The importance of connections: Ways to live a longer, healthier life
Social connection, prosociality, spirituality, optimism, and work—growing evidence suggests these five factors can play an important role in improving the well-being of people and communities.
Jeanne Calment, the French supercentenarian who lived to the age of 122, the longest verified human lifespan on record, credited her extraordinary longevity to several factors including the use of olive oil, a nightly glass of port, frequent laughter, and a resilient attitude. “If you can’t do anything about it, don’t worry about it,” she famously quipped.
While scientists tend to agree on the benefits of olive oil (less so on a daily nightcap), research is increasingly showing that social and psychological factors, such as being connected to others, having an optimistic outlook, and having a positive, resilient mindset, like Calment, also play a critical role in promoting well-being and longevity.
We asked faculty members at Harvard T.H. Chan School of Public Health to weigh in on the benefits of being connected and how social ties and other factors can strengthen people’s sense of belonging and lead to better health.
Social connection
Researchers agree that social connection can help people live longer and healthier lives. Being socially disconnected, for example, is associated with higher risk of illnesses, including heart disease, stroke, anxiety, depression, and dementia. Loneliness and social isolation have also been shown to increase the risk for premature death by 26% and 29% respectively.
Around the world, social disconnection has become so pervasive that countries like the U.K. and Japan have appointed special ministers tasked with combatting this public health crisis. And in the U.S. last year, Surgeon General Vivek Murthy declared a national social disconnection epidemic, warning that about 50% of adults in the country are struggling with loneliness.
“Loneliness is a gap—between the social connections we have and the ones we want to have —and that gap can be closed by changing how we make sense of loneliness and seek to address it,” said Jeremy Nobel, who teaches a course on loneliness and public health at Harvard Chan School. He thinks the health care system, in particular, can play an essential role by both reducing the stigma that surrounds loneliness and referring patients to community resources that can help them overcome it—an approach called social prescribing that is already in use in the U.K. and is currently being tested by some health care providers in the U.S. “It’s not the same as asking the health system to take care of loneliness, but to be aware of it, to understand it as a serious health risk, and to educate and guide patients to available resources that can help them feel less lonely,” he said.
These resources can include social activities such as walking groups, cooking or sports classes, and volunteering opportunities, and creative ones, from drawing classes to book clubs. Nobel established the non-profit Foundation for Art & Healing, whose most prominent initiative, Project UnLonely, offers programs that use the arts as a public health tool to address social disconnection. “Creativity, imagination, and self-expression can help people feel better connected to themselves, other people, and the bigger human experience,” he said. “The arts rewite our lonely brains, changing how we make sense of the social world around us, seeing opportunity where we once saw threats. That shift in perception helps people realize they can navigate loneliness before it becomes a chronic issue.”
Ultimately, Nobel wants people to change how they think about loneliness. “It doesn’t mean there’s something wrong with us,” he said. “Loneliness is a biological signal indicating that we need human connection, just like thirst is a signal telling us that we need water. I’ve never met anyone embarrassed about being thirsty, so why are we embarrassed about being lonely?”
Prosociality
People who engage in prosocial behaviors—defined as behaviors intended to help or benefit others, such as sharing, volunteering, or making a charitable donation—tend to enjoy better health themselves, evidence suggests.
For example, the Baltimore Experience Corps Trial, a large study to evaluate the health benefits of volunteering for older adults, found that seniors who spent about 15 hours a week tutoring and mentoring young children in public schools experienced improvements in both their cognitive and physical health, including better memory and increased mobility and strength. Other studies have shown that people who volunteer tend to live longer lives.
“One of the most surprising findings in the literature has been that these acts benefit the giver as much as, if not more than, the receiver,” said Laura Kubzansky, professor of social and behavioral sciences at Harvard Chan School. “I think they also benefit the community as a whole. We saw it during the pandemic when people who were more prosocial were also more likely to wear a mask and get vaccinated, which in turn kept their communities healthy by lowering rates of COVID-19 infections and deaths.” (In 2022, a Lancet Commission identified low levels of prosociality as one of the factors that hindered an effective public health response in many countries around the world.)
Last year, Kubzansky wrote an opinion piece in Nature Human Behavior with Richard Davidson at the University of Wisconsin-Madison and Elissa Epel at the University of California San Francisco arguing that prosociality is a critical but underappreciated factor affecting population health and calling for more research into its effects. “In public health, we tend to focus on factors that put certain people at risk for disease or injury. But we should also look at the factors that could help people stay healthy,” said Kubzansky. “Prosociality may be one of those assets. If we could figure out a way to foster greater prosociality, I think we would see better community health.”
Spirituality
When Tyler J. VanderWeele set out to investigate the relationship between religious practice and health, he expected to find a positive association. After all, faith had always been a vital part of his life. It had helped him in many profound ways, he said, including by providing a supportive community and giving both hope and meaning to his life. His instinct was right, but the significance of the findings took him by surprise. “The effects, on important health outcomes, were substantial,” said VanderWeele, John L. Loeb and Frances Lehman Loeb Professor of Epidemiology at Harvard Chan School and director of the Human Flourishing Program.
One study he led found that adults who attended religious services more than once per week were 30% less likely to die in the following 16 years than adults who never attended. Another showed that people who went to religious services at least once a week were much less likely to die from so-called deaths of despair, such as deaths related to suicide, drug overdose, and alcohol poisoning. And another found that participating in spiritual practices during childhood and adolescence may have several positive health outcomes in early adulthood, including lower rates of depression, smoking, drug use, and sexually transmitted infections.
While these studies, which relied from data from the Nurses’ Health Studies, included predominantly Christian participants, VanderWeele said similar effects on mortality risk have been found in other rigorous surveys conducted among Jewish populations in Israel and Taoist populations in Taiwan.
They also seem to be consonant with the first wave of data collected as part of the Global Flourishing Study, an ambitious research project launched in 2021 by VanderWeele and colleagues at Harvard and Baylor University, in partnership with Gallup and the Center for Open Science. The study follows more than 200,000 participants in 22 countries around the world, looking at different factors that may influence their flourishing, such as happiness, spirituality, financial well-being, and social connectedness. Preliminary results seem to suggest that, across the religious traditions examined, people who participate in spiritual practices go on to report better health.
For VanderWeele, this has important implications for both clinical care and public health practice. “I don’t think it’s unreasonable to ask health care providers and public health authorities to encourage people who already hold spiritual beliefs to participate in their religious community. And to promote other forms of community participation for people who are not religious,” he said. “The public health community needs to pay more attention to these factors. If we don’t, we’re blind to the forces that are shaping population health.”
Optimism
Optimism is good for your health, said Kubzansky. She defines optimism as the disposition or tendency to have expectations that the future will be good.
“The findings are remarkably consistent,” she said. “Across different racial and ethnic populations, we have seen that people who are more optimistic are more likely to age in good health and less likely to suffer from chronic diseases, physical illness, or cognitive impairments in old age. Optimists are also more likely to live exceptionally longer lives, beyond age 85 or more.”
Earlier this year, researchers found that postmenopausal women who reported higher levels of optimism showed healthier functioning on two indicators that can predict someone’s ability to maintain physical health and independence as they age—number of times they were able to stand up from a chair without using their hands during 15-second trials, and grip strength. And a 2020 study of U.S. Army active-duty soldiers found that those who were more optimistic had a 22% lower risk of developing hypertension in the following three and a half years.
The biological mechanisms underlying these associations are still not clearly understood. For example, studies looking at the relationship between optimism and biomarkers linked with reduced cellular aging have proved inconclusive. “Optimists tend to consume healthier diets, smoke less, and be more physically active. But behaviors alone don’t explain all the differences we see,” said Kubzansky, who is currently investigating whether a healthier gut microbiome could be associated with higher levels of optimism.
Whatever the pathways might be, finding ways to increase optimism at the population level, such as strengthening the welfare system to better support people overcoming challenges, may help improve public health. “It’s important that people feel a sense of hope when they think about the future. When they don’t, they stop believing that it’s worth trying to make changes to improve their health or other things,” said Kubzansky.
While there are ways to help people feel more optimistic, such as cognitive behavioral therapy and writing exercises, Kubzansky said it’s not a small order to change someone’s mindset and the way they view the world. “Many people face barriers and constraints that genuinely make it harder to feel optimistic,” she said. “We need to recognize the social context in which people live and create the conditions that make it more likely that they feel like they can manage those constraints and look at the future with more optimism.”
A healthy workplace
Work is one of the most important—and neglected—social determinants of health, according to Lisa Berkman, Thomas D. Cabot Professor of Public Policy and of Epidemiology at Harvard Chan School and director of the Harvard Center for Population and Development Studies. “Work drives income, social ties, and the opportunity for meaningful participation in society,” she said. “As such, it also shapes both our cognitive and physical health in many different ways.”
Different aspects of the workplace can influence the way workers age, but according to Berkman, the most important ones are whether employees have control over their schedule, deal with reasonable job demands, and enjoy positive social relations at work, meaning they feel supported by both their colleagues and supervisors. Berkman’s own research in both Europe and the U.S. found that workers who have little control over their workload tend to suffer from higher mortality rates, especially when they also have more challenging family needs, such as in the case of single parents. Furthermore, women who live in countries where public policies ensure several months of fully paid maternity leave were 16% less likely to suffer from late-life depression than women without paid maternity leave, according to a 2015 study co-authored by Berkman. “Work and labor policy can have a protective effect on people’s health. Or they can accelerate the aging process,” said Berkman.
The good news is the factors that affect health can be modified through corporate interventions or labor policy. In fact, a study Berkman recently conducted found that workplaces that adopted policies to increase flexibility and improve work-life balance saw their employees’ risk of cardiovascular disease significantly decrease, especially among older workers, with no changes in their productivity. (Berkman and colleagues at Harvard Chan School and the MIT Sloan School of Management have developed a toolkit to help employers promote the health and well-being of their workforce.)
Governments too can enact policies to help workers age in good health, for example by adopting paid family leave or making sure employees have a number of guaranteed hours to work and making work conditions less precarious. Most importantly, said Berkman: “It needs to be a public health approach.”
