Why Your Doctor May Soon Start Asking About Your Social Life

When we talk about taking care of our health, most of us think about two things: our physical health and our mental health. But there is a third dimension that is just as important and far less discussed — and according to Vandhana Wadhwa, M.D., West Region chief medical officer at CareMore Health, ignoring it may be quietly affecting millions of Americans in ways they do not even recognize.

Social health, the quality and consistency of the meaningful connections we have with the people around us, is now being recognized as a critical pillar of whole-person care. And with spring and summer bringing more opportunities for gathering, community and connection, there may be no better time to take stock of where yours stands.

In this interview with The Educated Patient, Wadhwa discusses what social health actually means, why it took so long for medicine to take it seriously and what patients can do right now to start nurturing it.

Most people are familiar with physical and mental health, but social health does not get nearly as much attention. How do you define it as a clinician, and why do you think it has taken so long for the medical community to treat it as seriously as the other two?

Vandhana Wadhwa, M.D.: Social health is a big part of your overall well-being, just like physical and mental health. It’s really about developing and maintaining meaningful connections you have with friends, family and the people around you.

That said, social health doesn’t look the same for everyone; it’s not about having the biggest group of friends. For some people, it means having a small, tight-knit circle they’re really close to. For others, it might include a broader mix of friends, family, acquaintances and even the everyday interactions they have with people they meet throughout the day.

Social health’s newfound attention within the medical community and beyond has likely come about for a few reasons:

• Decades ago, one’s health was almost entirely defined solely by their physical health. As time went on, attention also started being paid to mental health, and clinicians noticed how the two had discernible impacts on one another. From there, the medical community began to take a more integrated approach to patient health that prioritizes whole-person care. This means that all aspects of a patient’s health are monitored, including their social health, so clinicians can get a fuller picture of their health profile and better understand how the various facets of their health are interacting with each other.
• Some of the societal stigma around social health issues has faded. In decades past, it may have seemed as if vocalizing or addressing one’s loneliness was a sign of weakness or uncomfortably vulnerable. Today, those issues may still impact some of the population, but some of the stigma has dissipated.

Loneliness and social isolation are linked to worse outcomes in conditions like heart disease, diabetes and depression. For a patient already managing one of those conditions, how much of a difference can improving their social health actually make — and what does that look like in practice?

VW: Improving one’s social health absolutely makes a difference for patients suffering from chronic conditions, like heart disease. Increasing socialization and making or maintaining connections with loved ones may not eliminate the threats posed by chronic conditions, but it can lower the risk of heart failure, strokes and more. In fact, poor social health can increase these sorts of health risks in patients suffering from chronic conditions. For example, patients with heart failure who are socially isolated have higher rates of readmission and poor health outcomes.

Social isolation hits older adults particularly hard, yet it is often invisible to the health care system until something goes wrong. What are the warning signs that a patient — or a family member watching from a distance — should be paying attention to?

VW: Family members should look out for loved ones if they notice they have begun to regularly eschew social gatherings or other events they would have normally attended.

They should also keep an eye out for loved ones who are going through major life-changing incidents, like a death in the family or loss of a career, and becoming a caregiver, as events like these can incur social isolation.

Watch for behavioral changes or a decline in self-care, whether it’s a lack of bathing, rapid weight loss or gain, or a sudden lack of enjoyment in the hobbies they previously took part in.

From a clinical standpoint, is there actual evidence that seasonal social opportunities have a measurable impact on health — and how can patients be intentional about taking advantage of that?

VW: There certainly is. We often see a reduction in health risks associated with chronic conditions when patients increase their socialization, often when the seasonal changes better allow for gatherings. Not only is it helpful for your physical health to go out and see your loved ones, but it also helps keep you active and moving, this way you are not stuck at home by yourself.

Patients should certainly make an active effort to nourish their social health in the spring and summer, but they shouldn’t then disappear during colder months. It’s quite important that they stay mindful of their social health in the winter as well; be sure to attend family gatherings during the holiday season if you are able to. It can be tempting to not want to leave the house when it’s cold out, but health benefits of going out almost always surmount them.

For someone who recognizes that their social life has quietly shrunk, what are the most practical first steps toward rebuilding meaningful connection, and when should that conversation happen with a doctor?

VW: You should make an appointment with your doctor as soon as you take notice of your declining social health; don’t wait for it to worsen further. It doesn’t need to reach some vaguely defined point to warrant intervention; address it as soon as it becomes apparent.

If you’ve got a little time before your doctor’s appointment, try not to just sit there waiting; you could use that time to do something small for your social health. It doesn’t have to be anything big or stressful. You don’t need to plan an event or gather a crowd.

• Maybe just reach out to someone you care about and haven’t talked to in a while. Send a quick message, check in, or see if they’d be up for a low-key hangout or a phone call. Even a short catch-up can feel really good.
• You might also think about getting involved in something local if that feels right for you. There are often simple, welcoming options like community groups or walking clubs, [or] faith-based groups that don’t cost anything and don’t require a big commitment. It’s a nice way to get out a bit, meet people and have some easy, friendly interactions.
• Keep in mind, there’s no pressure; you don’t have to make a new best friend. Even just a few genuine conversations or moments of connection can make a difference in how you feel.
• Pick up a hobby or volunteer, if you would find that helpful.