Healthy living has benefits hugely greater than anything medicine can deliver. - Bandolier 136, Oxford evidence-based medicine website
Social networks: an introduction
1.) emerging research is introduced that highlights the great importance of personal social networks for disease prevention, psychological resilience & optimal wellbeing.
2.) links are provided to three ways of taking this forward - self-determination theory, social identity theory, and Dunbar's 5-15-50-150 model.
"Of all the means which wisdom acquires to ensure happiness throughout the whole of life, by far the most important is friendship." Epicurus
"No man is an island entire of itself; every man is a piece of the continent, a part of the main." John Donne
"Friendship is the single most important factor influencing our health, well-being, and happiness." Robin Dunbar, Oxford emeritus professor of evolutionary psychology
These are very strong endorsements for the importance of relationships in our lives. Epicurus and John Donne's sayings have been handed down through the generations. Professor Robin Dunbar's statement however is from his 2018 paper "The anatomy of friendship" and he is not claiming poetic licence, but is making his assertion as an evidence-based fact. Looking more closely at what he's written, it becomes apparent that he is using the term "friendship" to cover close relationships in general ... in couples and families as well as in non-genetically related friendships. It is still a very strong statement ... "Friendship is the single most important factor influencing our health, well-being, and happiness."
The main points I want to share in this chapter are: 1.) I start by looking at research underpinning Robin Dunbar's huge claims for the importance of social networks for health, well-being, and happiness. I then go on to explore what we can helpfully do about these findings for our own lives and the lives of others. I do this using three overlapping approaches - points 2, 3 & 4 - each of which adds a useful new way of caring for our relationships. 2.) So I introduce the lens of Self-determination theory to highlight our key psychological needs for autonomy, competence, relatedness & beneficence and the importance of choosing life (and relationship) goals that respond in a balanced way to these needs. 3.) I then go on to explore the way Self-identity theory contributes further fascinating insights into the importance of multiple formal and informal group memberships for optimal involvement in relationships. And then 4.) I introduce Robin Dunbar's own layered model of personal social networks and consider how we can use this viewpoint to chart and improve the balance of our relationships still further. In later chapters in this relationship section of the book, I will look too at building closeness, working with conflict, and involvement in different kinds of relationships including couples, families, non-kin friendships, and even professional health care interactions. But first, what is the basis for claims about the very extensive benefits of social networks?
1.) Well as far as the health claim is concerned, this rests to a large extent on the fascinating 2010 paper - "Social relationships and mortality risk: A meta-analytic review" - which found that across 148 studies (308,849 participants), there was "a 50% increased likelihood of survival for participants with stronger social relationships. This finding remained consistent across age, sex, initial health status, cause of death, and follow-up period." A linked commentary in the British Medical Journal reported: "Having strong social relationships seems to have an effect on survival comparable to that of quitting smoking and larger than controlling traditional risk factors, such as obesity or hypertension ... Overall, strong social relationships improved the odds of survival by 50%. Similar results were found for two aspects of relationships, defined by the researchers as structural (integration in social networks) and functional (received or perceived social support), although the link with integration was somewhat stronger."
An associated editorial - "Social relationships are key to health, and to health policy" - commented: "Evidence from observational studies has documented the association between social relationships and beneficial effects on health outcomes, such as mortality ... Now, a systematic review and meta-analysis of the literature sheds further light on these questions ... Quite remarkably, the degree of mortality risk associated with lack of social relationships is similar to that which exists for more widely publicized risk factors, such as smoking. Arguably, such a level of risk deserves attention at the highest possible level in determination of health policy." And more recent reviews show similar concerning patterns - see, for example "Social relationships and risk of dementia: A systematic review and meta-analysis" and "Loneliness and social isolation as risk factors for mortality: A meta-analytic review".
So the very strong links between relationships and physical health are well supported. Why aren't we doing more about this? Well sadly it often takes a couple of decades or more for new scientific findings to make the long journey to changes in clinical & health policies. The recent appointment of a UK minister for loneliness is an encouraging development. There's much work to be done as a recent survey of British & Americans reported "while respondents' perceptions of the importance of established behavioural risks was positively and highly correlated with their actual importance, social factors were seen to be far less important for health than they actually are." Men and younger participants, the researchers noted, were more likely to underestimate the importance of social factors for health.
But it's not just about physical health & mortality - relationships are also immensely important for our resilience to psychological stress, and for our levels of happiness & life satisfaction. This is crucially relevant for pretty much all of us. The major paper "Social support and protection from depression: systematic review of current findings in Western countries" states "Evidence is overall highly consistent and supports the notion that social support is an important protective factor against depression." Exploring the same territory, the 2016 paper "Factors contributing to depressive mood states in everyday life: a systematic review" reported "A review of the literature suggests that poor sleep, negative social interactions, and stressful negative events may temporally precede spikes in depressed mood. In contrast, exercise and positive social interactions have been shown to predict subsequent declines in depressed mood." Interestingly a further 2016 paper - "Impact of functional and structural social relationships on two year depression outcomes" - highlights that relationship quality is likely to be more important than quantity in protecting against depression.
And study after study has underlined the crucial importance of relationships for happiness & wellbeing. Csikszentmihalyi & Hunter's "Happiness in everyday life: the uses of experience sampling" found highest levels of reported happiness when people were with friends. Diener & Seligman's study on "Very happy people" reported how social happy people are. And it's not just sociability, it's depth too. Demir et al found that friendship variables (number, quality, personality, conflict) accounted for nearly 60% of variance in happiness, with friendship "quality" being of particular importance. Similarly Reis et al's "Daily well-being: the role of autonomy, competence, and relatedness" reported that to satisfy relationship needs "The best predictors were meaningful talk and feeling understood and appreciated by interaction partners". And in a further study - "Eavesdropping on happiness" - Mehl & colleagues used digital audio recorders to track real world behaviour and found that "The happy life is social rather than solitary, and conversationally deep rather than superficial".
This strong link between relationships & wellbeing also seems true for all age groups, so a big study on school children found that "peer belonging and relationships with adults at home and school were the strongest predictors of life satisfaction." Headey & colleagues' important series of studies on wellbeing - for example "Choices which change life satisfaction: Similar results for Australia, Britain and Germany" - highlights the importance of giving high priority to relationships to lastingly improve overall life satisfaction. While Siedlecki's study on 18 to 95 year olds shows that social support links strongly to wellbeing across all adult age groups.
Now what can we best do about all these findings? I said I would suggest responses informed by Self-determination theory, Self-identity theory, and Dunbar's Layered model of social network structure. So 2.) Here's a link to the next section of this chapter - Social networks: the value of a self-determination theory lens . 3.) Here's a link to the two-part third section - Social networks: social identity & the importance of both formal & informal group memberships (background) and Social networks: social identity & the importance of both formal & informal group memberships (what can we do?). And 4.) Here's a link to the three-part fourth & last section - Social networks: Dunbar's 5-15-50-150 model (support clique/closest relationships), Social networks: Dunbar's 5-15-50-150 model (sympathy group & full active network) and Social networks: Dunbar's 5-15-50-150 model (assessing how we're doing). All three of these sections give you overlapping & helpful ways of understanding personal relationship networks, assessing how one is doing, and clarifying ways of looking after & growing the health of one's relationships.
And here's a link that will take you back to the full list of book chapters.