The Value of Social Connection for Immune Health
By now, for most of us, social distancing has becoming a normalized part of our lives. We have holed up inside our living spaces for the sake of public health, doing our best to instill some aspect of normalcy in a world that feels far from normal. As we dig into books, work through puzzles, engage in yet another zoom conference call, or escape for hours into a Netflix binge, we are adjusting to (for many of us) the unfamiliar cloak of physical social isolation. This physical isolation has us sitting on the edge of a two sided coin: on one side it might feel comforting to disengage, it allows us space and time to grieve for all that we have lost; it can feel indulgent to spend the day in our pajamas with the comforts of our home always within reach; it allows us to spend time with our families, partners, and pets that we live with, which for some can be an unexpected gift in this time of chaos. On the other side of that coin is the cost: loneliness in which our arms no longer remember the imprint of a loved one’s embrace; fear as we grapple with the unknown and the unrelenting concern for our health, the health of others, and our jobs; the lack of safety as we no longer are able to rely on our social networks for support, as the already vulnerable and marginalized become significantly more so.
As our world comes suddenly and astoundingly to a halt, it has forced us to grapple with both the welcome and unwelcome reality that is our fundamental need for social connectedness. Indeed for many of us, this time has become one in which we have started to reach out to friends and family with whom we long ago lost connection, to neighbors who are in need of a helping hand or just a smiling wave from afar, to friends, counselors, therapists, via telephone or zoom for extra support and comforting words to help ballast the anxiety, fear, and worry many of us are struggling with. As the cloak of physical isolation starts to weigh on us, perhaps we even start to consider others in a new light, finding empathy for those who bear the burden of that weight both in pandemic and non-pandemic times.
Our need for social connection is not just an emotional one, it has profound effects on our mental and physical health as well. Studies have shown that social isolation is as significant of a risk factor for death as is physical inactivity, obesity, and lack of access to healthcare. Additionally, social isolation has been linked to increased incidence of heart disease in all races and increased cancer mortality in Caucasian populations. It has been linked to outbreaks of both herpes and Epstein barr virus. How is this possible? The key lies buried deep within our genome.
Our genome contains all of our genetic material, acting as a very detailed instructional manual if you will, for the body. As research on epigenetics have shown, not all of our genome is set in stone, rather some of it can be influenced by our environment and our experiences. Think of your genome as a switch bank; some genes are switched on all the time and others are switched either on or off depending on specific environmental factors. For example, long term exposure to a specific pollutant might turn on a genomic switch that predisposes you to a neurodegenerative disease. On the flipside, eating a diet high in certain key nutrients might act to switch on a tumor suppressor gene, helping your body fight against a specific cancer. Social isolation, it turns out, can act to switch on or off specific genes that influence our immune system health.
One study that looked at social isolation over a period of 4 years found that genes that promoted inflammation were selectively upregulated (switched on) whereas genes that helped to control viral infections were downregulated (switched off). This could explain why social isolation is associated with inflammatory conditions such as heart disease and cancer as well as conditions that are a result of a weakened immune response such as viral infections and poor response to vaccines. This pattern has not only been seen in those experiencing social isolation but has also been seen in patients experiencing bereavement, traumatic stress, a recent cancer diagnosis, and low socioeconomic status.
The good news is that in the same way that social isolation can promote inflammation and our susceptibility to viruses, social connectedness can reverse these outcomes, helping to regulate our immune system in a healthier way. Interventions that help to alleviate the experience of loneliness have been shown to reduce the expression of pro-inflammatory genes, effectively flipping the “inflammation switch” that was turned on during isolation, back off. Furthermore, activities that act to reduce stress can also aid in this process.
Social connectedness not only is vital to our emotional wellbeing, it is essential for our health. Although for the near future it may be physically impossible to gather together, there are many ways to connect with one another. Whether it is through phone conversations, Marco Polo apps, zoom meet ups, a letter to a friend, a care package to a family member, even a thank you card to an essential worker, it is vital that we remain connected. For not only are we stronger together, we are healthier together as well.
References:
Alcaraz KI, Eddens KS, Blasé JL, Diver WR, Patel AV, Teras LR, Stevens VL, Jacobs EJ, Gapstur SM. Social Isolation and Mortality in US Black and White Men and Women. American Journal of Epidemiology, 2018; DOI: 10.1093/aje/kwy231
Cole, SW. Social Regulation of Human Gene Expression: Mechanisms and Implications for Public Health. American Journal of Public Health, 2013; 23(103), S84-92. doi: 10.2105/AJPH.2012.301183
Ong AD, Allaire, JC. Cardiovascular Intraindividual Variability in Later Life: The Influence of Social Connectedness and Positive Emotions. Psychology and Aging, 2005; 20(3), 476-485. https://doi.org/10.1037/0882-7974.20.3.476
Sin NL, Graham-Engeland JE, Ong AD, Almeida DM. Affective reactivity to daily stressors is associated with elevated inflammation. Health Psychol. 2015 Dec;34(12):1154-65. doi: 10.1037/hea0000240.