Friends and longevity: the science of social connection

Mike Bohl, MD, MPH, ALM - Contributor Avatar

Written by Tzvi Doron, DO 

Mike Bohl, MD, MPH, ALM - Contributor Avatar

Written by Tzvi Doron, DO 

last updated: Apr 08, 2020

3 min read

We write a lot about cholesterol, blood pressure, a heart-healthy diet, and the benefits of physical activity—and rightly so. All of that stuff is vital to a long, healthy life. But it turns out that the way we spend our time—and who we spend it with—might also be important. The science is clear. Social connection is a fundamental part of a healthy lifestyle and may be one of the major factors that determine how long and how well you live.


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Social connection, cardiovascular disease, and mortality

The quality of your social connections is directly related to your risk of cardiovascular disease. Even “perceived loneliness” has been associated with a 29% increased risk of heart disease and a 32% increased risk of stroke (Valtorta, 2016). And the mortality rates are worse for people who already have heart disease. Poor social integration (e.g. a low number of close relationships) predicts a 61% increased risk of death (Kreibig, 2014). Some studies show even higher risks to social isolation (Havranek, 2015).

Researchers have also looked at the relationship between social isolation and overall mortality. And while these outcomes are difficult to measure, the consensus is that loneliness predicts an increased risk of dying from all causes. A review of 148 studies (with over 300,000 participants) indicated a “50% increased likelihood of survival for participants with stronger social relationships, regardless of age, sex, initial health status, and even cause of death.”

This means that loneliness is as dangerous to your health as smoking and an even bigger risk factor than obesity and a sedentary lifestyle (Holt-Lunstad, 2010).

Why is social connection so important?

People have a lot of explanations for why loneliness increases the risk of heart disease, stroke, and mortality. One popular explanation is that people who are socially isolated are more likely to engage in negative health behaviors such as smoking, weight gain, and excessive alcohol use (Umberson, 2010). Another possible explanation is that the negative psychological states associated with loneliness cause changes that increase the risk of heart attack, stroke, and death. This includes an increase in activation of the sympathetic nervous system and hypothalamic-pituitary-adrenal (HPA) axis—two systems involved in your stress response.

The downstream effects of social isolation include inflammation, high blood pressure, increased blood clotting, and decreased immune function, which all lead to plaque buildup in the arteries—aka heart attack, stroke, and death. And it’s not just speculation. In a very real sense, loneliness and social isolation are bad for your health.

The prescription: friendship

There aren’t really any “side effects” to spending quality time with the people you care about and cultivating new relationships. Your overall survival rate increases by 50% if you have strong social relationships. One study found that more than 80% of centenarians communicate with a friend or family member daily (Elder Care Alliance, 2018). Another common thread for people in the 100+ club is regular social engagement. Take part in your community and you might be an old-timer dispensing advice 80 years from now.

Participate in your community

Research has consistently found that attending church regularly comes with a decreased risk of organ dysfunction and death (Bruce, 2017). Some studies show that this is at least partially due to better social connectedness and better health behaviors (Strawbridge, 1997). If you’re not religious, it’s possible that these benefits could come from other kinds of social groups and gatherings. Crossfit, for example, has served as a gathering place for thousands of people.

And if grunting and throwing tractors around isn’t your thing, there’s no shortage of options. Meetups are another great example of a way to get together and make social connections with people with common goals and interests. Find a club, join a team, attend a silly lecture series, and go to the coffee hang afterward. However you do it, engage with the people around and nourish your existing relationships with friends and family. There’s just something about getting together with people who share your values and interests.

Give social connection a try. It may even help you live longer.


If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

April 08, 2020

Written by

Tzvi Doron, DO

Fact checked by

Mike Bohl, MD, MPH, ALM

About the medical reviewer

Dr. Mike is a licensed physician and a former Director, Medical Content & Education at Ro.