What is Social Health?

Written by Steve Rose

Steve Rose, PhD, is an addiction counsellor who assists those struggling with substance abuse, gambling, gaming, and internet addiction.
As a sociologist, I’ve been interested in the concept of social health. By this, I refer to the health of a social environment, including issues related to poverty or social isolation. While mental health has been gaining attention in the recent decade, we have been neglecting the importance of social health. Social health important since the health of a social context affects the physical and mental health of an individual. By improving the health of our communities, individuals are empowered to live healthier lives, filled with a sense of purpose and belonging.

What is Social Health?

Social health is the ability of a social context to foster interdependent social relations in a way that meets the needs of individuals and the needs of the broader group. In order to explore what this means, let’s consider what it means to be healthy. There are many perspectives on health: biological, psychological, and sociological.  We are familiar with the idea of physical health and mental health, but we often forget that our societies are also living organisms, in need of checkups, diagnoses, and treatment. So what is a healthy society? A healthy society as one that is socially integrated in a way that meets our basic physical and psychological needs, facilitating a sense of higher purpose. This is a sociological take on Abraham Maslow’s view:
The good or healthy society would then be defined as one that permitted man’s highest purposes to emerge by satisfying all his basic needs.
For Maslow, his famous hierarchy ranks these needs from the most basic to the most advanced. I don’t necessarily agree with his strict rank ordering and a 2011 study on the topic confirms this skepticism. Throughout my research on suicide, I’ve come to see how social needs are as important as our biological need for food. Those whose social needs are not met may find themselves at risk of dying by suicide. Although I agree with Maslow’s broader theory of human flourishing, I prefer to draw on more recent psychological research on our basic social needs. According to Self-determination theory, we have three basic social/psychological needs: competence, autonomy, and relatedness. Competence consists of the sense that one has specific skills and is progressing in their abilities. A healthy social environment provides worthy goals with clear guidelines that act as signposts to human action. Without socially sanctioned signposts regulating our actions, individuals may feel lost or purposeless. The classic sociologist, Emile Durkheim, writes:
All man’s pleasure in acting, moving and exerting himself implies the sense that his efforts are not in vain and that by walking he has advanced. However, one does not advance when one walks toward no goal, which is the same thing when his goal is infinity.
Consider any worth-while goal or endeavor and you will quickly realize it is marked by the stamp of social values. Our goals are often regulated by what is deemed valuable to a particular social context. Although we need social regulation to give us purpose and a sense of contribution, this does not mean we need to simply conform, bringing us to the next fundamental need: Autonomy consists of feeling that one is in control of one’s own actions. In sociological terms this means social regulations are not overbearing and fatalistic. Although autonomy is important, too much of it can produce individualistic social contexts where individuals no longer feel connected to a broader community. This brings us to the last fundamental need: Relatedness consists of the sense that one can depend on a close circle of other individuals. In his classic sociological text, Suicide, Durkheim states:
“…when community becomes foreign to the individual, he becomes a mystery to himself, unable to escape the exasperating and agonizing question: to what purpose?”
Interdependence is the key to a healthy social context that balances individual needs with the needs of the group. Interdependence requires goal alignment between the individual and the group. As stated in my article addressing the question, What is a healthy identity?:
“…the military is a great example of institutionalized interdependence. Identities are built within a system of distinct, yet related, roles where one’s unique skills, abilities, preferences, and character, all contribute to an organization with functional capacities beyond the sum of its individual parts.”
Image result for society
Unfortunately, interdependence is easily forgotten in modern individualistic social contexts: We forget we are all in the same boat. Although we are individuals, social forces affect us all. Interdependence works on many levels: organizationally, nationally, and globally. Healthy societies are like living organisms, institutions and organizations are the organs, and individuals are the cells that compose the organs. Societies interact with other societies, just as our bodies interact with other bodies; organizations interact with other organizations, just as our bodily organs interact; and individuals interact with other individuals, just as our cells interact. Social health consists of a world of interdependent social relations. It is a world where social environments facilitate individual flourishing. A world where economies work to fulfill human needs, rather than a world where human needs are sidelined at the expense of economies.

Social Health Affects Physical Health

Physical health issues are intertwined with social health issues. Consider loneliness, a major aspect of social health. Recent research looked at the impact of loneliness as a risk factor for mortality and found:
Current evidence indicates that heightened risk for mortality from a lack of social relationships is greater than that from obesity.
The researchers also found loneliness is comparable to other health indicators, including substance abuse, responsible sexual behavior, mental health, injury and violence, environmental quality, immunization, and access to health care. Although studies are now mounting regarding the risk of social isolation, it is a relatively neglected issue. The researchers note:
The current status of research on the risks of loneliness and social isolation is similar to that of research on obesity 3 decades ago.
Luckily, sociology is often incorporated into medical school training, giving clinicians an understanding of how our bodies, minds, and social environments are interrelated. There has been progress in this regard, but in practice, physicians often emphasize the biological component at the expense of the psychological and the social. If we want to understand human thriving, the social component is essential. According to an 80 year long Harvard study that followed a group of individuals since their college years, the quality of our close social relations is the best predictor of health and happiness:
“..people’s level of satisfaction with their relationships at age 50 was a better predictor of physical health than their cholesterol levels were.
In a TED Talk on the study, Robert Waldinger emphasizes the dangers of social isolation, stating:
Loneliness kills. It’s as powerful as smoking or alcoholism.
This is all the more concerning, given the increasing rates of social isolation in affluent societies, particularly among the aging population. Modern conveniences allow us to live more independently than ever, but we need to consider the costs to our mental and physical health. We need to consider the health of our communities.

Social Health Affects Mental Health

“Mental health cannot be defined in terms of the adjustment of the individual to his society, but, on the contrary, must be defined in terms of the adjustment of society to the needs of man.“ – Erich Fromm
In The Sane Society, Erich Fromm advocates a radical approach to mental health that goes against mainstream psychiatry. He argues that the psychiatric approach to mental health assumes the problem is the individual’s inability to adapt to their environment, neglecting the fact that the social environment might itself be the problem. Building on Karl Marx’s theory of alienation, Fromm argues that individuals in modern industrial society are compelled to take on an alienating “marketing personality”. This is a self-centered approach to social relations whereby individuals focus on what they can get from others, rather than what they can contribute to others. This orientation is characterized by a lack of loving relations, according to Fromm. In his book, The Art of Loving, Fromm defines love as the ability to go beyond one’s own self interest and work toward collective goals. Fromm says that one must courageously throw oneself into loving relations based on faith in collective values in order to overcome feelings of loneliness that commonly plague the modern individual with the marketing personality. By engaging in loving relations, one is able to fulfill the basic needs of human beings, according to Fromm:
“…the need for relatedness, transcendence, rootedness, the need for a sense of identity and the need for a frame of orientation and devotion.”
Although loving relations are ideal, they are difficult to engage in since modern industrial society drives individuals to to engage in individualistic competition with everyone else, or drives them to seek simple pleasures and conformity to a safe, comfortable, but ultimately alienating relation. Fromm’s approach to mental health is radical since it targets the root causes of many existentially oriented mental health concerns and the human need to meaningfully connect with others. Loneliness is one of the most dangerous states, and our relations with one another through the marketing personality perpetuates the failure to connect. The feeling of productivity by getting ahead of others is a temporary satisfaction that leaves one isolated in the end. The problem with mental health defined as mere adjustment is that the psychiatrist may be working to help individuals adjust to an unhealthy social condition. Over-prescribed psychiatric drugs merely work to keep the unhealthy social condition intact by numbing the individual to its psychological effects. This is comparable to constantly taking painkillers for a sore muscle resulting from poor posture. Rather than fixing the structural problem, the drug helps keep it intact. Although these drugs are still useful, their over-prescription at the expense of fixing root causes is the main concern.

Social Health Looks at Root Causes 

A sociological perspective considers with root structural causes to problems. For example, consider the root causes of crime. Here is a rough example to put this into context: Social issues (open faucet) produce crime (a wet floor) and the police are dispatched to deal with it (the mop). One way to deal with crime is to dispatch more police to clean up the mess. Although it makes sense to dispatch more mops, we need to consider the root cause of the problem and turn off the faucet. Sociologically, the means studying the social issue producing the problem. Politically, it means implementing a viable policy to prevent the problem. Crime will never be completely eliminated. People will make bad decisions, and police are necessary to ensure individuals are punished. But focusing on enforcement at the expense of prevention neglects the root causes.

Social Health Goes Beyond the Individual 

Consider the difference between the following two statements:
“Man is nothing else but what he makes of himself.“ Jean-Paul Sartre “…it is society which, fashioning us in its image, fills us with religious, political and moral beliefs that control our actions.” – Emile Durkheim
Is man self-made, or made by society? Do we have free-will to guide his own destiny, or is his fate dictated by larger social forces? These questions have divided people for decades. Existentialists such as Sartre stand strong on the side of radical individualism (as seen in the quote above), whereas Sociologists such as Durkheim talk about “collective currents” having the potential to sweep individuals into religious fervor, or  on the other hand, drive them to suicide. The existential perspective has gained recent popularity in the personal-development field. Tony Robbins fully embraces the existential theme of individual autonomy in his books, Unlimited Powerand Awaken the Giant Within. On the other hand, the sociological perspective has gained recent popularity in movements advocating for social justice. Strong adherents to the existential perspective often view the sociological perspective as a way to avoid taking responsibility for one’s problems by blaming a part of society (e.g. the rich or the government). On the other hand, strong adherents to the sociological perspective often view the existential perspective as failing to get to the root of a problem (e.g. focusing on one’s own success while neglecting unjust structural relations). Personally, I am deeply invested in both of these perspectives and believe they are complimentary. As both a Sociologist and personal-development genre fan, I’ve often felt like I’ve been living in two different worlds. Although I felt these perspectives were complimentary, I had not been able to articulate how until reading the work of Victor Frankl. Victor Frankl, an Existential Psychologist, survived three Nazi concentration camps and lived to write about the experience in his book, The Will to Meaning. In the first half of the book he details his experience in the concentration camps, stressing his unshakable drive to survive so that he could publish the manuscript he had written before his captivity. In the second half he describes his perspective on the human psyche, building on the prevailing psychotherapeutic theories of Freud by asserting the need for a logo-therapeutic approach to psychological despair. Frankl claims despair is suffering without meaning. In order to fix an individual’s psychological despair, that individual must find meaning by serving a cause outside of one’s self. It is the individual’s responsibility to come to that meaning themselves, and logotherapy was designed to assist the individual in their search. When an individual acquires this sense of meaning, the suffering does not go away, but it no longer leads to despair. Frankl repeatedly emphasizes the need of the individual to take responsibility for one’s attitude:
“Everything can be taken from a man but one thing: the last of human freedoms  to choose one’s attitude in any given set of circumstances, to choose one’s own way.”
Although his commitment to the ideals of existentialism are clear, Frankl is highly cognoscente of the problem with meaning in  the Modern West. He calls this the existential vacuum. Frankl Defines the existential vacuum as the diminishing importance of tradition in the Modern West. No longer being told what to believe by tradition, individuals are left to find their own personal meaning in life. The growth of cultural freedom must be balanced with responsibility for one’s own existential well-being. Frankl states:
“I recommend that the Statue of Liberty be supplemented by a Statue of Responsibility on the west coast.”
Although this call to individual responsibility may echo the individualism of Jean-Paul Sartre, Frankl disagrees with Sartre’s belief that men can create their own standards. In his book, Man’s Search for Ultimate Meaninghe states:
“The self cannot be its own law giver. Sartre believed that man can choose and design himself by creating his own standards. However, to ascribe to the self such a creative power seems to be still within the old idealistic tradition.”
So where do these standards come from, if not from the self? Frankl’s answer is an unconscious religiousness, and he goes on to discuss a transcendent source, using the word “God” or “spiritual source”. Although Frankl uses religious language, this “transcendent source” can also be interpreted in a non-religious way. For example, one’s community may serve as a transcendent power beyond oneself as an individual. Rather than a transcendent mystical thing, Durkheim discusses spirituality as the experience of “collective effervescence” a word he uses to describe the high an individual may experience when engulfed in collective action. In The Elementary Forms of Religious Life, Durkheim states:
Howsoever complex the outward manifestations of the religious life may be, at bottom it is one and simple. It responds everywhere to one and the same need, and is everywhere derived from one and the same mental state. In all its forms, its object is to raise man above himself and to make him lead a life superior to that which he would lead, if he followed only his own individual whims: beliefs express this life in representations; rites organize it and regulate its working.
In The Division of Labour in Society, Durkheim expands on his belief that our moral regulations are necessarily social by considering the rise in occupational groups that will take the place of religion as a source of integration and regulation in the modern context. This, I believe, is the key to Frankl’ss own sense of meaning. Fixated on finishing his psychological manuscript, Frankl maintained resilience while in the concentration camps. But the value of finishing the manuscript was far from his own creation; the value laid in the fact that it represented a significant contribution to the field of Psychology, advancing human knowledge, and helping countless generations after the war. Frankl’s sense of purpose was directly bound up with his social role as a psychologist. The meaning he found in his work was bound up with the social value it held. Although it is an individual’s responsibility to make something of themselves, the individual’s social context sets the stage for meaningful action.

Conclusion

As C.Wright Mills has stated, the domain of sociology is:
“to translate personal troubles into public issues.”
Social health is important because our societies are living organisms. Like a physical organism, social life can develop pathological characteristics, resulting in damage to the individual parts that make up the organism. There have been huge advances in medicine and mental health in recent decades, but health of our societies cannot be neglected. We are on the verge of the most severe mental health crises in decades and it can be directly attributed to changes in our social environments. If you would like to read more about how our new social environments affect mental health, you can check out my article, Why We Are Addicted To Social Media: The Psychology of Likes.

Looking for General Support?

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Curious if online therapy works? I wrote an article here, looking at the evidence.

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