Why connecting with other people is vital to healthy aging
The patient was a veteran in his late 60s, but Dr. Wayne Dysinger, his primary care physician and a veteran lifestyle and preventive medicine expert in Riverside, Calif., thought he looked old enough to be 80. The patient, who had come to the doctor for a checkup, seemed tired and sad.
His health problems were daunting: poorly controlled diabetes, hypertension, chronic pain, and post-traumatic stress disorder. As part of a lifestyle and prevention exam that explores all aspects of a person’s well-being, Dysinger gave his patient a short questionnaire to measure “connectedness,” a gauge of how much the man socialized with family and friends.
“This gentleman gave himself a score of zero,” Dysinger said, noting that the man’s two sons did not live nearby. “I asked him to list his friends, and he couldn’t really list any. If we can’t get him connected, he will probably die within the next two or three years. When he's on his own, it’s harder to sort through and effectively treat the issues.”
Socializing with others, or what health professionals call “connectedness,” is now recognized as a major factor associated with healthy aging, affecting a range of conditions including diabetes, heart disease, arthritis, mobility issues, and chronic pain, Dysinger said.
A collection of studies published in 2014 in the journal Health Psychology found that having regular, positive social interaction was linked to better health. The research supported the idea that interaction with close friends or family members can affect chronic disease processes, such as hypertension and obesity and can affect the success of a smoking cessation program. A 2018 study published in Annals of Behavioral Medicine concluded that socially isolated older adults were less likely to engage consistently in physical activity, eat fruits and vegetables, and were more likely to smoke. That study found that social isolation was more detrimental to health than loneliness. “Health behaviors change best within a community,” said Dysinger, whose practice, Lifestyle Medicine Solutions, provides primary care services with an emphasis on modifiable lifestyle and behavior factors that impact health. “Humans are social beings. We’re not meant to be isolated.”
At Blue Shield of California, social connection is considered one of six pillars of good health along with regular physical activity, healthy diet, avoiding smoking, emotional resilience, and good sleep hygiene, said Bryce Williams, vice president of Lifestyle Medicine at Blue Shield.
“Social isolation seems to be getting worse,” Williams said. “More Americans are reporting that they feel socially isolated, and that has a big impact on health.”
To encourage social connectedness and support good health, Blue Shield encourages patients to access support groups, such as groups for people with diabetes, obesity, mental illness, or cancer. Patients can choose between groups that meet in-person or in online forums. Today, however, many people with health problems prefer online support groups, Williams said. That could be problematic because heavy use of social media, in general, has been linked to feelings of isolation. A recent study of 2,000 young adults found that the heaviest users of social media felt the most social isolation, he noted.
At Blue Shield, 70% of members prefer to use the organization’s virtual support groups rather than meeting in person, simply due to the convenience of not having to drive to a meeting place, Williams said. However, the organization’s research shows those who attend support groups in person tend to have slightly better health outcomes.
Blue Shield continues to explore how social media might be used to foster positive socialization, Williams said.
“Can we create virtual communities for good at a time when some of the medical literature is saying some popular forms of social media can cause people to feel more socially isolated?” he asked. “How does belonging, with benevolent intent and compassion, to a virtual support group offer hope for building connections? I don’t think we have the answer yet.”
Seeking a variety of social connections
Ideally, people should have several types of social connections, Dysinger said. A program founded by the best-selling author Dan Buettner identified five places in the world, referred to as “Blue Zones,” where people live the longest and are healthiest: Okinawa, Japan; Sardinia, Italy; Nicoya, Costa Rica; Ikaria, Greece; and Loma Linda, California. Blue Zones research has identified three types of social networks: family members, close friends, and groups of friends or acquaintances, such as co-workers or fellow members of church groups, clubs, or organizations. People should aim to have all three types of social connections.
But as people age, become frail or housebound, and see their relatives and friends die, social networks can shrink. Sometimes the solution is to begin by making one connection at a time, Dysinger said. To help the socially isolated veteran, he says he will recommend a support group offered through the primary care practice. Dysinger also uses a “lifestyle medicine” prescription pad to list practical and simple instructions on how to connect with other people. For example, as a first step, he may ask his patient to call an acquaintance once a week.
“I told him that connecting was going to be a key thing we were going to work on together,” Dysinger said. His patient began to cry.
“He knew he was lonely,” Dysinger said, adding that the tears were a positive sign. “I knew then we would have a good chance with him.”
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