Social connectedness is the degree to which people have and perceive a desired number, quality, and diversity of relationships that create a sense of belonging, and being cared for, valued, and supported.

Our analysis connects the geo-specific average family structure with the prevalence of chronic conditions in those geographies. We find that household size and composition, particularly in lower-income areas, can have significant implications for health outcomes.

Unpacking the data
Our research uncovered a bidirectional link between family structure and economic wellbeing at a county level that appears to translate to chronic condition health outcomes for the county, particularly for the lower third of income counties.

Social connectedness and health can be bidirectional and cyclical
Chronic conditions can require at-home management and can be mentally and physically burdensome. Conversely, loneliness and social isolation have been associated with poorer health outcomes through biological, psychological, and behavioral pathways. Our other key findings include:

• Household dynamics varied between income groups, with a differential effect on health outcomes. Understanding these dynamics can help fill gaps in health equity.
• Partnership in the household, especially in lower-income communities, can act as a form of wealth and improve health outcomes.
• Single parent households across all income groups, generally, could benefit from increased social connectedness and support.

Community social structure encompasses the networks and spaces that facilitate social interaction and support, contributing to overall community health.

Our research highlights the importance of third places—community spaces outside of home and work—in fostering social connectedness and, in turn, enhancing health outcomes. This insight has us asking: How can community leaders and stakeholders help develop and sustain an infrastructure that’s most relevant to the people they serve in order to improve health outcomes?

Unpacking the data
The kinds of community-level third places that are associated with better mental and physical health vary between income groups. However, the availability of community centers is generally associated with better health outcomes and is specific to the community it serves.

Tailoring social infrastructure could be the key to diverse community health needs
Different communities have different needs when it comes to achieving better population health, so any potential investment or intervention should be community driven and relevant. Our key findings include:

• In lower-income counties, better mental and physical health was associated with an increase in social and civic organizations.
• In middle-income counties, better mental and physical health was associated with an increase in libraries and archives.
• In upper-income counties, better mental and physical health was associated with an increase in child day care centers.

Communities are bound not only by geography but can also be bound by the local community resources that foster social connectedness and combat isolation. Each community may be unique in their needs for specific social infrastructure and third places. To better meet people where they are, providing accessible physical spaces to encourage and foster civic and community engagement may improve overall community health and wellness.