JULIANNE HOLT-LUNSTAD: OK, my name is Julianne Holt-Lunstad. I am a professor of psychology and neuroscience at Brigham Young University. My work, my research focuses on relationships, so, social relationships and their impact on our health. And in particular, physical health. This work has, of course, led me to looking at social isolation and loneliness but conversely also looks at the protective effects of being socially connected as well.
ARNOLD: So, essentially, when Julianne started her research, like no one was doing much with loneliness. There were only five studies published in 1988. So, as new research started to bubble up to the surface, she began gathering evidence from all over the world to really connect the dots. She began looking at all of the different ways that people are connected. And she found that people with a high level of social connection had a 50% increased rate of survival. But people didn’t really believe her right away.
SCHWARTZ: I can see why. Really? 50 percent? That seems incredibly high.
ARNOLD: Yeah it sounds like so much! But in order to prove it, she took the study a step further.
HOLT-LUNSTAD: So really what I did was, as you know, the impact of this on our health, our physical health, and even how long we live, is not very well-recognized by the general public or even the medical community. But there are decades of epidemiological research. Where large scale studies have followed people, in some cases thousands of people, over years. And often decades, to see to what extent are people socially connected or conversely, isolated or lonely, and does this predict how long people live?
Because this was so unrecognized, we benchmarked it relative to other factors that people take very seriously. So, things like smoking, alcohol consumption, obesity, physical inactivity. What we found was that this was comparable and in many cases exceeded the magnitude of risk associated with these other factors.
So, then I did another one specifically looking at isolation and loneliness. This time we had data from over 3.4 million people worldwide. Again, we found a significant effect. So, isolation, loneliness and living alone were each independent risk factors for premature mortality.
SCHWARTZ: So, I wonder how the types of relationships you have make a difference? Honestly, most of the strong relationships I’ve built as an adult have been through running.
ARNOLD: Yeah, same. I totally went there in my mind as soon as she mentioned relationships, too. And it’s so much more complex than I even originally imagined. Here’s what Julianne said:
HOLT-LUNSTAD: Of course, relationships are complex. Understandably, researchers have studied this in a variety of ways. One of the things we did in the big meta analysis was tried to organize to see whether some were more predictive of risk than others. So generally, we were able to categorize these in three different ways.
One was when they look at the structure of our relationships or network. So, this would get at the size of your network, or how many people you have contact with or how frequently you have contact with them. Whether or not you live alone. So, really kind of numbers-based. So, they really just get at the presence or absence of others in your life, right? And they may not get at how meaningful those relationships are or whatnot.
And, so, the next one gets at the functions our relationships serve. And some look at the extent to which there’s social support whether it’s perceived or received. The extent to which you have someone you can turn to for a favor, for understanding. For advice. So, these functions that our relationships serve.
ARNOLD: We really lean on one another for advice, for grounding, for reality checks, for just acceptance. I feel like that is what we do when we’re out running together. And it’s so interesting to me because I think about how oftentimes, without running, many of us may not have crossed paths. And now we’re really close friends.
SCHWARTZ: Right, and with running friends, there’s a tendency to really connect. We’re not distracted by technology or anything else when we’re running. And honestly, that’s kind of unique these days. Plus, when we run with others, we’re conquering a challenge together. I mean, do you think those feelings help us connect on a deeper level?
ARNOLD: Yeah, I absolutely do, and I think you really nailed it on the head when you said we’re free of distractions and we’re like, conquering this thing together. And there’s a lot of power in that. Going through adversity with someone else. So, when I talked to Julianne a little more about this, she also talked about the quality of relationships and loneliness and the role various relationships serve in our lives.
HOLT-LUNSTSTAD: Finally, the last, third category gets at quality. Positive and negative aspects. How satisfied you are in your relationship or how much conflict or strain there is in the relationship. Interestingly, they all predict health outcomes. So, not only are the close, intimate, positive, meaningful relationships are really important. There's also evidence to support even casual interactions, you know, saying hello when you pass on the street or to the person bagging your groceries, or whatever, even those little moments of social connection can be beneficial.
Having a diversity of relationships may be particularly strong because different kinds of relationships might fulfill different kinds of needs that we have. And so, we shouldn’t discount these but we should recognize, however, that negativity in relationships has been associated with risk. So, not all relationships are positive. Negativity can be not only associated with stress but detrimental physical health outcomes.
ARNOLD: So, this part got me thinking about marginalized people like the BIPOC community, and how maybe loneliness is an even bigger obstacle for them because of microaggressions. This is the thing we touched on earlier when you were interviewing Mike.
You know, maybe someone is less likely to say hello to someone of color on the street running by or smile at them when they run by because of some kind of racial bias. And what if over time, does that develop into a pattern of loneliness? And if so, does that make it harder to be included, or to feel included? So, I asked Julianne about that and she said it might be true. And here’s why.
HOLT-LUNSTAD: There is some research suggests that those who are members of marginalized or stigmatized groups are at increased risk for social isolation and loneliness. That doesn’t mean that they always are, or are not. We can’t just assume that anyone is or is not isolated or lonely but it does increase one’s risk. You point to one potential source for that. That’s another point to always be conscious of. The mechanisms behind these. And how we can act to disrupt these kinds of cycles.
ARNOLD: I also, naturally, asked her if she thought that running could potentially be an avenue to build community?
ARNOLD: And, well, she says, yeah. She doesn’t run, but it sounds like her husband is a prolific runner. He’s done several marathons, ironmans, and so she’s been at these events supporting him, and she’s also a really avid hiker.
HOLT-LUNSTAD: I’ve been at these events and have seen firsthand the amount of support that is required. While my research doesn’t focus specifically on runners I have seen how there can be this sense of community around that. And there is some research to support outside of events like that, a walking or running or any exercise program. Having someone to do it with, people are more likely to stick with it. Having that support. Knowing that person is counting on you to meet at six am, you’re more likely to get out there and show up for that person depending on you. That in turn is linked to better outcomes also.
SCHWARTZ: My big takeaway from that is really that she says “someone else to do it with.” I do think that running with others reinforces the idea that you can count on those friends. It makes me think of some of the conversations I had with the Achilles athletes! But we’ll get to that later.
ARNOLD: OK, so one other thing here that I think might sort of tie in, is this idea of negative bias.
HOLT-LUNSTAD: One of the things characteristic with individuals with chronic levels of loneliness is a negative cognitive bias, or repetitive negative thinking. What this means is in ambiguous social situations there’s a tendency to perhaps assume negative intent.
ARNOLD: So, Julianne gave this example of like if you text your friend and they don’t respond right away. Your response could be, oh they’re busy, maybe they’re making dinner or they’re with their family. Or, you could think, oh that person’s ignoring me. Then you could take it a step further and actually text them and say, “Are you ignoring me?” Then you’ve created this defensive situation. That sort of energy can spread. Then you’ve put your friend in this awkward situation where they have to react to that. Versus assuming goodwill, I guess you could say. We talked about that negative feedback loop that happens and then she took it a step further to talk about some emerging research in gratitude.
HOLT-LUNSTAD: So researchers are looking at can empathizing with the other, can that help disrupt and start to lessen the repetitive negative thinking? Can we decrease that in a way to interrupt that cycle?
Another strategy is around gratitude. By expressing gratitude to someone, telling them something like, hey, I just wanted to reach out, and let you know I really love this interview, thank you so much for considering me. You are an amazing interviewer, all of these sorts of things, that will elicit, of course, a more of a positive response in return, right? By expressing gratitude by those relationships it strengthens those relationships, and creates an upward spiral instead of a downward spiral and can reduce loneliness. These are some ways that we’re trying to find to disrupt these cycles.
SCHWARTZ: Gratitude is definitely having its moment in the sun. And for good reason!
ARNOLD: Kate. I’m going to use this opportunity to tell you that I’m grateful for you. And for this podcast recording that we’re doing in this closet right now.
SCHWARTZ: Aw, that’s really sweet. I’m grateful for this closet. (Both laugh). And you, of course.
ARNOLD: We went on to talk about COVID-19 and its affect on loneliness. Really tangental to today’s conversation, but interesting stuff. But I also found it really relevant to our next conversation. And to the conversation that you and Mike had, Kate. Here’s what she said.
HOLT-LUNSTAD: And so, now the challenge is, what can we do to help reduce the health burden of this? And reduce risk. Thinking about this from not only just individual-based intervention programs, but public health policy. How do we address this on a population level? Every aspect of our life is influenced by a social component. What we do can have an effect for good or bad. So, these policies we’re implementing can either reduce or increase risk. So, I’m really excited about the future. Because this is an important turning point. I hope we can take this turning point in a positive direction and be much more consciously aware and socially aware.