Always Talk to Strangers

People who know and trust their neighbors are less likely to have heart attacks. New research builds on the understated health benefits of a sense of belonging and community.

The first time I met my neighbor, my heart did stop, briefly.

Do you remember those cylindrical, metallic “neuralyzers” that the men in black in Men in Black used to erase people’s short-term memories? I think about those things all the time. Specifically how great it would be to have one. It would be unethical to use my neuralyzer on other people, because I’m not a man in black. I would just want it for myself, for when I see or hear things I can’t really deal with. Or when I say or do things I immediately regret, which is pretty often. It would also be great at times like when I first met my neighbor.

My building has three units, and I had been living in mine for a few days before Stephen and I actually crossed paths. We introduced ourselves, talked a little about the neighborhood and our mutual intentions to be respectful and communicative, possibly even social, and then said good night. He turned and started walking to the stairs. But then he stopped and turned back.

“Oh, and, I probably shouldn’t be telling you this.”

Of the sentences I realistically expect to hear in life, that may be my favorite. Do go on.

“The last tenant in your apartment, he was your age … he died in there.”

Stop.

“But everything should be fine now,” he continued, and turned to leave again. “Well, good night.”

No one brought up this fact prior to my moving in. Stephen was right, he probably shouldn’t have told me. He would have spared me nights and nights of unwanted speculation. Gas leak? Murderous robbery? Something to do with the plumbing? But on the whole, I’m better off for having met my neighbor.

Specifically, according to new research published today from psychologists at the University of Michigan, I’m less likely to die of a heart attack than I would be if I gave in to my more introverted tendencies.

Social connection at the neighborhood level has long been known to be associated with good mental health, and some aspects of physical health. But this is the first study to look specifically at neighborhood social cohesion and heart attacks, which hit more than 700,000 Americans every year and cost everyone billions of dollars.

"There's evidence suggesting that negative factors of the neighborhood, things like density of fast food outlets, violence, noise, and poor air quality impact health,” lead researcher Eric Kim, a psychologist in his final year of doctoral work at the University of Michigan, told me. I'd add broken windows. One 2003 study found that “boarded-up housing” predicts high rates of gonorrhea in a neighborhood, as well as premature death due to cancer or complications of diabetes. (And murder.) More recently, researchers from University of Pennsylvania looked at the health detriments associated with vacant land. By their understanding, abandoned buildings lead to isolation and erosion of social relationships, mutual trust, and collective efficacy, which leads to poor physical health.

Kim’s team is focusing on the other side of things: the positive elements of a neighborhood that “might perhaps be protective or even enhancing of health." For a young scientist, Kim is precociously well versed in the language of hedging.

The study du jour, published in Journal of Epidemiology and Community Health, is based on assessments of social connectedness in 5276 adults in urban, suburban, and rural areas. The subjects rated how strongly they agreed with the following four prompts:

  • "I really feel part of this area."
  • "If [I] were in trouble, there are lots of people in this area who would help."
  • "Most people in this area can be trusted."
  • "Most people in this area are friendly."

The responses landed the participants on a seven-point Likert scale. And then they were followed. Four years later, 148 of them had experienced heart attacks.

“On the seven-point scale,” Kim explained, “each unit of increase in neighborhood social cohesion was associated with a 17 percent reduced risk of heart attacks.”

“If you compare the people who had the most versus the least neighborhood social cohesion,” Kim continued, “they had a 67 percent reduced risk of heart attacks.”

But does it really matter if you feel connected in your community, as long as you have relationships and connectedness somewhere? (Like, on the Internet?)

Rare among studies of its kind, Kim and colleagues controlled for social connectedness at the individual level. "We also controlled for dispositional factors,” he said, “thinking that perhaps optimistic people might think that they are more socially connected.” The survey included measures of optimism, and the analysis also accounted for things like age, race, income, marital status, education, mental health, and known risk factors for heart attacks like diabetes, obesity, and high blood pressure.

"Are you saying that people should get out and meet their neighbors and join community groups?" I asked.

"I don't think there's enough evidence for that,” Kim said, like a rock. “This is only a correlation; we didn't really isolate causation. But I really don't see how that could hurt."

I immediately thought of several ways. But it's more fun to envision it going well. 

“Hey, I’m your neighbor from downstairs.”

“Oh, hi. I hear you singing sometimes.”

“Cool, I hear you dancing.”

Presented by

James Hamblin, MD, is a senior editor at The Atlantic. He writes the health column for the monthly magazine and hosts the video series If Our Bodies Could Talk.

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