Why does self-reliance make you sick?
Newspapers used to run occasional human interest stories about very old people dying. These profiles often had a subtext, which went something like this: So-and-so died yesterday at the age of 102, and remained fiercely independent to the end. He never took very good care of himself, smoking two packs a day since he was a teenager. He liked his whiskey.
You don’t see these stories nearly so much anymore. That’s in part because living past 100 isn’t all that uncommon anymore, but it’s more than that. In our hearts, we knew all along that these misbehaving centenarians were aberrations. What’s more, our sensibilities about personal health have shifted dramatically, so that journalists are less likely to romanticize unhealthy habits. The fact is, smoking and excessive drinking don’t prolong life. They shorten life and diminish its quality.
That’s true of the “fiercely independent” part, too. Health psychologists have known for years that isolation is rarely the path to health or longevity. Health comes with a rich and diverse social life, with lots of friends and family, church membership, political engagement. Old people with many relationships of different kinds live longer, stay sharper with age, and suffer less disease.
But why? What is it about being connected to others that makes us healthier and more long-lived. How does a rich social life translate into healthy cells and tissue, and conversely, how does isolation trigger the biological processes of disease and death?
Carnegie Mellon University psychologists Sheldon Cohen and Denise Janiki-Deverts have been studying these important questions, and in the new issue of Perspectives on Psychological Science, they provide a progress report. Here’s the gist:
Most the evidence so far is what scientists call “correlational,” which means that it doesn’t really say anything about cause and effect. It may be indisputable that socially integrated people are far healthier than loners, but that doesn’t mean that a rich social life causes better health. It could very well be that healthier people feel more like being around other people, and that people who feel lousy simply prefer to be alone. This needs to be sorted out.
One way to sort it out is to actually intervene in people’s lives–enrich their lives and see what happens. But this isn’t easy to do. Scientists can’t really tell people to join the Rotary or to reconcile with estranged love ones. As a result, interventions haven’t been done much, and the ones that have been done mostly put people together with others facing the same health challenges, like cancer. These efforts have had mixed results at best.
So the existing studies leave a lot of questions begging for answers. For example, do socially connected people have particular psychological traits that help them cope with disease, or avoid it altogether? Do they have different expectations or world views? Are they more optimistic, trusting, or confident? Do they help others more, and could that selflessness have health benefits? And how about the social network itself: Is the diversity more important that the sheer numbers, or the other way around?
Most important, what can be done to help? Perhaps there are ways to reunite estranged family members, if that is proven to mitigate loneliness and improve health. Or maybe the elderly can be encouraged to join social and recreational groups. Perhaps some basic social skills training would give people the psychological tools to connect more on their own.
It’s also possible that people’s perceptions of their social networks are more important than the actual details of their lives, so that interventions might target how people think. One study of this type did bolster people’s sense of being supported, but it didn’t have any appreciable effect on health or disease. And that, of course, is what matters in the end: how social connections “get under our skin” to influence disease and mortality.