Social Interactions and Health: New Insights into the Role of Connectedness

“The first need is connectedness to self, the second need is connectedness to others and the third need is connectedness to the world”

The American College of Lifestyle Medicine (ACLM) should be proud to be one of the first medical organizations to clearly acknowledge that social connections are a key component to overall health and well-being. ACLM underscored this by including the concept of positive social connections as one of the six pillars in lifestyle medicine. ¹

ACLM’s position in this area has been buttressed by a number of publications, most recently the outstanding, evidence-based report “Together: The Healing Power of Human Connection in a Sometimes Lonely World” issued by former Surgeon General Vivek Murthy. ² Other seminal publications in this area include Robert Putnam’s 2000 book “Bowing Alone: The Collapse and Revival of American Community.” ³ Some of the longevity work by Dan Buettner and colleagues also helped establish the concept of connectedness in Blue Zones. ⁴ In addition, a wonderful book by Drs. Waldinger and Shultz entitled “The Good Life: Lessons from the World’s Longest Scientific Study of Happiness” provided further documentation of the value of interpersonal connections. ⁵

While each of these contributions helped us further understand connections, they often focused on negative health consequences of a lack of connections. For example, Dr. Murthy reported that loneliness is as deadly as smoking 15 cigarettes a day and more lethal than consuming six alcoholic beverages per day. Citing abundant research he reported that loneliness is more dangerous to health than obesity. He also observed that loneliness “not only crushes the soul but is linked to strokes, heart disease, dementia, inflammation and suicide.”

While these alarming facts buttressed the clarion call to the dangers of loneliness and disconnection, less attention has been focused on the healing power of connectedness. Dr Murthy provided some thoughts in this area by recommending the following four strategies to enhance connectedness:

• (1) Spend more time each day with those you love

• (2) Focus on each other

• (3) Embrace solitude

• (4) Help and be helped

In the current issue of the American Journal of Lifestyle Medicine (AJLM), we are delighted to publish a seminal paper describing the powerful health promoting benefits of connectedness. The paper also provides a sophisticated and user-friendly framework for achieving connections.

This paper by Merlo, Snellman and Sugden ⁶ describes a model of connectedness broken up into six domains. (1) Happiness (2) Purpose in Life and Meaning Making (3) Empathy and Compassion (4) Social Connection and Community (5) Nature (6) Spirituality and Religion.

These six domains are further cross referenced to three needs that all humans share. The first need is connectedness to self, the second need is connectedness to others and the third need is connectedness to the world. This is an extremely important paper which offers fresh insights and abundant academic support for the health benefits of connectedness. It provides a road map with an enormous amount of medical evidence about how lifestyle physicians should approach this issue. This article expands on the pioneering work of Dr Merlo who continues to provide innovative and persuasive linkages between lifestyle psychiatry and lifestyle medicine. ⁷

I was particularly impressed by the insightful discussion of how connectedness to self precedes and is foundational to all other forms of connection. Connection to self is based on compassion to self and gratitude to others, both of which are strongly linked to happiness and purpose in life.

Two aspects of the article by Merlo, Snellman and Sugden are particularly relevant to practitioners of lifestyle medicine and indeed, to every physician. The first is that it includes an enormous amount of hardcore science in psychiatry and neurology. The second is that the authors provide a series of practical applications for how connectedness can be utilized in counseling sessions for all age groups including children, adults, older adults, and individuals who are pregnant. All of these recommendations should help lifestyle medicine practitioners make the linkage between connectedness to clinical counseling sessions.

I am also especially pleased that the article by Merlo, Snellman and Sugden serves as the lead article inaugurating the theme around the topic of connectedness and its impact on health offered in this issue of AJLM. Eighteen months ago I wrote an Editorial in AJLM entitled “Loneliness and Lifestyle Medicine.” In this Editorial I lamented that AJLM was receiving relatively few research articles and commentaries in the area of connectedness. I challenged our readership to consider increased work in this area followed by submission of papers to AJLM. I am delighted that this has now started to happen as evidenced by the articles contained in this issue.

There is no longer any serious question that connectedness, whether it be to one self, other people, or the planet, satisfies basic human needs all of which are critically important to health. These are central concepts in the area of lifestyle medicine. I am proud that the lifestyle medicine community has seized the leadership position in articulating why these issues are so important to both short and long-term health and quality of life.