Relational health is VITAL to our health and well being.  Yet, as health providers, many of us are not taught to routinely ask our patients about their relational health nor how to intervene when we are concerned.  We often ask about our patient’s nutrition, physical activities, smoking, and alcohol intake, but we do not generally ask if our patient feels loved, has someone they can talk to when they are sad or scared, or if they feel that they belong.  These are just as important, if not more so, to our patients’ health.   

VITAL is aimed at translating the research, science, public health advances and policy perspectives into clinical practice and to offer clear strategies and tools for what you can do in your busy practice to assess for relational health and treat when needed. 

Promotes overall improved  health and longevity

• There is a vast and growing body of literature showing that relational health - social support, social integration, loneliness, and isolation - can impact a wide array of behavioral, mental and physical health outcomes.^{1, 2, 3, 4, 5, 6, 7}  Supportive relationships can help us grow positive neural pathways, and improve our physical, cognitive and emotional health. ^8,9  This includes improving our neurological, endocrine, immune  and genetic regulatory systems. ^{1,10, 11, 12, 13}

• In adults, relational health has been shown to impact cognitive function, obesity, cardiovascular health, diabetes, sleep issues, immune function, depression, and mortality. ^{14, 15, 16, 17, 18, 19, 20, 21}

• Social support and social integration has been shown to have an equal or greater impact on mortality than smoking, alcohol consumption, exercise, and obesity – and those are really important. People who have adequate social relationships have a 50% greater likelihood of survival than people who do not. ²⁰

• In children, relational health has been shown to impact diabetes, cholesterol levels, somatic concerns, sleep, medical adherence, asthma and immune function, obesity, self-regulation skills, depression, and behavior. ^{17,18, 24, 25, 26, 27, 28, 29, 30, 31}

• There is also growing literature taking a lifespan approach showing that child relational health can impact adult health outcomes. ^{32, 33, 34, 35, 36, 37}

• Positive relational health can encourage healthy behaviors and adherence to medical regimens, and being part of a support system can be a source of information, motivation and social pressure to better care for oneself. ^{1, 38}  

Buffers toxic stress

• Supportive relationships can protect us from the negative impacts of stress. A supportive person can calm us down when we are scared, decreasing our heart rate, blood pressure, stress hormone levels, and even our risk for getting the common cold. ^{1,9, 39, 40, 41}

• Positive relational health helps eliminate or dampen the threat response. Responsive caregiving has been shown to inhibit HPA axis reactivity in the presence of stressors. ⁴²  

• Interventions that promote responsive parenting have been shown to improve cortisol patterns and mitigate some of the negative effects of ACEs. ^{42, 43, 44, 45, 46, 47} 

• Healthy relationships can model or teach coping skills for future stress. ^{45, 48, 49} 

• Having a constant trusted adult can impart life-course resilience - decreased smoking, alcohol consumption, poor diet, and poor mental health - to mitigate some of the potential impacts of ACEs. A cross sectional survey of 7,047 adults ages 18 to 69 years found that while increasing ACEs was associated with increased smoking, alcohol consumption, poor diet and poor mental health outcomes, having an “always available adult” greatly decreased these associations. ⁵⁰

Prevents child abuse

• The promotion of safe, stable and nurturing relationships including parenting education and strengths-based approaches can increase parental warmth and attunement, decrease harsh or physical parenting practices, and prevent the intergenerational transmission of adversity. ^{47, 50, 51, 52, 53} 

• Having a continuous trusted adult can impart life-course resilience against ACEs. A cross sectional survey of 7,047 adults ages 18 to 69 years found that while increasing ACEs was associated with increased smoking, alcohol consumption, poor diet and poor mental health outcomes, having an “always available adult” greatly decreased these associations. ⁵⁰ 
   

Improves patient satisfaction and decreases health care costs

• Models including trauma informed care, patient-centered care, motivational interviewing and medical homes all involve aspects of promoting positive relational health and have been shown to improve patient care, patient satisfaction and health care costs. ^{54, 55, 56, 57, 58, 59, 60}

• “Physicians, health professionals, educators, and the public media take risk factors such as smoking, diet, and exercise seriously; the data presented [in our meta-analysis on social support and mortality] make a compelling case for social relationship factors to be added to that list. With such recognition, medical evaluations and screenings could routinely include variables of social well-being; medical care could recommend if not outright promote enhanced social connections; hospitals and clinics could involve patient support networks in implementing and monitoring treatment regimens and compliance, etc.” ²³  

Access "Why Relational Health: Site References" HERE.