Americans enjoy being independent, but we all need connections to flourish

The demographics of U.S. society are changing: New census data indicate that 25 percent or more of Americans live alone. Many of these individuals do not have natural, built-in support systems, which is critical for mental and physical health.

Given these changes, can we turn to hired help, paid professionals, or community volunteers to provide the benefits of social support? The answer is a resounding yes, and as a society we had better be prepared to supplement our friend-and-family support with outside help.

Social Connectedness: The Surgeon General’s Priority

This year, Surgeon General Vivek Murthy has highlighted the fact that in current times, Americans have fewer social ties than in previous decades, and with that, have poorer mental and physical health. Sadly, Americans report having fewer close friends than in generations past, according to a New York Post article. And, average family sizes have decreased.

Part of the reason for the change is because the internet and other media are able to showcase opportunities throughout the country, many people choose to move away from their biological families and early friends to seek out interesting jobs or just to find adventure. However, with this comes sociodemographic change. Traditional social support, thus, is not a given for most Americans.

In addition, individuals living in communities have become more isolated, with many no longer participating in organized religion or joining local clubs and organizations, such as the Boy Scouts of America. Murthy strongly advocates for improving social connections as a means to decreasing depression and anxiety and improving well-being. If we have fewer close friends and smaller families, we may need to use formal, professional means to enhance needed social relationships.

Positive Biochemical Changes via Support

Research has demonstrated that psychosocial variables, like optimism (a variable with positive effects) and depression (a variable with negative effects), can sometimes tilt the scales to help improve or worsen a health diagnosis. Similarly, the positive psychosocial variable of social support is often associated with slightly improved health outcomes in persons who receive such support and may even delay death.

The biological mechanisms by which social support improves a person’s health are still under investigation, but it is hypothesized that social support decreases cortisol and/or inflammation in humans, with a slight improvement in health. While it is difficult to research this somewhat non-specific variable, studies point toward a positive effect of social support.

Researchers have categorized social support into types including emotional support; informational support; tangible social support; positive social interaction; and affectionate support, among others.

Some of these types of support, such as affection and emotional support, might best come from an intimate partner. However, other support can essentially be hired or can come from community volunteers. Health coaches or counselors can provide informational support. An occupational therapy aide (OTA) can provide tangible support; for instance, an OTA aide can help a senior walk to a community dining room at a seniors’ residence. If one does not have close friends, trying a Meetup app group may provide social interaction.

Seniors can hire drivers and as such receive tangible support. Young moms can join community groups to get informational support to help them with child-care challenges. All of these types of support may help the recipients feel reassured about their situations and produce less stress hormone affecting their well-being (and ultimately their health).

Availability of Formal Social Support

Non-family or friend resources abound and provide excellent support. Recent studies show that community doulas coaching pregnant moms can improve birth outcomes, especially in minorities. Friendly visitor programs have been shown to decrease senior loneliness (42 percent) and social isolation (53 percent).

Frail elders living in states where there are higher levels of home services had less depression. And, some studies suggest that formal support helps individuals have less stress about perceived health problems.

The contrary is true: Decreased tangible support has been shown to be associated with depression. And social isolation and lack of support worsens one’s chance for dementia.

From a health policy perspective, the U.S. should incentivize training formal supports, such as case managers and doulas, which in the long run could save the nation money. For example, case managers providing emotional and informational support have helped to keep patients recently hospitalized from re-hospitalization.

Professional Providers

Our country will thrive and enjoy better health if we support these professional providers of social support. But people will have to come together to advocate for better pay for these crucial workers.

If our system does not help with these social connections, we will have to find them ourselves. Some people might choose to join a house of worship. Others might sign up for a local volunteer effort, such as through the American Heart Association.

Still, others could work part-time at a local shop or at the library, meeting people they might not normally encounter. Social support can also be found by asking a teen to mow your lawn or paying a neighbor to provide transportation or do household chores.

Finally, each of us can be a support to another person in our community. Studies show that there are health and biological benefits to both giving and receiving social support. Support might make a tiny difference in health outcomes for an individual, and giving and receiving support might just help the loneliness epidemic.