24 Jun

Social Capital: we’re nothing without it

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Relate, the UK’s largest provider of relationships support, have launched a Best Medicine campaign “to put relationships at the heart of the NHS”. Their report details how “good quality relationships matter for our health and wellbeing and can improve health outcomes; but long-term health conditions can also have a significant impact on our relationships”. It goes on to argue that “it is important to ensure our relationships are resilient and robust if we are to draw on such relationships as assets to health and wellbeing.”

The evidence for the link between relationships and both physical and mental health is strong. Weak relationships can lead to unhealthy behaviour (for example substance abuse), whilst supportive relationships encourage health promoting behaviour, particularly for men (who are more likely see a doctor or change diet if encouraged to do so). Relationships also buffer stress with significant physiological benefits, whilst loneliness is known to damage health. A meta-analysis concluded that the influence of social relationships on the risk of death is greater than that of physical inactivity and obesity and comparable with well-established risk factors for mortality such as smoking and alcohol.

Relationships are also essential in the provision of care: 6.5 million people in the UK currently care unpaid for an ill, frail or disabled family member or friend. But 75% of carers were found by Carers UK to have difficulties in maintaining relationships and social networks due to the demands of caring. As one carer put it: “Friends have drifted away so I am exhausted from caring and have little support. I am becoming increasingly isolated and depressed.”

Over the last five years the Relationships Foundation has consistently argued for a more comprehensive family policy with clearly designated responsibility. Rather than it being seen as a narrow agenda around parenting, childcare and the funding of relationship support services, it needs to recognise how policy in all areas can both influence families and depend upon them. We’re therefore encouraged to see more relational approaches to policy being adopted across the political spectrum. The ConservativeHome website has just run a series on the family as the missing link in policy to promote ‘aspiration’ which quotes our assessment of the costs of relationship breakdown. Earlier in the year the Labour MP John Cruddas spoke at an event organised by the Relationships Alliance (of which Relate are a part). In referring to the problems that can be caused by weak relationships he concluded the:

“These problems aren’t a failure of public services or even the economy – though both these play their part. They are a failure of relationships. So we need to stop making policy as if grandparents, mothers, fathers and children exist in separate silos and not as part of a whole family. Throughout our lives we are dependent upon others for our wellbeing and sense of identity. Relationships give meaning to our lives. They bind us all together into society and give us our sense of belonging. We are literally nothing without them. …  We need government that helps create the conditions for families and people’s relationships to thrive.”

The Best Medicine campaign should therefore be seen as part of a wider movement to recognise the importance of our closest relationships, and the potential for many government departments to play a part in supporting them. Too often social capital, and particularly that which resides in families, is an invisible and neglected resource in policymaking. Relate make ten recommendations for ways in which relationships could be better addressed by the health system. These illustrate the kind of specific changes that are necessary of relational thinking is to turn into relational practice.

  1. The UK Secretary of State for Health becomes Secretary of State for Health and Wellbeing
  2. Couple, family and social relationships become a core part of the work of local Health and Wellbeing Boards
  3. Government establishes an inquiry into how relationships can be included in health policy frameworks, including outcomes frameworks
  4. The What Works Centre for Wellbeing commissions research into long term health conditions and relationships
  5. Public Health England establishes a National Health and Relationships Intelligence Network
  6. Directors of Public Health consider the best ways to gather data on the quality and stability of relationships to inform local authorities and commissioners
  7. Clinical Commissioning Groups and local authorities have a duty to undertake a ‘Family Test’ when considering new local policies and in the commissioning cycle
  8. Relationship support and impairment-specific charities partner to provide support
  9. Public Health England supports local authorities to embed plans to strengthen relationships and incorporate relationships into Joint Strategic Needs Assessment and Joint Health and Wellbeing Strategies
  10. The Department for Work and Pensions pilots a local ‘family offer’ with a focus on health and wellbeing, particularly on the couple, family and social relationships of people with long term health conditions.