How Do Others Get under Our Skin?
Social Relationships and Health
As highlighted by the various chapters in this volume, there has been a growing recognition and interest in the role of social relationships in health and well-being throughout life. Indeed, over the past several decades, a considerable body of research has documented associations between the extent and quality of an individual's social relationships and better health and longevity (Broadhead et al., 1983; Cohen & Syme, 1984; House, Landis, & Umberson, 1988). While the evidence linking social isolation or lack of social support to increased risks for morbidity and mortality continues to grow rapidly, important questions remain concerning the precise mechanisms or pathways by which such social circumstances influence health outcomes. Various hypotheses have been offered (and supporting data found) for mediating pathways through social network influences on attitudes and behaviors that are known to have an impact on health and longevity, for example, evidence for associations between more healthful lifestyles and more successful risk-reduction efforts, such as reducing dietary fat, exercising, and smoking cessation (Bovbjerg et al., 1995; Cohen, 1991; Duncan & McAuley, 1993; House, Robbins, & Metzner, 1982; Sallis et al., 1989; Seeman, Seeman, & Sayles, 1985; Umberson, 1987). Social ties and support, however, have also been found to remain significant predictors of morbidity and mortality in their own right, independent of any associations with other risk factors (Broadhead et al., 1983; Cohen, 1991; Henry, 1983; Seeman et al., 1993; Seeman, Kaplan, Knudsen, Cohen, & Guralnik, 1987; Seeman & Syme, 1987). One area that has not received a full exploration is the hypothesis that there are more direct biological effects of social ties on human physiology, which may contribute to the observed associations between such ties and differential morbidity and mortality risks (Bovard, 1961, 1962, 1985; Cassel, 1976; Williams, 1985).
In this chapter, evidence that links social relationships to various health outcomes, including overall longevity and coronary heart disease (CHD), is outlined.