Cited by 980Health disparities and outcomesAttachment and Relationship DynamicsHealth, psychology, and well-being

The DOI matches its Crossref record; 80 of the 80 references it cites were found in a registry or an index; none of the 81 sources its claims cite is checked for support yet.

Advancing social connection as a public health priority in the United States.

Open access
Holt-Lunstad, Julianne, Robles, Theodore F., Sbarra, David A.·2017·American Psychologist

Abstract

A robust body of scientific evidence has indicated that being embedded in high-quality close relationships and feeling socially connected to the people in one's life is associated with decreased risk for all-cause mortality as well as a range of disease morbidities. Despite mounting evidence that the magnitude of these associations is comparable to that of many leading health determinants (that receive significant public health resources), government agencies, health care providers and associations, and public or private health care funders have been slow to recognize human social relationships as either a health determinant or health risk marker in a manner that is comparable to that of other public health priorities. This article evaluates current evidence (on social relationships and health) according to criteria commonly used in determining public health priorities. The article discusses challenges for reducing risk in this area and outlines an agenda for integrating social relationships into current public health priorities. (PsycINFO Database Record

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This article argues that social connection should be treated as a U.S. public health priority, applying standard prioritization criteria to existing evidence on relationships and health. It concludes that the size and seriousness of social disconnection rival other leading health determinants, but that intervention science and surveillance infrastructure lag behind.

Key findings

  • Applying the Basic Priority Rating System's core criteria (size and seriousness), the authors judge the evidence sufficient to prioritize social connection: being socially connected is linked to roughly a 50% lower risk of premature death, with consistent effects across measurement approaches, gender, age, and country of origin.
  • Prevalence indicators cited include 27% of the U.S. population living alone, more than half of adults unmarried, 1 in 5 never married, divorce affecting about 40% of first marriages, 20–43% of adults over 60 reporting frequent or intense loneliness, and 3 in 10 marriages described as severely discordant.
  • Urgency is argued from trends: average core network size fell by one-third since 1985, single-occupant households rose 10%, and networks became less likely to include non-kin.
  • Intervention evidence is mixed: a meta-analysis of family-involving interventions for chronic illness (over 8,000 patients) found moderate effects, corresponding to a 72–84% greater chance of improved mental or physical health versus usual care, while the ENRICHD trial (over 2,000 post-MI adults) improved support and depression but not event-free survival.

Methods

  • Conceptual/analytic review rather than an empirical study; the authors evaluate existing literature against public health prioritization criteria (BPRS, aligned with WHO Health Impact Assessment).
  • Evidence drawn from prior meta-analyses, epidemiological cohorts, census and survey data, and randomized trials, benchmarked against established risk factors such as diet, physical activity, and tobacco.
  • Recommendations are developed by analogy to the CDC's obesity and physical activity efforts, covering guidelines, surveillance/risk scoring, big-data targeting, and coalition-building.

Limitations

  • Stated by the authors: the evidence base is incomplete, with literature gaps, multiple causality, and disappointing interventions; large-scale economic cost estimates for lacking social connection are still needed; societal-level relationship interventions are nearly nonexistent; and precise prevalence estimates are difficult given the multi-factorial construct.
  • Evident from the text: this is a narrative synthesis without a systematic search or quality appraisal, and several key figures (e.g., prevalence, effect sizes) are cited secondhand from other sources rather than reanalyzed here.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1037/amp0000103

Cites

80 of 80 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 81 cited sources checked · 0 supported · 0 flagged

Show all 63 claims

  • Probably not a substantial claim. 34
  • It may state two separate claims as one. 25
53 of 53
  • The paper relies on this without support.

    Social connection is largely ignored as a health determinant because public and private stakeholders are not entirely sure how to act.

    “social connection is largely ignored as a health determinant because public and private stakeholders are not entirely sure how to act.”
  • The paper relies on this without support.

    The pace of developing effective social relationship interventions is considerably slow.

    “the pace of developing effective social relationship interventions is considerably slow”
  • The paper relies on this without support.

    The pace of developing effective social relationship interventions is unlikely to change until social connection receives greater public health prioritization in terms of attention and resources.

    “this is unlikely to change until social connection receive greater public health prioritization— in terms of both attention and resources.”
  • The paper relies on this without support.

    Accurately forecasting risk is critical for prevention efforts.

    “Accurately forecasting risk is critical for prevention efforts.”
  • The paper relies on this without support.

    Population-level surveillance serves three important functions: determining progress towards goals, developing risk scores to forecast future problems, and identifying at-risk populations based on demographics, health status, and location.

    “Population-level surveillance serves three important functions: 1) determining progress towards goals; 2) developing “risk scores” that can be used to forecast risk of future problems; and 3) identifying at-risk populations based on demographics, health status, and location.”
  • The paper relies on this without support.

    Targeted interventions require knowing who is at risk in terms of demographics and/or health status, and where they are in terms of settings and geographical location.

    “Targeted interventions not only require knowing who is at risk in terms of demographics (age, gender, ethnicity, socioeconomic status) and/or health status, but where they are in terms of settings (school, work) and geographical location.”
  • The paper relies on this without support.

    Meaningful public health benefits will only be realized when existing intervention efforts are deeply rooted in science and the pursuit of translatable research findings.

    “meaningful public health benefits will only be realized when the existing intervention efforts—from individual-level changes to community and societal action—are deeply rooted in science and the pursuit of translatable research findings.”
  • The paper relies on this without support.

    An obvious concern for prioritizing social connection is jumping to action ahead of the available data.

    “an obvious concern for prioritizing social connection is jumping to action ahead of the available data.”
8 of 8

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Citations

Cites

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Show all 80 references

Research works printed but not linked: 2

  1. Barilla D Marshak HH Anderson SE Hopp JW 2010 Can psychosocial support reduce newborn admissions? MCN: The American Journal Of Maternal/Child Nursing 35 1 33 39 10.1097/01.NMC.0000366808.75079.c 20032758 · DOI
  2. Martire LM Helgeson VS under review

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Metadata

Authors
Holt-Lunstad, J., Robles, T. F., & Sbarra, D. A.
Affiliations
  • University of California, Los Angeles (US)
  • University of Arizona (US)
Venue
American Psychologist
Published
2017-09
Volume
72
Issue
6
Pages
517-530
ISSN
  • 0003-066X (ISSN-L)
  • 1935-990X
OpenAlex
W2753856199
Cited by
978
References
80
Citations by year
2026: 110 · 2025: 171 · 2024: 142 · 2023: 114 · 2022: 127 · 2021: 111 · 2020: 99 · 2019: 54 · 2018: 45 · 2017: 4
FWCI
61.21
Type
journal article
Language
en
Open access
Locations
  • American Psychologist (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • UA Campus Repository (The University of Arizona) (acceptedVersion)
  • ScholarsArchive (Brigham Young University) (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD069498, R03HD077387)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
  • Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
Keywords
social connectedness, interpersonal relationships, public health priorities, health determinants, all-cause mortality, morbidity, close relationships, social determinants of health, public health policy
MeSH terms
Delivery of Health Care, Health Priorities, Humans, Interpersonal Relations, Public Health, Social Support, United States, Social Determinants of Health

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