Social Connection, Public Health, health, Priority, Public Health Priority, United States


A robust body of scientific evidence indicates that being embedded in high-quality close relationships and feeling socially connected to the people in your life is associated with decreased risk for all-cause mortality as well as a range of disease morbidities. Despite mounting evidence that the magnitude of these associations is comparable to many leading health determinants (that receive significant public health resources), government agencies, healthcare providers and associations, and public/private healthcare funders are slow to recognize human social relationships as either a health determinant or health risk marker in a manner that is comparable to other public health priorities. This article evaluates current evidence (on social relationships and health) according to criteria commonly used in determining public health priorities. The piece discusses challenges for reducing risk in this area and outlines an agenda for integrating social relationships into current public health priorities. Social Relationships and Public Health “The secret of getting ahead is getting started.” - Attributed to Mark Twain; remains unsourced Broad-based epidemiological studies provide clear and compelling evidence that social relationship status and functioning predict an array of important health outcomes and risk for premature mortality (House, Landis, & Umberson, 1988; Holt-Lunstad, Smith & Layton, 2010; Sbarra, Law, & Portley, 2011; Robles, Slatcher, Trombello, & McGinn, 2014; Shor & Roelfs, 2015). There is also a rich literature documenting the potential mechanisms that connect relationships to health outcomes (e.g., Uchino, 2006). Academics in interdisciplinary fields (e.g., epidemiology, psychology, sociology) have known about these findings for decades, but this work and its implications have only recently begun to trickle into the discussions of major health organizations. Most notably, the World Health Organization (WHO) now lists “Social Support Networks” as a determinant of health (WHO, n.d.) and the United Kingdom (UK) Minister of Health has established loneliness as a health priority (UK Department for Work & Pensions, 2015). Despite these laudable efforts, social relationships remain notably missing from the lists of currently accepted determinants of health for most major U.S. government agencies, healthcare providers and associations, and public/private healthcare funders 1 (e.g., Centers for Disease Control [CDC], Healthy People 2020, American Heart Association), and largely unrecognized or underappreciated by the general public. These facts raise important questions: Why are social relationships not adequately acknowledged and what steps may be necessary to update national public health priorities in a manner that is more consistent with the empirical research in this area? This paper addresses these questions and outlines an agenda for integrating social relationships into current public health priorities moving forward. Many people—from psychologists to public health officials— will assume that public health prioritization refers to large-scale interventions and/or social engineering that somehow legislates “better relationships” for all; understandably, this perspective may lead to reactance and concerns that any public health focus on social relationships is premature, naïve, or a form of unnecessary government involvement in matters of personal choice. However, quite simply, greater public health prioritization refers to directing “resources, time, and energy to those issues that are deemed most critical and practical to address” (CDC). Such resources can be directed toward education, basic and applied research, surveillance, containment and prevention efforts, public health policy, interventions, and even, if the data supports it, social engineering.

Original Publication Citation

Am Psychol. 2017 September ; 72(6): 517–530. doi:10.1037/amp0000103

Document Type

Peer-Reviewed Article

Publication Date



American Psychology




Family, Home, and Social Sciences



University Standing at Time of Publication

Full Professor

Included in

Psychology Commons