Can Being Alone Lead To Premature Death?

Photographed By Maria Del Rio.
By Samantha Joel

If someone asked me to pick the most influential finding that has come out of relationship science to date, I’d say it’s this: relationships matter for health. In 1988, James House and colleagues published their classic research paper showing that social isolation is a powerful predictor of premature death. Since then, dozens of studies have tested — and consistently replicated — this link.

A recent meta-analysis of 148 studies (spanning over 300,000 participants!) showed that people with stronger social relationships are about 50% more likely to survive over a 7.5 year period compared to those with weak social ties. This is a huge effect: it suggests that social isolation is more dangerous than a number of well-established risk factors of mortality, such as obesity and physical inactivity.

In response to these findings, many policy makers, health practitioners, and members of the general public have started viewing social relationships not just as something nice to have, but as a fundamental human need. Humans simply need to have close relationships in order to survive and thrive.

But the issue of how relationships affect health is not as well understood. What aspects of social relationships are particularly important? How do social relationships influence the body? These sorts of questions about specificity and mechanism are what many researchers in the field are now figuring out.

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In a study recently published in Psychological Science, researchers tested how romantic relationships might influence health. They predicted that one aspect of romantic relationships that may be particularly important for health is partner responsiveness.

What is that, exactly? A responsive partner is someone who makes you feel understood, validated, and cared for. In a previous post, I talked about how having a responsive partner is like navigating a relationship in easy mode: It’s much easier to work through issues with a partner who is understanding, validating, and caring, compared to a partner that lacks these characteristics. But there is also some research suggesting that people might in fact be physically healthier when they feel that their partner is responsive to their needs.

How exactly could a partner’s responsiveness “get under the skin” to influence health? Slatcher and colleagues predicted that responsiveness might affect cortisol production. Cortisol is a hormone that helps to regulate a diverse set of functions in the human body, ranging from higher-order functions like learning and memory to more basic functions, like immune system responses and the breaking down of food (i.e., metabolism). New research suggests that the body’s rhythm of cortisol production throughout the day has important implications for health. People with “steeper” cortisol profiles — higher cortisol output in the morning, with declining output throughout the rest of the day — tend to have better health outcomes compared to people with flatter profiles.

Social isolation is more dangerous than a number of well-established risk factors for mortality.

Slatcher and colleagues predicted that having a high-quality romantic relationship — in which the person feels that their partner is responsive to their needs — might lead to long-term improvements in how the body produces cortisol. To test this, the researchers analyzed over a thousand participants who were either married or living with their partners. Participants indicated how responsive they thought their partner was by rating how much they thought their partner cared about them, understood their feelings, and appreciated them. Participants also provided four saliva samples per day over a four-day period, so that researchers could determine their cortisol profiles. A decade later, the same participants completed the same measures, allowing the researchers to examine how responsiveness might predict changes in cortisol profiles over time.

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The researchers found that people who felt their partners were more responsive at Time 1 had healthier cortisol profiles ten years later: They had higher cortisol levels shortly after waking up, as well as a steeper decline in cortisol levels throughout the day. This was true even for people who were no longer with the same partner, suggesting that people may benefit from high-quality romantic relationships even after those relationships have ended.

What's more, these effects held for a number of other relevant components, such as gender, age, and depressive symptoms, suggesting that the results could not be attributed to these other factors. However, the researchers did find that their results were partially explained by negative emotion: People with more responsive partners subsequently tended to experience fewer negative emotions, which helped to explain their improved cortisol profiles.

These results suggest that having a thoughtful, caring romantic partner, even temporarily, may have a lasting, positive impact on how our bodies function. But as this is the first study of its kind, more research is needed before we can feel confident about this conclusion. It’s difficult to say, especially just from this single study, that responsive partners cause people to produce cortisol more effectively. If responsive partners do improve cortisol profiles, it’s not at all clear how that process happens. The negative emotion results give us a clue — perhaps responsive partners lead to steeper cortisol profiles because they help people to regulate their emotions more effectively? — but at this point, we can only speculate about the specific mechanisms that might be at work.

The question of why healthy relationships go hand-in-hand with healthy bodies is one of the field’s biggest puzzles. This new study represents one of science’s more ambitious attempts to fit the pieces together.

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