Pal Power

Lotte Prager owes her life, and much of the happiness she has enjoyed during her 81 years, to friends. It was friends who helped her escape Nazi Germany in 1937 by paying her first year's tuition at a British teaching college. Then friends at the college helped her get her relatives, including her parents, out of Germany. Following her move to the U.S., Prager met her husband-to-be at a party given by other friends, and after her husband died and her children had grown up, yet another friend helped her find an apartment in New York City. Retired from her career as a social worker, Prager now relies on friends for companionship and the comfort of knowing, as she says simply, that "they will do for me and I will do for them."

Prager's saga may be dramatic, but there is a growing body of evidence that a rich social network may play a life-enhancing, even lifesaving role, particularly as we age. In study after study, researchers have found that people who have strong social relationships live longer--and happier--lives. In a recent study of 2,800 people 65 and older in New Haven, Conn., for example, Carlos Mendes de Leon, at the Rush-Presbyterian-St. Luke's Medical Center in Chicago, found that those who had more friends were less likely to become disabled and more likely to recover if they did suffer a period of disability. In an earlier study of 11,000 people 65 and older, Teresa Seeman, now at the UCLA School of Medicine, found that, over a five-year period, those with no ties to others were two to three times as likely to die as those with bonds to spouses, friends, relatives, churches and other organizations. Other studies have found that people with narrower social networks are more likely to have a heart attack--and to die afterward--while people with more social contacts are less likely to suffer cognitive decline.

Why are good relationships so good for our health? Seeman suggests two mechanisms. The first is behavioral: family and friends encourage loved ones to eat better, consume less alcohol, curb tobacco use, exercise and seek medical care. Second, good relationships appear to enhance actual physical well-being. In experiments, the presence of a friend decreased physiological stress responses in subjects performing difficult mental tasks, whereas unsupportive social situations increased them.

Though friends and family are frequently lumped together in research measuring the link between health and social support, they are distinct and separate in real life. The chief difference? "You choose your friends, but you're stuck with your family" is how an adolescent might put it. That's good news and bad news for friendship. "Friends don't make the demands that family members do. Friends generally won't be asked to give money or nursing care," says sociologist Jan Yager, author of Friendshifts. "They are probably going to mainly have fun together." On the other hand, she notes, "because it's optional, friendship can be withdrawn more easily than family relationships."

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