The Missing Piece in Global Health? It’s Our Relationships

By Sabina Storberg
Oct 10, 2024
United Nations in Geneva

When we think of health, we often think of the individual: eating right, exercising, managing stress, or going to therapy when things get tough. But there’s something missing in that picture. An elephant in the room that we rarely acknowledge in public health debates: the health of our relationships. We talk about mental health, physical health, and even financial health—but relational health, the quality and wellbeing of our close relationships, is barely part of the conversation.

Here’s the surprising thesis: Relational health is the foundation of human well-being, and the failure to include it in public health policies is not just a gap—it’s a crisis.

Relationships Aren’t Just Personal—They’re Public Health

Let’s start with the basics: relationships matter. Research has repeatedly shown that the quality of our relationships directly affects not only our mental health but also our physical health and longevity.

  • A comprehensive study published in Harvard Gazette on the famous Harvard Study of Adult Development—which tracked people’s lives over 80 years—found that close relationships, more than money or fame, are what keep people happy throughout their lives (Waldinger, 2016).
  • Research in Journal of Health and Social Behavior shows that poor relational health—whether through strained marriages, family conflict, or social isolation—correlates with increased levels of stress, anxiety, depression, and higher mortality (Holt-Lunstad et al., 2010). Relational conflict can even trigger chronic diseases like heart disease and diabetes (Robles et al., 2014).

Yet, relational health has remained a private matter. There is a common misconception that relationships are personal, not a public health issue, but the research paints a different picture. Relational health isn’t just a "nice-to-have"—it’s critical to the health of society as a whole.

The Epidemic We Aren’t Talking About

There’s a hidden epidemic happening in homes worldwide: deteriorating relationships. In fact, relational distress is more common than we acknowledge:

  • The American Psychological Association reports that around 40-50% of marriages in the U.S. end in divorce. This often results in mental health issues for both the individuals and any children involved (Amato, 2010).
  • Studies in Social Psychiatry and Psychiatric Epidemiology have shown that people experiencing relational distress are at a higher risk of anxiety disorders, major depressive episodes, and even suicide (Whisman et al., 2000).

The effects of relational distress extend beyond the home. When relational health is poor, it affects workplace productivity, increases the demand on mental health services, and often leads to higher healthcare costs as stress-related illnesses and mental health issues rise. This is where the crisis deepens.

By ignoring relational health in our public health frameworks, we are also increasing the burden on the healthcare system. The WHO and policymakers around the world have called for integrating mental health into primary care, but where are the efforts to treat and support relational health as part of this holistic approach?

Relational Health = A Public Good

Public health campaigns have long been instrumental in changing societal behaviors. We've seen anti-smoking campaigns, mental health awareness initiatives, and even pushes for better diet and exercise habits. What if we applied the same lens to relational health?

Imagine this: instead of only seeing public health as a matter of individual lifestyle choices, we started seeing our relationships as part of the picture.

  • New Zealand’s Ministry of Health has already pioneered steps in this direction by emphasizing the role of social connections in overall well-being, showing a pathway for other countries to follow (Ministry of Health NZ, 2018).
  • Research from the Institute for Family Studies highlights how improving relational health through family counseling, relationship education, and support systems could dramatically reduce divorce rates and improve children's mental health (Wilcox et al., 2017).

What’s Keeping Relational Health Out of Public Health?

Despite the clear evidence that relationships are central to our well-being, there’s been little movement to bring relational health into the fold of public health policies. 

Why? Several barriers keep this out of the conversation:

  • Historical Focus on Individual Health: Public health has traditionally focused on the individual—treating diseases, promoting exercise, and managing individual mental health. Relationships, while seen as important, have been regarded as too personal to be addressed by public health initiatives.
  • Cultural Stigma: Many cultures still view relational issues as private matters to be dealt with behind closed doors. Seeking help for relationship problems, particularly through therapy or counseling, is often seen as a sign of weakness.
  • Lack of Data and Advocacy: While there’s no shortage of research showing the importance of relational health, there’s been little in terms of large-scale public health campaigns or advocacy around it. Most healthcare systems don't even provide insurance coverage for couples counseling or family therapy (OECD, 2020).

The Way Forward: A Relational Health Revolution

It’s time to change the conversation. If we want healthier individuals, we need healthier relationships. 

Here are three bold steps to take:

  • Integrate Relational Health into Primary Care: Just as mental health is now being integrated into primary care systems around the world, relational health should follow suit. Family counseling and couples therapy should be accessible through public health programs, with costs covered by insurance.
  • Leverage AI and Digital Tools: Tools like Inetta.ai and other AI-driven platforms offer an innovative way to provide 24/7 relationship support at a lower cost, reaching those who may not have the time or resources for traditional therapy. These tools can be integrated into broader healthcare offerings, making relational health more accessible and scalable.
  • National Campaigns on Relational Health: Just like mental health awareness campaigns, we need national and global campaigns to normalize relational health. Public messaging can help destigmatize seeking help for relationships and encourage healthier relational practices from a young age.

We live in an age where individualism is celebrated, but at what cost?

If we truly want to improve public health and reduce the burden on our healthcare systems, we need to look beyond the individual and recognize the profound role that relationships play in our well-being.
Relational health is not a luxury—it’s a necessity. 

It’s time for governments, policymakers, and healthcare providers to take it seriously. By integrating relational health into the broader public health agenda, we can create a healthier, happier, and more connected world.

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