Don’t forget one of the most rewarding pillars of health: nurturing social connection!
by Beth Biggee, MD
“Interdependence is and ought to be as much the ideal of man as self-sufficiency. Man is a social being”
Lifestyle Medicine and Integrative medicine focus on using the pillars of health to prevent disease, mitigate health problems, and promote wellness. The pillars of health include healthy nutrition, adequate physical activity, stress management, restorative sleep, avoiding unhealthy environmental substances, and fostering positive social connections.
Social connection is a pillar of health that is often overlooked. The World Health Organization in June 2025 published a report, From Loneliness to Social Connection, organizing a plan for healthier societies addressing social isolation as a public health issue. Loneliness and social isolation is widespread despite our connection on electronic devices and modern travel around the globe. Isolation continues and severely affects health, wellbeing, and society as a whole.
An analysis of studies looking at over 1 million individuals found that social isolation was associated with a 33% increased risk in all-cause mortality. Loneliness was also found to be linked to the onset and development of diseases such as coronary heart disease, cancer, dementia, mental health diseases, diabetes, and autoimmune inflammatory diseases.
Social disconnection is linked to increased risk of autoimmune disease, onset of autoimmune disease, and worsened activity and outcomes. Prolonged social isolation may be associated with adrenal gland stress and cortisol abnormalities, increased inflammatory cytokines, metabolic effects, and disruption of the immune system. In the Women’s Health Initiative Observation Study the onset of rheumatoid arthritis and lupus were associated with women who reported 3 or more major life events, abuse, interpersonal events, or caregiving more than 3 days a week. Lupus patients report loneliness and social isolation being associated with more pain, depression, and disability. Rheumatoid arthritis patients with less social support had excess disability over time.
The good news is that interventions such as listening support, joining an exercise class, and even text messaging or video support programs can improve quality of life in autoimmune patients. One such study, called the ADAPT Trial, last year suggested this effect for 124 lupus patients. Joining an exercise class like gentle Yoga or Tai Chi in a group setting can foster social connection while improving function and reducing inflammation. It also addresses the physical activity pillar of health. The 8 week Mindfulness-Based Stress Reduction program from the University of Massachusetts Memorial Health is an in person or on line program with a group of participants that uses body scan meditation, gentle yoga, and sitting meditation. This also addresses the stress reduction pillar of health.
There are many support groups for those with autoimmune conditions such as the Arthritis Foundation, CreakyJoints, Lupus Foundation of America, but there are many Do-It-Yourself ways to foster social connection. In addition to joining an exercise group, meditation group, class, or support group consider once a week putting on your calendar an appointment to call, video, or get together in-person with a friend, neighbor, or family member. This appointment also does not need to be with a person. Time in nature, with pets, and with animals count as social connections in my opinion. Just 20 minutes for a lunch break outdoors watching and listening to the birds while smelling the pine trees and flowers, or throwing a ball with your dog count as social engagements in my book. The planet, plants, and animals thrive on connection. They depend on it for survival. That flower needs the bees and the wind, even you to carry its pollen off to the next adventure.
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Be Well,
Beth Biggee, MD ABIM, ABOIM, DipABLM