BOZEMAN — Long before “social distancing” became a household phrase, researchers observed that isolation can increase an individual’s risk for mental health disorders and chronic disease. Conversely, having a larger and more diverse social network can protect against depression and even physical risk factors such as high blood pressure.
But few studies of this kind have been conducted among American Indian populations, which face significant mental and physical health disparities and lower life expectancy, particularly in Montana, said Neha John-Henderson, assistant professor in Montana State University’s Department of Psychology and an investigator with the Center for American Indian and Rural Health Equity, or CAIRHE.
“Blackfeet community members and stakeholders have long held that a key resilience factor for their community is social connectedness,” John-Henderson said. “They acknowledge that social connectedness has diminished over time in their community, but they believe efforts to restore and increase connectedness could have a tremendous positive impact on the health of their people.”
Earlier this month John-Henderson received a four-year, $2.18 million grant from the National Institute on Minority Health and Health Disparities, part of the National Institutes of Health, to investigate dynamic relationships between social connectedness and health risk factors in American Indians living on the Blackfeet Reservation — the first comprehensive, multiyear study of its kind, she said.
“If we can show there is an association between social connectedness and better health in this community, we can develop culturally appropriate ways to promote connectedness, thereby improving health in this vulnerable population,” she said.
Over a two-year period, John-Henderson and her team will examine long-term changes in indices of mental and physical health and social connectedness among 280 adults on the Blackfeet Reservation, where she has worked with local research partners since 2016. John-Henderson hypothesizes that positive changes in social networks — such as increased reports of positive social interactions and social relationships — will be associated with improvements in sleep quality, mental health and levels of immune system proteins and cardiometabolic markers as measured in blood samples.
The study also will consider shorter-term effects of daily social interaction on health. Participants will report on positive and negative social interactions six times a day using a mobile phone app, while a device worn on the wrist during the same two-week period will measure activity and sleep. Surveys will assess a participant’s mental well-being. John-Henderson believes that more frequent social interactions and greater reports of social connectedness will be associated with fewer symptoms of anxiety and depression, as well as greater sleep duration and optimal sleep quality.
“In addition to understanding long-term correspondence between social connectedness and health, it’s important to understand more immediate effects of social connectedness on outcomes linked to health as they unfold in daily life in our actual environments,” she said.
Data collection will take place at Blackfeet Community College in Browning, where John-Henderson has worked with faculty member Betty Henderson-Matthews and student research interns for the past five years. Henderson-Matthews will oversee research activities at the college with the help of a project coordinator and Blackfeet Community College students. Analysis of blood samples will be conducted by CAIRHE’s Translational Biomarkers Core Laboratory on the MSU campus.
Jason Carter, MSU’s vice president for research, economic development and graduate education and an expert in sleep and cardiometabolic disease, said the study will address novel and timely questions that have been amplified by COVID-19.
“Social connectedness is a valued and foundational element within tribal communities,” said Carter, who will serve as a co-investigator on the study. “The COVID-19 pandemic has only reinforced the value of social interactions, even in modified and mitigated ways. This partnership with the Blackfeet community will significantly advance our understanding of the complex relationships between social connectedness, mental health, sleep and cardiometabolic health in ways that will help tribal communities be better prepared for future pandemics and adversities.”
In her preliminary work on the Blackfeet Reservation, including two pilot studies funded by CAIRHE from 2017 to 2019, John-Henderson found that community connectedness appears to offset physiological risk for disease, particularly among individuals who experienced high levels of trauma early in life. Meanwhile, feelings of loneliness and perceptions of less community connection were associated with more anxiety and depression.
A separate CAIRHE study she led found that frequency of positive social interactions was inversely related to blood pressure, and that average perceived social connectedness was inversely related to levels of immune system inflammation. Adults who reported more loneliness across a one-week period also experienced worse sleep during that time.
These studies and work done in John-Henderson’s Stress, Adversity, Resilience and Health Lab at MSU indicate that the nature of one’s social environment may have a greater effect on health among at-risk populations compared to others, she said.
“High levels of inflammatory markers, higher levels of depression and anxiety, high blood pressure and poor sleep quality are all risk factors for higher levels of chronic disease in American Indian adults,” said physician Alexandra Adams, director of CAIRHE and a co-investigator on the new study. “The preliminary research suggests that social connectedness may be a resilience factor that promotes better health and well-being in this community. We’re excited that findings from a new, larger study could lead to innovative Blackfeet programs and traditional teachings that strengthen community cohesion for better health.”
John-Henderson is the third CAIRHE investigator to receive a multiyear, multimillion-dollar NIH grant since the center’s founding in 2014. Elizabeth Rink of the Department of Health and Human Development received one in 2018, while Monica Skewes of the Department of Psychology received a $3.2 million grant earlier this year. All three studies use a community-based participatory research approach founded on an equitable partnership between the MSU faculty member and tribal community colleagues.
Since joining MSU in 2016, John-Henderson also has received research support from Montana INBRE and the American Indian/Alaska Native Clinical and Translational Research Program. Her new NIH-funded study will begin in early 2022.