Social health is more than a feeling—it’s a measurable dimension of well-being shaped by relationships, belonging, communication, and emotional safety. Below, we define social health, explore how it connects to physical and mental health, examine policy impacts, and share how Presidium Health helps restore connection. For the broader context, see our overview of social determinants of health.
What Does It Mean to Be Socially Healthy?
When people in the United States think about health, the focus often begins—and ends—with physical well-being. We talk about physical activity, healthy eating, and avoiding excessive alcohol consumption. Yet health goes beyond lab results and fitness goals. Another equally vital dimension is often overlooked: social wellness.
To be socially healthy is to build meaningful relationships, cultivate supportive relationships, and maintain a sense of human connection within our social network. It means developing social skills that help us navigate different social situations while ensuring that we feel safe, heard, and respected. In short, we are social creatures, and our health depends on more than just biology—it depends on connection.
Core Elements of Social Health
Explore how social health fits into the wider SDOH landscape in the differences between determinants of health and social determinants article. Social health can be broken into several interrelated elements that directly shape overall health (hover or tap an icon to discover details):
Healthy Relationships
Strong relationships with close friends, family, caregivers, and neighbors provide stability and emotional support. They are essential for resilience during illness or stress. For example, research shows that patients recovering from surgery often heal faster when they have strong family or caregiver involvement compared to those who recover in isolation. Friendships not only provide companionship, but also act as a buffer against loneliness, which has been shown to increase risks for heart disease and depression.
The Link Between Social Health and Physical Health
Decades of research show that social health is not optional—it’s fundamental. Consider these connections: For real-world impacts and case studies, see our real-world examples of social determinants of health.
- Immune Function and Chronic Illness: A robust social network helps reduce inflammation and regulate blood pressure. Strong ties lower the risk of heart disease and diabetes. Social bonds are thought to reduce stress hormones, which otherwise strain the immune system.
- Mental Health and Longevity: People with support systems and social support report less depression, lower anxiety, and live healthier lives over time. They are also more likely to maintain routines that support a healthy life such as regular physical activity and adequate rest.
- Daily Habits: Whether it’s developing healthy habits like getting a good night’s sleep, cooking healthy eating meals with family, or cutting down on time spent in front of the TV, social connections encourage accountability. When surrounded by peers who value wellness, individuals are more likely to adopt similar practices.
- Lifestyle Factors: In recent years, researchers have tied isolation to risky behaviors such as poor diet, inactivity, and excessive alcohol consumption. All of these shorten life expectancy.
A national survey on loneliness confirmed that loneliness and lack of connection rival smoking, obesity, and inactivity in health risk. In fact, decades of research reveal that maintaining supportive relationships is as critical as regular physical activity for long-term survival.
The Hidden Epidemic: Loneliness as a Mortality Risk Factor
When people think about health risks, they often imagine smoking, obesity, or lack of exercise. What rarely gets equal attention is loneliness, despite its staggering impact on life expectancy. In 2023, the U.S. Surgeon General issued an advisory calling loneliness a public health crisis, placing it on par with smoking up to 15 cigarettes per day in terms of risk to overall health.
- Mortality Risk: A landmark meta-analysis of over 300,000 participants found that individuals with poor social relationships had a 50% higher risk of early death—a greater impact than obesity or physical inactivity.
- Chronic Illness Burden: Social isolation is linked to higher rates of hypertension, heart disease, stroke, and dementia. In fact, adults experiencing loneliness have a 29% increased risk of heart disease and a 32% higher risk of stroke (CDC, 2023).
- Economic Costs: A 2020 AARP study estimated that social isolation among older adults costs the U.S. healthcare system $6.7 billion annually, largely due to increased hospitalizations.
Loneliness is not just an emotional state—it manifests biologically. Social isolation raises cortisol (the stress hormone), weakens immune responses, and accelerates cellular aging. Researchers using MRI scans have even found that socially isolated individuals show heightened activity in brain regions linked to pain, suggesting that loneliness is processed like a physical injury. In short, improving social health isn’t just about “feeling better.” It is a clinical intervention as vital as prescribing blood pressure medication or recommending smoking cessation.
Visual Opportunity: Consider embedding a comparative chart of mortality risk—loneliness vs. smoking, obesity, and inactivity—to show why social health deserves equal attention in healthcare models.
Why Many Patients Struggle With Social Health
Despite the evidence, many patients across the United States face serious barriers to building or maintaining social connections. This is especially true for high-utilizers of emergency rooms and hospitals. Assessment of SDOH impacts in California outlines several system-level pressures that mirror these hurdles. Barriers include:
- Poverty and homelessness, which disrupt support systems and create instability. Without safe housing or stable income, relationships are often fractured.
- Chronic illness or disability, which make it difficult to engage in social situations. For example, mobility challenges may prevent someone from attending community events, while mental health conditions like anxiety can lead to withdrawal.
- Stigma and discrimination, which erode trust and discourage participation (NIH).
- Social media use, which can sometimes amplify loneliness when digital interaction replaces face-to-face human connection. While online communities can be valuable, excessive scrolling often leads to comparisons, isolation, and reduced real-world engagement(Pew Research).
Instead of building close friends or supportive relationships, many patients end up socially isolated. Their sensitive information may be addressed by the healthcare system, but the human context behind it is often ignored. This leaves individuals without the emotional scaffolding they need to thrive.
Policy, Law, and Social Health
Social health does not exist in isolation—it is often shaped by broader forces such as policy, regulation, and legal rulings. Decisions made in courts or by legislators can unintentionally alter the conditions in which people live, work, and connect with others. One recent example, Grants Pass v. Johnson, highlights how legal frameworks intersect with the social determinants of health, particularly for vulnerable populations experiencing homelessness.
How the Supreme Court’s City of Grants Pass v. Johnson Ruling May Influence Social Isolation
On June 28, 2024, the U.S. Supreme Court issued a landmark decision in City of Grants Pass v. Johnson, reshaping how cities can respond to homelessness. At issue was whether anti-camping ordinances—laws banning people from sleeping or sitting with even basic protective items like blankets or cardboard in public spaces—violated the Eighth Amendment’s ban on cruel and unusual punishment.
The Court ruled 6–3 that such ordinances do not violate the Constitution, arguing that they regulate conduct (sleeping in public), not status (being homeless). Writing for the majority, Justice Gorsuch emphasized that homelessness policy is a complex, local challenge best left to city leaders. Dissenting justices, however, warned that the decision effectively criminalizes poverty, since unhoused individuals have no alternative place to exist if shelter beds are unavailable.
This ruling overturned the protections of Martin v. Boise (2018), which had previously barred enforcement of anti-camping laws when no adequate shelter existed. The decision now gives cities the green light to fine, arrest, or remove individuals for the mere act of sleeping outside—penalties that often start at nearly $300 and can escalate into criminal trespass charges.
Below is a table outlining Seven Perspectives of Advocates vs Policymakers:
| Area of Impact | Advocates’ Perspective | Policymakers’ Perspective |
|---|---|---|
| Displacement from Public Spaces | Disrupts fragile support systems; reduces access to food, outreach, community resources. | Maintains safe, accessible, clean public spaces for residents, businesses, and public safety. |
| Less Visible Living Conditions | Relocation to remote areas increases risk and complicates outreach. | May reduce sanitation/fire hazards in central areas and encourage use of designated services. |
| Psychological & Emotional Strain | Criminalizing survival behaviors deepens stigma and isolation. | Targets conduct, not identity; aims to balance compassion with accountability. |
| Fines & Legal Barriers | Fines/records hinder housing, jobs, and healthcare access. | Consequences may incentivize engagement with shelter or programs. |
| Impact on Vulnerable Populations | People with disabilities/mental illness face disproportionate harm. | Discretionary, “objectively reasonable” enforcement; potential diversion/specialized courts. |
| Loss of Personal Belongings | Sweeps can remove medications, IDs, and legal documents, disrupting care continuity. | Encampment clearing framed as protecting public health; protocols may safeguard belongings. |
| Municipal Priorities | Enforcement may divert resources from housing-first models. | Enforcement as one tool alongside housing investments; local flexibility emphasized. |
Why This Matters
The Grants Pass ruling represents more than a legal decision; it illustrates how policy can shape the lived experience of vulnerable populations. By normalizing the punishment of basic survival behaviors with how cities may address unsheltered homelessness, the ruling has potential implications for health, safety, and social connection. For many, these changes may increase barriers to stability, while for policymakers, they underscore the tension between local governance, resource allocation, and public health outcomes.
Viewed through the lens of social health, the decision highlights how structural factors—laws, regulations, and enforcement practices—can deepen inequities related to levels of isolation, belonging, and access to community. It serves as an example of how legal frameworks interact with the social determinants of health, and how shifts in governance can ripple outward into the day-to-day lives of people who are already at the margins.
How Presidium Health Restores Social Health
At Presidium Health, we know that good social wellness is essential for achieving a healthy life. That’s why we integrate clinical treatment with relational care, recognizing that health outcomes depend on more than prescriptions—they depend on people.
- Companionship programs that replace isolation with consistent human connection. Companionship fosters trust, encourages healthy habits, and reduces the risks tied to loneliness.
- Caregiver continuity, so patients interact with familiar faces who understand their history and sensitive information. Continuity helps build trust and increases care adherence.
- Community engagement initiatives that build support systems through local groups, peer circles, and neighborhood events—giving patients both practical resources and social belonging.
- Education on healthy habits such as healthy eating, physical activity, and getting a good night’s sleep as a foundation for healthier lives.
These interventions not only prevent repeated hospitalizations but also promote healthier lives where patients feel supported and understood. Patients who once cycled through emergency rooms begin to experience stability, dignity, and trust—all key components of true wellness.
The Bigger Picture: Social Health as a Public Health Priority
The concept of social health is no longer just an individual matter—it is a public health issue. Healthcare providers, policymakers, and communities must recognize that improving social wellness is essential to reducing healthcare costs and achieving better outcomes. When patients have supportive relationships, they are more likely to follow treatment plans, maintain healthy habits, and avoid preventable crises.
For healthcare systems, this shift represents an opportunity. Integrating social wellness into care models doesn’t just improve outcomes— it creates healthier lives across communities. For patients, it offers more than treatment. It offers connection, dignity, and hope. To explore the full set of related topics, visit our Social Determinants of Health hub.
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