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Liz Margolies, L.C.S.W. Headshot

The Healthy Reflection of Our Friends

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I could tell a great deal about your physical and mental health without ever meeting you. I just need to meet your friends.

First, I'd want to see how many friends you have. Adults with multiple social connections are healthier and live longer than their more isolated peers. Social ties even reduce mortality risk for people with documented medical conditions. This doesn't apply to your Facebook "friends," but the real people who know you and have your back. Maybe the list more closely resembles the number of people you text. Human attachments save our lives.

The powerful health impact of friendships begins when we are young and its effects are cumulative over our lifetime.In fact, low social support levels in LGBT youth are associated with an increased risk for suicidal ideation. For LGBT youth who face family rejection and social stigma, friends can be life preservers in a turbulent sea of discrimination.

The costs of friendship run both ways, as both unhealthy and health-promoting behaviors spread through our social networks. If your friends smoke, you probably do too. If, then, one of your friends quits, it increases the likelihood that you will quit as well. Similarly, if you are overweight, you are more likely to have overweight friends and romantic partners. If, on the other hand, your friends exercise regularly, you are more likely to hit the gym too.

The same holds for mental health. Happiness seems to spread through social networks, meaning that if your friends are content, you are more likely to feel pretty good yourself.

Friends exert a "social contagion effect" and I think LGBT people need that effect to counter the negative impact of stigma and discrimination on our health. If friendship has the clout to heal us, there is huge power in our community.As they used to say in the '70s, "an army of ex lovers cannot fail." We have to learn to harness this power we already have and use it to our best health advantage.

How does this social contagion work? Friendships affect our health through multiple channels. First, we talk about a topic among our friends, like what we read or heard about a new diet, for example. Then, we are prone to developing a shared appraisal of it, like if we think the diet will work or is a waste of time. Finally, we use our friends to come up with cooperative strategies to address the problem, like how we can help each other stay on the diet. We figure it out together, we support our group conclusions and we help each other make changes.Or, together we agree that change isn't necessary or worth the effort it will take.

The research is filled with studies on the importance of social connections for health, but there is little that directly addresses the LGBT community. I could find a wealth of material about minority groups; disadvantaged groups, African Americans, disabled women, older adults and adolescents, and some of us are members of these groups too. But, we need to know more about how LGBT connections, often invisible or without legal ties, influence our health.

For example, new research found that cancer patients who are married are more likely to be diagnosed early, receive appropriate treatment and even live longer than unmarried patients, across all types of cancer. In fact, single patients were 53 percent less likely to receive appropriate therapy than married patients. In all, marriage is as protective as chemotherapy against cancer.

What does this mean for LGBT cancer survivors? Are LGBT people at a significant survival disadvantage in the 33 states without legal recognition of our relationships? Or, do our families of choice and our partners offer us the same health protections that legal marriage does? We don't yet know for sure, but it looks like the absence of legally recognized marriage may limit the health benefits of our relationships. Since, as a group, we begin with higher cancer risks, the answers to these questions are critical to our survival. We need data and we need funding for research on our relationships.

Look at your friends now. Do you have enough of them? How healthy and happy are your friends? How do they reflect your commitment to wellness? Remember, if you want to make changes, doing it as a group will increase your likelihood of success. There is no stopping the power of our community.