Patel is the Pershing Square Professor of Global Health at Harvard Medical School and is affiliated with the Public Health Foundation of India and Sangath
Acts of love and caring are the most potent influences on our well-being
As we mature into adulthood and older age, it is our social relationships, not the number but their quality, which will determine how long we live and the quality of these years of life.
If the pursuit of a long and healthy life is the central goal of medicine, indeed humanity itself, then love is its most powerful intervention. This may seem like a fatuous declaration, and I might be undermining my own academic pretensions by using this word in preference to the scientific jargon which medicine shrouds itself in, but the facts speak for themselves. These facts come from a number of scientific studies focusing on different stages of our lives and examining the diverse ways in which love expresses itself.
From the earliest hours of our lives, being loved by our parents is the most important predictor of our well-being. Some of the mechanisms are obvious, for example being fed adequately. But there are more potent, less visible, pathways too. Parenting, the technical term used to describe the way a parent responds to their child with affection, attention and admiration, is profoundly important to stimulate the brain to learn effectively and manage one’s emotions competently, both essential to a healthy and long life. The experience of being loved by one’s child is, in turn, a driver of the parent’s well-being. During our youth, the range of relationships through which love can be expressed expands significantly to include our peers, teachers and even strangers in our neighbourhoods. Being excluded or friendless, or spending time in schools or neighbourhoods where hate or violence breeds with impunity, greatly damages our health. As we mature into adulthood and older age, it is our social relationships, not the number but their quality, which will determine how long we live and the quality of these years of life.
Perhaps the most celebrated study which provides compelling evidence on the potency of these factors is Harvard’s Grant and Glueck study which has been in progress for over 75 years. The study followed up two distinct groups of men, one comprising 456 men from poor families in Boston and the other comprising 268 Harvard graduates. Successive generations of researchers regularly carried out extensive health assessments of these men. Over time, many men died, and the researchers were able to study which factors, across the life course, predicted mortality. Not surprisingly, the usual medical suspects, from smoking to high cholesterol levels, were important predictors. But the factors which out-weighed all others, as the most important predictors of a long and healthy life, were the quality of the relationships the men had with others and the extent to which they were engaged with their communities.
There are other strands of research which complement this evidence, perhaps most vividly the impact of the loss of love on our well-being. The most grievous loss of love any of us will experience is that of our intimate partner, particularly after a long and fulfilling period of living together. An example of a study examining the impact of such loss is the University of Michigan Health and Retirement Study. Researchers followed up 12,316 people for 10 years, observing who lost a spouse and then recording when they themselves died. Losing a partner dramatically increased the risk of dying, especially in the first three months after the loss when compared with those whose partners were alive, the risk increased by a whopping 66 per cent.
Many people will mock the idea of love being a potent medicine simply on the basis of such observations. They will demand proof, in the form of a plausible biological mechanism. How, for example, can soothing one’s crying baby and experiencing their joyful smile in response, hugging a friend and feeling their arms tighten around you, caring for one’s neighbour and knowing they will stand by you in your hour of need, experiencing mutual pleasure during sexual intercourse, enhance our well-being and extend life? We now know that such acts are associated with a range of bodily changes, for example due to the increased amounts of oxytocin, sometimes referred to as the “love hormone”, released in response to such behaviour. And, when acts of love are life-long investments, their effects are incremental because of sustained biological processes and behavioural choices.
The science pointing to the fact that our social relationships are profoundly important for our health would come as no surprise to most of us: After all, we can each look into our own lives and recognise the magical effects of being loved by someone and, equally importantly, loving them, on our own well-being. It would also not surprise evolutionary biologists who have long recognised that a foundational feature of our species is that we are social creatures. We need — indeed we thrive on — connections with others. And, importantly, these “others” are not restricted to our small circle of family and intimate friends. The power of love works just as well when we care for those who are lonely as they grow old or suffer mental health problems, those who are excluded or marginalised because they are different from the majority in one way or another, those whose lives we have authority over such as the persons who serve us in our homes or work-places. The important point is that, far from this being an act of charity for someone we perceive as being less fortunate than ourselves, caring for others, through direct acts of compassion or by standing up for their rights, ultimately stands to benefit us just as much. It triggers the biological mechanisms which make us healthier and happier, and fuels the social mechanisms which make our communities harmonious.
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