developing periodontitis compared with men who did not participate in religious meetings.
Relationships and Youth
Connectedness is essential to children’s well being, as well. A sample of 2,022 students (999 boys and 1,023 girls) ages 12-14 years was measured at two time points twelve months apart on school connectedness and mental health symptoms (general functioning, depression, and anxiety symptoms). After adjusting for any prior conditions that could have led to mental health problems, the authors of the study reported stronger than previous evidence of the association with school connectedness and adolescent depressive symptoms and a predictive link between school connectedness to future mental health problems. Early studies suggest that there are substantial percentages of violent youth who do not perceive themselves to be liked by classmates and who report loneliness.
Even though the data regarding church attendance and health is mixed, attending church on regular bases may help. Researchers in Arizona found, using multilevel modeling to assess change, church attendance had a protective effect against the emergence of mood problems among older adults. London researchers in a meta-analysis study, investigated 69 studies (28 articles) and 22 studies (11 articles) investigating the association between religiosity/spirituality and mortality in initially healthy populations and diseased populations, respectively and found that The results of the meta-analyses showed that religiosity/spirituality was associated with reduced mortality in healthy population studies, but not necessarily in diseased populations.
Hospitality Reduces Hospitalization
Family-first movements – we need them. The prophet Malachi mentions the importance of this. However, in our eagerness to bond with and protect our children, we need to guard against overprotecting them, which can lead to social exclusiveness. If we want our children to become productive members of society, we need to start encouraging and allowing them to do helpful acts of kindness outside the home while they are young.
Years ago a famous health educator, “There are many others to whom we might make our homes a blessing….The Israelites, in all their festivities, included the poor, the stranger, and the Levite….These were regarded as the guests of the people, to share their hospitality on all occasions of social and religious rejoicing, and to be tenderly cared for in sickness or in need. It is such as these whom we should make welcome in our homes. How much such a welcome might do to cheer and encourage the missionary nurse or the teacher, the care-burdened, hard-working mother, or the feeble and aged, so often without a home.”
“Our sympathies are to overflow the boundaries of self and the enclosure of family walls. There are precious opportunities for those who will make their homes a blessing to others. Social influence is a wonderful power. We can use it if we will as a means of helping those about us.”
Circumstances, distance, misunderstandings, and human limitations and frailties can separate us from earthly friends, but none of these or any other vicissitude of life can separate us from our Heavenly Friend. If we so choose, He is at our right hand always ready—, encouraging, instructing, and supporting us.
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