Having few friends predicts early death as much as smoking or alcoholism

“Low social interaction as high a risk factor for early death as smoking 15 cigarettes daily or being an alcoholic, and twice the risk factor of obesity.”

Julianne Holt-Lunstad, a psychologist at BYU, published a recent meta-analysis with Timothy Smith and J. Bradley Layton (that culls from learning across 148 longitudinal health studies covering over 300,000 individuals). They showed that increased involvement in social networks on average reduces one’s chance of mortality over the period of any particular study by 50+%, a greater effect than either stopping smoking or eliminating one’s obesity/physical inactivity.

The study “Social Relationships and Mortality Risk: A Meta-analytic Review” appears in the journal PLoS Medicine.  They controlled for baseline health status,  and found consistent results for friendships with family, friends, neighbors and colleagues across age, gender, initial health status, cause of death, and follow-up period.

The life-protective benefits of friendship were strongest for complex measures of social integration and lowest for simple measures of residential status (e.g., living alone versus with others) .  In studies that had greater dimensions of social involvement (whether one was in a network, the kinds of social support one got, etc.), the life-protecting benefits of friendships were higher, likely corresponding to the multiple pathways through which friendships provide benefits.

Low social interaction, according to the authors, was as high a risk factor for early death as smoking 15 cigarettes a day or being an alcoholic.  Low social interaction was a higher risk factor than not exercising and twice as high a risk factor for early death as obesity.

Co-author Tim Smith noted: “We take relationships for granted as humans – we’re like fish that don’t notice the water….That constant interaction is not only beneficial psychologically but directly to our physical health.”

The longitudinal studies they analyzed tracked health outcomes and social interaction for a period of seven and a half years on average.

The 50% increased survival rate is quite likely an underestimate: these longitudinal studies don’t track relationship quality but only one’s inclusion in a social network, so they include negative relationships as well. Survival benefits of friendships are likely to be much higher if one could isolate only positive and healthy social relationships.

Holt-Lunstad speculated that the pathways of social relationships to improved longevity stem range from  “a calming touch to finding meaning in life.” She believes that those who are socially connected take greater responsibility for others’ and their own lives and take fewer risks.

Here is key Figure 6 from their study:

Unlike some other work, such as Eric Klinenberg’s Heat Wave, where shut-in elderly were especially at risk of death in Chicago’s 1995 heat wave, the findings of Holt-Lunstad are generalizable to all age groups.