Poor mental and physical health and unhealthy behaviors exact a huge toll on individuals, families, and society. Solid scientific evidence establishing the causal impact of social ties on health provides the impetus for policy makers to ensure that U.S. health policy works to protect and promote social ties that benefit health. Scientific evidence supports the following premises, and it is from this empirical footing that we can build a policy foundation for promoting both social ties and health:
Although social ties have the potential to benefit health, policy efforts must recognize that social ties also have the potential to undermine health, and that the link between social ties and health ple, gender, race, and age are associated with different levels and types of responsibilities, strains, and resources in social ties that then influence personal health habits as well as the health of significant others. In order to be effective, policies and interventions must account for the ways in which social constraints and resources influence health across social groups (House et al. 2008). Moreover, care must be taken to develop strategies that increase the power of social ties to enhance individual health without imposing additional strains on care providers. Thus, we suggest two additional policy components for the basic foundation suggested above:
How can policy makers use the scientific findings on social ties and health to advance population health and reduce social disparities in health? They can begin by addressing six fundamental goals.
Promote Benefits of Social Ties
Support and promote positive features of social ties (e.g., supportive interactions, healthy lifestyle norms). For example, Health and Human Service’s Healthy Marriage Initiative is designed to promote positive marital interactions that may foster mental and physical health of couples and their children. This initiative uses a multifaceted approach, including public awareness campaigns on responsible parenting and the value of healthy marriages, as well as educational and counseling services delivered through local organizations such as schools and faith-based organizations. The absence of legal marriage may reduce the benefits of committed partnerships for the health of individuals in gay and lesbian relationships (Herek 2006; King and Bartlett 2006; Wienke and Hill 2009).
Do No Harm
Avoid policies, programs, and interventions that increase relationship burdens and strains or that undermine positive features of relationships. For example, many programs for the sick and elderly increase caregiving responsibilities for family members-responsibilities that ily relationships. This problem is exacerbated by hospital and insurance policies that force family members to provide medical care at home. These costs are borne more heavily by women, minorities, and those with fewer socioeconomic resources. Policy efforts should recognize that specific programs may benefit some groups but harm others.
Reduce Social Isolation
This addresses one of the most fundamental findings from research on social ties and health: The most socially isolated Americans are those at greatest risk of poor health and early mortality (Brummett et al. 2001). Policies can reduce the risk of social isolation in the first place by enhancing our educational system to impart social-emotional skills, interests in civic engagement, and meaningful employment (Greenberg et al. 2003); by ensuring that all communities are economically developed and contain public places to safely congregate and exercise (Mechanic and Tanner 2007); and by fostering stable ericans. Notably, some groups are more likely than others to experience social isolation. For example, widowhood increases the risk of social isolation. Women are more likely than men to be widowed, and widowhood affects a higher proportion of African Americans than other races, and at earlier ages; among those aged 65 to 74, 24.3 percent of African Americans are widowed compared to 14.8 percent of whites (U.S. Census 2009). Coordinated programs could help identify socially isolated adults, perhaps through their physicians, and they could mobilize local resources to offer social and instrumental support to these individuals.