When you heard the word “relationship,” what is the first thing that you think of? Most likely, a significant other. This is only one of many types of relationships, though. We interact with numerous people that play different roles in our lives, such as parents, siblings, children, and friends. The connections we have can be significant. However, sometimes relationships can be harmful. How do you know which type you’re in? What health impacts can a good one have? What about a bad one?

It’s an inherent desire, as humans, to be close to other people by connecting and building relationships. According to The Mental Health Foundation, relationships are “the way in which two or more people are connected, or the state of being connected.” The idea is that you share your time, experiences, and stories with people and allow them to do the same.

There are three kinds of relationships. Intimate are those you have with people who love and care for you, like family and friends. Relational are the ones you have with people you see regularly or share an interest with, such as coworkers or those who serve your morning coffee. Collective are people who share a group membership or an affiliation with you, including people who vote as you do or who have the same faith.

The more you share, you build a group of people in your life who care about you and who you care about. This connectedness generates a positive feedback loop of social, emotional, and physical well-being. So, the relationships we have with other people are vital to our well-being mentally, emotionally, and physically.

Research has demonstrated that relationships influence our long-term health in ways that are as powerful as adequate sleep, regular exercise, a good diet, and not smoking. Dozens of studies have shown that people with social support are happier, have fewer health problems, and live longer than those who don’t. Relationships have been found to have a more significant impact on avoiding early death than taking blood pressure medication or not being exposed to air pollution.

Researchers at Brigham Young University completed a meta-analysis of 148 studies on mortality risk; the results showed that social disconnection is at least as harmful as obesity, physical inactivity, and smoking up to 15 cigarettes a day. The review also discovered that strong social relationships increase the likelihood of overall survival by 50% regardless of a person’s age, sex, or health status. A different study of over 309,000 people found that the lack of healthy relationships increases the risk of premature death from all causes by 50%.

One study started in 1938 by Harvard University was conducted to see what makes us happy. It’s the longest-running study on human development in history and had 724 participants. It looked at every part of who we are, from physical and psychological traits to social life and IQ. The findings were published in the 2012 book Triumphs of Experience and indicated that happiness and health aren’t a result of wealth, fame, or hard work but come from our relationships.

Studies have found that people who have more extensive and diverse types of social ties tend to live longer and have better physical and mental health than people with fewer such relationships. These supports may be especially protective during difficult times.

It’s important to realize that the quality of our relationships matter, especially close relationships, because this can affect endocrine function, immune function, and nervous system activity. These systems are linked to leading causes of illness and death, such as cardiovascular disease, infectious diseases, and cancer. The neurochemical oxytocin, which is released during social bonding, has been shown to reduce blood pressure and lower cortisol levels. Cortisol, the stress hormone, plays a role in many things, like glucose metabolism and weakening immune function. Reduction of stress helps lower anxiety and depression rates while encouraging higher self-esteem, greater empathy, and more trusting and cooperative relationships.

The clearest example of the link between relationships and health is the impact they have on the cardiovascular system. Studies show that individuals who are in secure, committed romantic relationships have a lower risk of heart disease than those who experience relationship discord. Research also indicates that factors, including anger, hostility, depression, anxiety, and post-traumatic stress disorder, elevate heart disease risk.

A 2007 study of 9,000 British Civil Service men and women measured relationship quality. The participants were asked about their relationships and the different negative aspects that exist in their close relationships. They were closely monitored for health problems. The findings show that those who stated “adverse” close relationships had a 34% increase in the risk of developing heart problems. This was true even after taking into account weight, social support, and other factors.

A more recent (2016) study from the University of Michigan supports this finding by remarking that “stress and [negative] relationship quality directly effect the cardiovascular system.” Furthermore, research indicates married people who have undergone heart surgery are three times more likely to survive the first three months after surgery than single patients.

Relationship impacts on cardiovascular health are just one area that is being examined. A Carnegie Mellon University study involving more than 200 healthy volunteers observed the influences relationships have on the immune system. During the study, participants were exposed to the common cold virus and observed for a week in a controlled setting. The results indicated that the more diverse people’s social networks, or the more types of connections they had, the less likely they were to contract the cold. Individuals who were most susceptible were those who had high levels of conflict and low social support levels. Interestingly, those with high conflict but also with high levels of social support still had some protection.

Being in a committed relationship has many other benefits. When it comes to healthy lifestyle choices, like diet, exercise, and not smoking, if your spouse, friends, or other loved ones are doing it, you’re likely to do it too. It’s a lot easier to take on healthy behaviors when you surround yourself with people who are doing the same. Experts figure that a partner’s concerns, whether pointing out worrisome symptoms or checking that you’ve taken your medicine, promote a healthier lifestyle, and individuals pay closer attention to health problems.

When you sleep next to someone you love and trust, it helps you fully relax and embrace sleep. The opposite is also true. If your relationship has conflict, you’re more likely to have inadequate sleep.

Several studies demonstrate that supportive marriages can improve survival rates in people with cancer. One major study of 3.8 million cancer patients published in 2009 found that 58% of married people lived for ten years post-diagnosis, compared with 52% of people who were never married, 46% of divorcees, 41% of widows/widowers, and 37% for those separated from their spouses.

It’s essential to point out that it’s not just the lack of relationships that is problematic, but living in conflict or a toxic relationship is more damaging than being alone. According to a study published in the Journal of Consulting and Clinical Psychology in 2008, close to 30% of married couples report several acrimonious relationships. In studies funded by the National Institute of Health (NIH), researchers found that how couples behave during conflict can affect wound healing and blood levels of stress hormones.

In one investigation involving over 40 married couples, researchers measured body chemistry changes over a 24-hour period before and after the couples discussed a conflict, such as money, in-laws, and communication. The results showed that the quality of the discussion is what mattered. Couples who were more hostile to each other had considerable negative changes, including big spikes in stress hormones and inflammation-related molecules. Individuals in more well-functioning marriages acknowledge that they disagree or found humor in the situation.

A different survey discovered that prolonged conflict with other people was strongly associated with lower self-rated health and more health issues. It’s been well documented that any stress has a significant negative impact on the immune system. It’s unhealthy to suppress your feelings, especially those involving anger or resentment.

While effective conflict resolution can improve and repair a relationship, unresolved conflict is bad. A failed attempt at reaching a solution is even worse. No question, relationship difficulties can put anyone on edge, but sometimes, it may contribute to full-blown anxiety. This is a double-edged sword because anxiety has been shown to cause relationship problems, too. If you’re dealing with extreme conflict, experts recommend couples counseling or individual therapy.

Although a significant amount of research involves married individuals, you don’t have to be romantically involved with someone to enjoy the benefits of a healthy relationship. Experts agree that a positive relationship can occur between any two people who love, support, encourage and help each other physically and emotionally. Individuals in these types of relationships listen to each other, communicate openly without judgment, trust and respect each other, consistently make time for each other, remember details about each other’s lives, and engage in healthy activities together.

Individuals in positive relationships often exhibit caring behaviors, such as a touch on the arm, holding hands, a rub on the shoulder, or a hug. All it takes is only a few seconds of contact to stimulate hormones that help overcome stress and anxiety. The power of hugging shouldn’t be underestimated. One study of more than 400 adults demonstrated that the more often people hugged, their chances of getting sick decreased.

One thing about relationships is that it affects all stages of our lives. Being an adult brings the joy of discovering new connections, including building a family. It’s also a time when critical risks for loneliness and isolation can significantly impact us with relationship breakdowns/divorce, poor work-life balance, children leaving the family home, retirement, and bereavement.

Given our lifestyles, the Pew Research Center stated in 2009 that the size of the average American’s core social network declined by a third since 1985. This has increased the feeling of loneliness that many people report feeling. Loneliness is detrimental to your health in many ways, causing disrupted sleep patterns, elevated blood pressure, and increased cortisol levels. It’s also a risk factor for antisocial behavior, depression, and suicide.

Research has shown that older people who remain connected with others and have strong relationships are likely to have a better quality of life, be more satisfied with their life, have a lower risk of dementia and mental decline, and need less domestic support. Sadly, friendships have been found to decline with age, and many adults wish they could spend more time with friends that they do have. This is evidenced by a study released by the Archives of Internal Medicine in 2012 that stated 20 – 43% of adults over age 60 experience frequent or intense loneliness. This may occur if a person’s mobility decreases, it can make it harder to get together with other people.

In addition to reduced mobility, many aging individuals have chronic illnesses, making it challenging to participate in activities that a person once enjoyed. Currently, roughly half of all adults have at least one chronic disease. It’s estimated that by 2030 more than 20% of the population will be over age 60 and that more than 80% of them will have at least one chronic condition. Another factor is friends and family passing away. This decreases the size of an individual’s social circle. To help combat loneliness, it’s vital aging individuals find new hobbies and interests to make new connections. Since more people are reaching old age without marrying or having children, this is especially true.

Younger people, like teenagers and people in their 20s, are at risk when they are isolated too. A lack of social relationships can impact a young person’s physical well-being by increasing the risk of obesity, inflammation, and high blood pressure. When we’re growing up, we learn how to relate to others from our parents and families. By mimicking the behavior and emotions of those around us, we come to understand, then model relationship-forming behavior throughout life. This is why experts say the attachment that a child has with their parent or guardian is a fundamental predictor for mental health/wellbeing and relationship satisfaction as an adult.

When children experience comforting, emotionally significant relationships with parents or other close family members, they tend to have better health in both the short and long term. According to one longitudinal study, which results were published in the Journal of Behavioral Medicine in 1997, college students with more caring parents had a lower risk of heart disease, ulcers, and other chronic conditions 35 years later. It’s important to realize that studies typically characterize the nature of parent-child relationships as positive or negative and supportive or unsupportive, but relationships aren’t static.

Across development, children’s needs from their parents change. For instance, parental behavior that’s attentive in early childhood would be overbearing to a teen. This is why tailoring the relationship toward the child’s specific needs at the moment is critical. Another factor to consider is that friends and peers play a more significant role in a young person’s life as they become more independent and start to build their own social networks during adolescence. Due to this shift, toxic relationships and negative experiences, such as bullying or social isolation, are more likely to occur and have a serious impact, making a supportive family environment all the more important.

There has been significant research done on relationships and their impacts. However, much more still needs to be discovered. In many cases, researchers consider personality factors and relationship factors as separate components. In real life, difficult personalities and relationship troubles often go together. Another area that needs further study is understanding the differences that culture and diversity play in defining a good relationship. It’s widely known that social experiences and expectations vary widely among different cultural groups.

Most of the information we have is based on middle-class, European-American families. For example, European Americans view social support as a good thing; however, people of East Asian heritage would see asking family members for support as stressful. Another element of this is that a good portion of the research on health and relationships focuses on the quality of marital partnerships. In some cultures, a person’s family of origin is placed higher than romantic relationships.

Governments and healthcare companies could help individuals reap the benefits of relationships by investing in interventions that improve relationships. If they did this, it could help address other health issues, such as obesity and tobacco use. The agencies could create formal guidelines for social activity, similar to nutrition and exercise guidelines, that could help individuals and clinicians know what they should do. Unfortunately, loneliness and social isolation aren’t addressed in public health campaigns. Psychologists could help the effort by incorporating research findings into their practice or wellness programs. This would make their patients aware of how their relationships impact their health.

In the meantime, there are things that each one of us can do that will make a difference. One is how we approach relationships. For many of us, it’s passive, meaning we do it subconsciously and without deliberate effort. This method overlooks the fact that it requires an investment of time to maintain good relationships. We all know that if we want to be physically well, we need to exercise and eat right. It takes commitment and dedication for good habits to become second nature.

We should use the same approach when it comes to building and maintaining good relationships. One way to test this is to ask yourself, “Do I have meaningful, long-term relationships?” You must be honest with yourself. Think about the relationships you have with the people in your life. Are they the sort of relationships you would like to have? Most likely, not. To change this, there are a variety of things you can do.

The best way to nurture healthy relationships with people who make you feel good is by spending time with them. Try connecting, or reconnecting, with someone every day. It’s easier to start with family members, friends, or coworkers. It can be via phone, text, or email. Let the person know that you’d like to spend more time with them. Arrange to get together and participate in an activity you both enjoy.

If you want to connect with new people, there are ways to do that too. You could start a conversation with someone you see every day, join a sports team/hobby group or volunteer. An excellent resource for activities is your local community center or library. It’s essential to try different approaches to see what works for you.

To be successful in your attempts, there are specific tips you should follow. It’s vital to set aside more time to connect. When interacting, be present. This means don’t check your phone, Facebook messages, or work emails during the designated time. Listen actively to what others are saying in a non-judgmental way. This means you’re concentrating on their needs at that moment. If you do this, they’ll be more likely to reciprocate, which will lead to you sharing how you’re feeling and experiencing being listened to and supported.

A key element is to recognize unhealthy relationships because we know that they can negatively affect our well-being. Once you realize that a relationship isn’t healthy and positive, do your best to minimize interactions with these individuals. It can be helpful to use relaxation techniques to let go of the stress that negative encounters cause. The flip side of this is to maximize the time you spend with the friends and family that you enjoy being around.

When people spend more time with each other, they create happy, productive communities. However, when it comes to the importance of community, it’s declining in modern society, with only 42.5% of people aged 16 to 25 indicating that associations with others in their community are valuable. When compared to 73.1% of those over 75, this is a significant decrease.

Another issue is the way we interact and form relationships has changed considerably in recent years. Several components have contributed to this, including the evolving family structure, development/reliance on online technologies, longer working hours, and changes in how we define community. These alterations mean that who we connect with and how we connect are forever changed.

Communities are no longer the traditional neighborhoods where everyone knows each other. This poses a slight problem because while online communities can help us connect, they also blur the lines on who our friends really are. As a society, we need to adapt and evolve to develop and sustain healthy online relationships. It’s essential to note that experts say that we can’t allow online connections to replace our offline ones because it’s the neurochemical response that occurs during face-to-face interactions that contribute to our well-being.

There’s no question that when you’re in a loving relationship (romantic or not), it gives you a sense of well-being and purpose. This is why it’s fundamental to understand just how meaningful relationships are to our health. As humans, we can’t grow as individuals and communities without them. They’re an integral part of our lives. Each one of us needs to make an effort to develop and maintain healthy, positive relationships in all areas of our lives.