Is the “Social Cure” a Cultural Universal?

The social cure theory rests on a bedrock of robust findings that belonging to many social groups benefits a person’s physical and mental health. However, our recent cross-cultural research (Easterbrook, Grigoryan, et al., 2024) questions the applicability of this theory for societies where social groups might serve other functions.

The social cure theory encompasses findings, from mostly Western societies, which show that the social networks a person belongs to, and the social support they have access to as a result, can shape their health and wellbeing. These social relationships are just as, if not more, important than poor health behaviours such as smoking, in determining health outcomes over the lifespan (Haslam et al., 2018; Holt-Lunstad et al., 2010). As per Tajfel and Turner’s social identity theory (1979), group memberships are a part of a person’s self-concept — affecting their self-worth, sense of belonging and the values they hold. It seems intuitive that positively identifying with different social groups, that is, viewing them as having a meaningful and rewarding place in one’s life, can protect against feelings of depression and stressful life events, and even aid chronic illness management (Cruwys et al., 2014; Haslam et al., 2016; Wakefield et al., 2020). But is this a universal cure?

However robust the finding that belonging to multiple groups bolsters well-being for Western societies, the strength of this ‘social cure’ effect wavers when investigated in East Asian societies, for whom cultural norms around social relationships focus on loyalty, harmony and the impermeability of group boundaries. Chang and colleagues (2016) found that for a sample of 60 Asian students, there was no relationship between belonging to multiple social groups and self-rated happiness and depression scores. This contrasts Australian students, for whom group memberships correlated with both higher happiness and lower depression scores. So if the social cure theory proposes that ‘we get by with a little help from our friends’ (or fellow football team members, work colleagues, or school-run partners), what cultural characteristics might shape this effect?

In our recent study, we point to societal-level relational mobility as one explanation (Easterbrook, Grigoryan, et al., 2024). Relational mobility describes the ease with which social relationships can be entered or exited voluntarily. This is highest in countries where the social cure theory originates, namely Australia and the US. People in these societies can more easily enter groups which make them happy (for example, because these groups have a higher social status or provide support to their members) and leave groups which do not make them happy (for example, because they have a lower status or do not provide support to their members). This helps form the positive social identities and social connectedness needed for the social cure process. Much like the quick cancelling of one gym membership for another if the exercise bikes are always taken up in one branch, societies with high relational mobility can exchange these group memberships when they feel another might offer better connectedness and have a higher status in society.

Conversely, in Asian societies, where social harmony and the good of the group tend to be prioritised over the good of the individual (Kim et al., 2006), these social bonds are more rigid. Groups cannot be easily exchanged for others if a person feels the group no longer offers enough psychological reward for the effort of belonging. In cultures where it is more difficult to break away from social groups and exchange social identities for more rewarding ones, could these multiple group memberships come to burden a person rather than relieve them?

We conducted a study in 29 societies and found that social support underlay the relationship between multiple group membership and well-being, while relational mobility determined the strength of this relationship. Although participants from societies with low relational mobility received more social support from their groups than those in societies with high relational mobility, this did not translate to lower depressive symptoms — the negative relationship between group membership and depression was, in fact, weaker. In other words, the potency of a social cure was reduced in societies with low relational mobility. It seems that if a person has less choice and flexibility over the groups they enter or leave, the less socially nourishing they may find the groups that they are in, in turn, offering less reward for health and well-being. Meanwhile, in cultures with high relational mobility, members can exchange old groups for new ones if they lose their social appeal, enabling these individuals to more readily form psychologically meaningful identities around supportive social networks — the key ingredient in producing the social cure.

We also found a stronger relationship between group membership and uncomfortable normative pressures in societies with low relational mobility, suggesting that stronger pressures to behave a certain way within social groups reduced the benefit that these group memberships offer. We argue that greater normative pressures around reciprocity in societies with low relational mobility could impose a burden on the person receiving support from their group. Whereas Western societies approach intra-group support-seeking more casually, those in low relationally mobile societies are less inclined to seek support (Kim et al., 2006; Chang et al., 2016). It makes sense that a person may glean less comfort from social support in a society where a) receiving it is regarded as an imposition on the group and b) this receipt necessitates giving this intense support back further down the line.

More research still needs to be done to investigate further factors that could explain variability in the social cure effect. For instance, the type of social support given is also likely to play a part in the effectiveness of these relationships in promoting well-being. Whilst Westerners favor emotion-based support, Japanese societies are shown to favor more solution-oriented support (Chen et al., 2012).

The conclusion we can draw from this research is that although we do ‘get by with a little help from our friends’, the ‘little’ part may be key and the ‘friend’ part cannot be overstated — a casual, non-committal receipt of social support from groups we wish to associate with is more conducive to producing the protective effect that the social cure theory describes. Too many constraints over the groups a person associates with and too much normative pressure from these groups reduces the positive impact they can have on health and well-being.

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The practical implications from this are evident — multiple group memberships should not be viewed as a universal inoculation against poor health outcomes across cultures. If you live in a society where joining new groups and leaving the old ones is not a big deal, joining as many groups as you can is likely to be good for your mental health. However, if you feel like you can’t leave the groups you are a part of, even if being a part of a group feels like a burden, you might want to be more careful in choosing which and how many new groups to join.