Psychologists and sociologists have long known how important a sense of belonging is for overall welfare. “[It] is a powerful, fundamental, and extremely pervasive motivation,” write the authors of an article published in Psychological Bulletin.^[1] Abraham Maslow, the psychologist famous for conceptualizing the hierarchy of needs, which he published in his 1943 paper “A Theory of Human Motivation,” wrote of the need for love and belongingness that emerges after basic safety and physiological needs are met.^[2] This need binds us all—the presence or lack of community affects everyone regardless of sex, gender, age, nationality, creed, or location, from children seeking a sense of belonging in their schools to the elderly in nursing homes.^[3][4][5]

Increasingly, public health authorities have emphasized this need for not only our mental health but also our physical health. Research shows that belongingness affects our likelihood of developing disease and our ability to achieve positive outcomes once certain diseases have progressed. Most importantly, social isolation increases overall mortality risk.^[6]

While there may be some uncertainty about how best to apply these findings—for example, some have questioned the efficacy of social prescribing services in the UK’s National Health Service (NHS)—there is clearly a need and an appetite for initiatives that support increased community engagement. ^[7]

How Does Community Support Promote Health?

The mortality data is striking. To give just a couple examples, after adjusting for many potentially confounding variables, including smoking, drinking, and exercise frequency, researchers found that each standard deviation increase in perceived neighborhood cohesion decreased the risk of heart attack and stroke by 22 and 15 percent respectively.^[8][9] Moreover, as mentioned above, the importance of community goes beyond prevention. Decades of research have confirmed that it also supports survival after traumatic events have occurred (e.g., in the months or years following a heart attack). “The pathways [explaining community’s protective effects . . .] are likely to be multiple and include behavioral mechanisms and more direct physiologic pathways related to neuroendocrine or immunologic function.”^[6]

While the effects of community belongingness on behavior change can vary by context (urban versus rural communities, for example, may affect behavior change differently), research has found a consistent association between the sense of belonging and the pursuit of positive diet and exercise behavior changes.^[10] Perceptions of community have also been found to increase the likelihood of people using certain preventive healthcare services.^[11] Generalizing these findings, it seems that communities support increased motivation and proactivity. And really, are there any more critical traits than these when it comes to maintaining a healthy lifestyle?

What Is a Health-Promoting Community?

This question may seem elementary, but there is a lot to consider. On the most basic level, we must have meaningful relationships, but at what cost? Is there a point at which the benefits of a community might be outweighed by unhealthy behaviors within those community spaces? What if your preferred way to achieve those relationships is to hang out at your favorite local bar every night and drink excessively?

The ideal, of course, is to find a community that supports your healthier behaviors. However, the goal is not to become a passive recipient of that support; a health-supporting community should also empower you to feel more individually capable: “For social support to be health promoting, it must [. . .] help people to be more competent and self-efficacious.”^[6]

Likewise, studies show that a healthy community is one in which you actively buy in and believe in the value of what you are doing. Perceptions of community might sometimes be even more important than the community itself. A study of perceived social cohesion in Japan illustrates this well: researchers found that individual-level cohesion was associated with reduced all-cause mortality, pulmonary disease mortality, and cardiovascular disease mortality, but community-level cohesion did not have a statistically significant association with mortality risk.^[12] “The health of cohesive communities,” they write, “appears to be more a reflection of the psychological perceptions of their residents than an attribute of the collective.”

Just like their members, communities come in all shapes and sizes.^[3] A community could be a formal or informal group. It could be a church or a neighborhood. It could occupy a physical or virtual space. Interpersonal relationships within all of these categories are valuable. And just in case you think it’s somehow crucial that you find and attach yourself to a large community, think again. Strong dyads and triads (connections between groups of two or three people) are also predictive of better health outcomes. Nothing illustrates this more emphatically than mortality data on married individuals versus single, divorced, or widowed individuals. “Widowhood’s harmful association with mortality exemplifies the relationship between social support and health,” write the authors of an analysis published in 2013.^[13] Controlling for age and gender, they found that becoming widowed was associated with nearly a 50 percent increase in mortality risk.

Be Deliberate and Reap the Rewards

Few who come to truly appreciate the profound health benefits of a whole food, plant-based dietary lifestyle would think to starve themselves of its healthiest foods. Why should we not hold our social lives to the same standards? Knowing the role healthy relationships play in our well-being, why would we ever avoid them? Who would willingly choose to abstain from having a community?

That is not to suggest that finding and cultivating a community is easy. In many ways, it can be much harder than eating healthy foods. Depending on your circumstances, you may find few people in your area with whom you would like to forge relationships. And even once you have found your people, maintaining a strong community requires deliberate effort. Communities can very quickly erode if neglected. The proof of eroding communities is everywhere: only around 50 percent of Americans report feeling close to people in their communities, according to a recent survey conducted by Pew Research Center, and young Americans are even more likely to feel distant from the people in their communities.^[14]

We are not doomed to live in isolation, though. For every grim trend on this subject, we can choose to see the potential. Now more than ever we need to cultivate community in the spaces where we can. That’s what we are trying to do with CNS Kitchen and Whole Communities, two free online platforms. It’s also something we work really hard to create at our in-person events. If you haven’t joined us for one of those events or on these platforms, we’d love to hear from you. In the meantime, what are you doing to get out and meet people where you live? How has community involvement played a role in your own health journey?

References

1. Baumeister RF, Leary MR. The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychol Bull. 1995;117(3):497-529.
2. Maslow AH. A theory of human motivation. Psychol Rev. 1943;50(4):370-396. doi:10.1037/h0054346
3. Social Networks, Host Resistance, and Mortality: A Nine-Year Follow-up Study of Alameda County Residents. Am J Epidemiol. 2017;185(11):1070-1088. doi:10.1093/aje/kwx103
4. Prati G, Cicognani E, Albanesi C. The influence of school sense of community on students’ well-being: A multilevel analysis. J Community Psychol. 2018;46(7):917-924. doi:10.1002/jcop.21982
5. Pastor-Barriuso R, Padrón-Monedero A, Parra-Ramírez LM, García López FJ, Damián J. Social engagement within the facility increased life expectancy in nursing home residents: a follow-up study. BMC Geriatr. 2020;20(1):480. Published 2020 Nov 18. doi:10.1186/s12877-020-01876-2
6. Berkman LF. The role of social relations in health promotion. Psychosom Med. 1995;57(3):245-254. doi:10.1097/00006842-199505000-00006
7. Bickerdike L, Booth A, Wilson PM, Farley K, Wright K. Social prescribing: less rhetoric and more reality. A systematic review of the evidence. BMJ Open. 2017;7(4):e013384. Published 2017 Apr 7. doi:10.1136/bmjopen-2016-013384
8. Kim ES, Hawes AM, Smith J. Perceived neighbourhood social cohesion and myocardial infarction. J Epidemiol Community Health. 2014;68(11):1020-1026. doi:10.1136/jech-2014-204009
9. Kim ES, Park N, Peterson C. Perceived neighborhood social cohesion and stroke. Soc Sci Med. 2013;97:49-55. doi:10.1016/j.socscimed.2013.08.001
10. Hystad P, Carpiano RM. Sense of community-belonging and health-behaviour change in Canada. J Epidemiol Community Health. 2012;66(3):277-283. doi:10.1136/jech.2009.103556
11. Kim ES, Kawachi I. Perceived Neighborhood Social Cohesion and Preventive Healthcare Use. Am J Prev Med. 2017;53(2):e35-e40. doi:10.1016/j.amepre.2017.01.007
12. Inoue S, Yorifuji T, Takao S, Doi H, Kawachi I. Social cohesion and mortality: a survival analysis of older adults in Japan. Am J Public Health. 2013;103(12):e60-e66. doi:10.2105/AJPH.2013.301311
13. Sullivan AR, Fenelon A. Patterns of widowhood mortality. J Gerontol B Psychol Sci Soc Sci. 2014;69(1):53-62. doi:10.1093/geronb/gbt079
14. Fetterolf J, Kramer S. Americans are less likely than others around the world to feel close to people in their country or community. Pew Research Center. May 8, 2024. https://www.pewresearch.org/short-reads/2024/05/08/americans-are-less-likely-than-others-around-the-world-to-feel-close-to-people-in-their-country-or-community/