friendship-Mathias-KlangThe time you spend in interaction with others can dramatically affect your physical health.

One evening I was called to an old, ramshackle home out in the country to examine a home death. When I arrived at the house, a deputy met me at the door. "Doc, sure looks natural. The old lady's been up here, all alone, for years. Never left the house. Never had any visitors. Never went to the doctor—not that I can blame her."

He looked rather suspiciously toward me as I ducked to enter the undersized door, ignoring his slight to the medical profession. He continued his soliloquy: "She had a friend who brought her food and supplies. Her friend found her here this evening and called us."

The dead woman was sitting in a rocking chair, almost porcelain looking, with skin that was white and smooth. She had surprisingly few wrinkles for someone born 52 years earlier. I suspected she was exposed to very little sunlight.

She had, by all outward signs, died quietly and peacefully. As I was contemplating the possible causes of death, the deputy chimed in with a theory I hadn't considered.

"I'll tell ya what she died of, Doc," he began slowly, almost thoughtfully. "Loneliness. You can put whatever you want on that death certificate, but I'll tell you what, son, she done died of loneliness. I see it all the time."

The result of the autopsy arrived at my office the next week. The conclusion? There was no obvious cause of death, so the pathologist declared that it had been a natural death.

Now, more than 25 years later, I think the deputy may have been right. So do some researchers—many of whom now declare that loneliness is one of the leading causes of death in the United States. Loneliness not only hurts us physically, emotionally, relationally and spiritually, but it can actually kill.

This makes sense because when we feel loved, nurtured, appreciated, valued, cared for and supported, we are much more likely to be happier and healthier. People who avoid loneliness have a much lower risk of getting sick, and if they do become ill they have a much greater chance of surviving. Your relationships matter—and they matter a lot.

In Genesis 2:7 we are told, "God formed the man from the dust of the ground and breathed into his nostrils the breath of life, and the man became a living being" (NIV). In Genesis 2:18, Moses records, "God said, 'It is not good for the man to be alone.'" The Hebrew word translated as "alone" carries an overtone of separation and even alienation, a sense of being incomplete—even a sense that the alone (or lonely) person is unable to be complete.

When I tell you that highly healthy people avoid loneliness like the plague, I'm not talking about people who are natural introverts—who get their energy from being able to think or read alone. I'm talking about people who fail to realize that unless they intentionally cultivate significant and meaningful relationships, they are putting themselves at unnecessary risk of becoming ill.

Loneliness and Your Health
Lonely people are at greater risk for life-threatening illnesses including heart disease, heart attack, stroke, diabetes and many types of cancer. For example, one study examined almost 12,000 people. The loneliest people had a three- to fivefold increase in heart disease.

The researchers concluded that social networks and close family ties help protect against disease and premature death. Another study evaluated patients who underwent open-heart surgery and found those who were lonely had a fourfold increase in the risk of death.

Those who reported that they did not draw strength and comfort from their religion were three times more likely to die within six months after surgery. However, these risks were additive, as those who did not engage in organized social activity and who did not receive comfort from their religion were more than seven times as likely to die within six months of their surgeries.

Many researchers are now saying that apart from our genetics, the most powerful across-the-board factor in predicting premature death and disease is loneliness and lack of social support. Almost all the medical studies that have examined this sort of social support conclude that it affects health positively.

People who believe that no one really cares for them, or who don't feel close to anyone, or who feel they have no one in whom to confide or to help them out of a bind—these folks are three to five times as likely to experience premature death or disease. Some studies indicate that the risk is even higher.

However, research also points to the good news: Developing a strategy to enhance relationships and reduce loneliness is very likely to lead to a higher degree of overall health. This does not have to be a large group of people; a small group may even be more effective—and even one or two very close friends can do the trick. But you can't be or become highly healthy without regularly interacting with others with whom you share interests and affection.

Therapeutic Relationships
There is no doubt that loneliness and poor relationships can predict poor health outcomes; but if I put in the effort to change, will it really make any difference? Let's see what the research can teach us.

In a study of heart attack survivors, those discharged from the hospital were assigned to one of two groups. Both groups of patients received the same heart care.

However, the intervention group also received frequent phone calls from the researchers. If the researchers detected any emotional or social problem whatsoever, a specially trained nurse was dispatched to the patient's home.

Just this simple relationship enhancement resulted in a 50 percent reduction in the patients' death rate after one year. Just one caring, helping person contributed to longer lives in the patients studied. Imagine the potential impact if every church or small group provided this caring service for its members!

In another study, Stanford researchers randomly assigned women with metastatic breast cancer to receive usual care or usual care plus a weekly support group designed to help the women manage stress and improve relationships. Guess what? The support group patients lived twice as long!

Giving support to others may improve your health. In one study of more than 700 elderly adults, the effects of aging were blunted more effectively by giving support than receiving it. The more love and support they offered, the more their health improved.

Other researchers tell us that for relationships to be highly healthy, there must be reciprocity—a mutual decision to give and receive love and support. People who just receive care from a social group and never give back, are much less likely to be healthy.

When I've seen patients who are lonely, one of the first things I prescribe is that they become active in volunteer work in their church. In my examining room I always had a list of volunteer and mission opportunities that my patients could choose from. I insisted that they commit to this activity. And almost invariably, when they "filled this prescription," when they began to volunteer and give of themselves, the change in their countenance and their disease process was dramatic.

Let me tell you about Alice. Her medical problem list was extensive. But as I got to know her, I was most concerned about her loneliness. She nodded, "My boys are telling me I need to get out. My pastor is telling me I need to get out. Now you're telling me." She was quiet another moment or two. "Where should I start?"

I gave her a list of volunteer and ministry opportunities and we discussed the options. One of them seemed to pique her interest.

It was a local vocational opportunity center near her home, where those living with mental impairments could receive job training and employment. I wrote a prescription with the name of the center and its phone number.

Three weeks later, I received a call from the center's director. "The best thing that ever happened to us down here is Alice," he told me. "Her laughter shakes the rafters. She's one big ball of energy—here the minute we open, and I have to kick her out in the evening. Kids love her. Staff loves her. Heck, I love her. Thanks for sending her, Doc."

Just two weeks later she was back in my office for a checkup.

"Alice," I reported, "your blood pressure is better, your pulse is slower, your blood sugar is better, you've lost a bit of excess weight, and you look better. What's going on? What are you doing to improve so much?"

"Aw, Doc, I guess I'm exercising a bit—like you've told me. I'm eating a bit better; that's probably making a difference. But most of all, I think it's being down at the center!"

In my years as a family physician, I often came across many individuals who would not seek to improve their health for themselves—but quite often, they would be motivated to implement strategies to improve their health if it might help others. They became convinced that avoiding loneliness and seeking healthy relationships would increase the likelihood of their becoming a highly healthy person.

Another factor in motivation is that you can increase the health of others you care about by dispensing grace in relationships, especially toward lonely people. It's almost like an infectious disease—albeit a good one: When you spread grace to others and they "catch" it, they will be more likely to "spread" it along to others. While building the strongest, healthiest relationships possible, you will avoid loneliness like the life-threatening plague it is.

Walt Larimore, M.D., is one of America's best-known Christian family physicians and the author of God's Design for the Highly Healthy Person (Zondervan). Along with Susan A. Crockett, M.D., he is the co-author of The Honeymoon of Your Dreams (Regal). His website is www.DrWalt.com. He lives with his wife, Barb, in Colorado.

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