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Won’t You Be My Neighbor?

Middle aged man meeting smiling female neighbor in countryside and talking cheerfully to her over fenceDr. Vivek Murthy, the U.S. surgeon general, recounts the tale of one of his more memorable patients who for years had worked in the food industry, living on a modest salary and leading an unpretentious lifestyle. One day he won a large jackpot in a lottery, and overnight his life changed dramatically. He quit his job and moved into a luxurious house in a gated community. Yet as he sat in Dr. Murthy’s office two years later, he sadly admitted, “Winning the lottery was one of the worst things that ever happened to me.” Wealthy but emotionally isolated, this previously social and vivacious person no longer knew his neighbors and  had lost touch with his former co-workers. He had also developed depression, high blood pressure, and type 2 diabetes.
If you had to guess the single most important strategy for maximizing your future well-being and longevity, you’d probably say more exercise, better diet, or quitting tobacco. But Peter Attia in his superb new book, Outlive, makes a strong case for tending to emotional health as the top priority if you’re on a quest to lead a long and vigorous life. For the past century in America, life expectancy had been rising from 47 years in 1900 to 68 years in 1950 to 79 years in 2019. But then it suddenly it reversed course and started falling—to 77 years in 2020 and 76 in 2021. This abrupt U-turn in longevity was due in part to the COVID pandemic, but also to rising deaths of desperation—suicide, drugs (mostly opioids), alcohol, car accidents, and gun violence. These fatalities typically result from risky and self-destructive behaviors arising out of emotional distress and social isolation.
Despite being among the hardest working and wealthiest nations in the world, the U.S. faces a mushrooming emotional health crisis. For millennia, our lives were inevitably woven into a fabric of interconnectedness while living in small tight-knit communities with lifelong friends and neighbors, and extended families nearby, often with a shared religion and worldview. Now most of these traditional sources of emotional support have unraveled, leaving many people feeling isolated and vulnerable.
Rat Park
The Rat Park study was an experiment designed to investigate the effects of living conditions on drug addiction. Rats were given a choice of two water bottles—one that was pure water, and the other that had water laced with morphine. When the rats were housed in standard bare metal laboratory cages with no social interaction or stimulation, they consistently chose the morphine-laced water and became addicted to it. Yet when the rats lived in a more stimulating natural environment with fellow rats to socialize and play with, and they had plenty of room to explore, they showed no interest in the morphine-laced water and didn’t get addicted to it.
The message of the Rat Park study for humans is that addiction is not solely caused by the chemical properties of drugs, but also by environmental and social conditions. It suggests that a lack of social support, connection with others, exercise, and fulfillment may contribute to addictive behavior.
The Good Life

Drs. Robert Waldinger and Marc Schulz in their splendid new book, The Good Life, assert that our most essential need in life is meaningful connections with others. What makes for a vibrant life that is fulfilling and meaningful? The simple and intuitive answer is relationships. The stronger our relationships, the more likely we are to follow a healthy lifestyle, which eventually translates into a long, happy, and satisfying life. Dr. Waldinger is the current director of the Harvard Study of Adult Development, which has been closely following a group of about 700 people year after year for their entire adult lives. This study, which has been going on for 85 years and counting, reveals that more than cholesterol, blood pressure, or any other factor, the strength of our connections with others determines how gracefully our bodies and our brains age.
Relationships in all their forms—family, friends, romantic partners, coworkers, pickleball pals, bicycling buddies, garden or book club members, Bible study groups, pets, and even plants—all contribute to a happier, healthier, and longer life. It’s never too late to improve the relationships you have and never too late to build new ones. According to Dr. Waldinger, “Good relationships keep us happier, healthier and help us live longer. This is true across the lifespan, and across cultures and contexts, which means it is almost certainly true for you, and for nearly every human being who has ever lived. We are sustained in a web of relationships that give our lives meaning and goodness.”
Neighbors with Benefits
In my humble opinion, neighbors are an important and often overlooked source of mutually beneficial emotional support. My mother, Leatrice, taught me by example that if you want to have a friend, you need to be a friend. She had about 15 people who considered her their very best friend, many of whom were neighbors. When I was growing up during the Baby Boom of the 1960s, my siblings and I would run outside into a backyard that was contiguous with 15 other backyards on our block in Grafton, North Dakota, a town of 4,000 people. There were about 60 kids within a few years of age of each other whose backdoors opened onto our shared backyard, with virtually no fences and very few hedges. We all knew each other and scampered in and out of various neighborhood homes like they were our own. My mother would frequently have coffee or birthday club with the other moms on the block. When the weather was nice, my parents would have happy hour on the back patio, where Helen and Bill and other neighbors often sauntered across the backyard to join them for a beer.
Each of us lives in a custom-built world—for better or worse—that is created by how we treat other people. Joan and I have throughout our lives tried to get to know our neighbors and befriend them. It hasn’t always been easy. About 23 years ago we moved next door to an older couple, let’s call them John and Mary. Our kids were little at the time and they would climb the neighbors’ trees and sometimes light fireworks off in their yard. And our dogs might have been barking too much or relieving themselves on the neighbor’s lawn. So, Mary would frequently call and leave nasty-gram messages on our answering machine, sometimes threatening to report us to the city. In contrast, it was easy to make friends with their black lab, Rory, and we offered to have him stay with us when they were out of town. That changed the whole relationship, and through the years we have gotten to be good friends with John and Mary and their family. When John developed Alzheimer’s, he would show up
confused at our front door, looking for Joan to reassure him that everything was going to be okay. She would take him by the hand and gently lead him back home.
Neighbors who become friends share a unique bond—one of place, a common turf. It’s reassuring to know that you have people in your neck of the woods that you can count on to watch your back. Good neighbors keep an eye on each other’s homes when one of them is out of town. We have other close neighbors with whom we exchange home-grown vegetables and fruits— depending on whose garden or fruit trees are producing at the time. It is much easier to spontaneously visit with and socialize with neighborhood friends since you often bump into them coincidentally.
Your Neighbor Might Just Save Your Life

On the other hand, we have neighbors down the street who for decades have walked by regularly and pretended to not know us. This just seems like a waste of a potential resource. Don’t delude yourself into thinking you live in isolation just because you can climb into your car, click the garage door opener, and never take the time to get to know your neighbors. They could save your life one day, or you could save theirs. Our friend and neighbor Kathy was out walking her Scotty dog last fall when she heard faint but distressed cries for help that she couldn’t localize. She immediately called 911 and within a few minutes, first responders arrived on our block and discovered Sara, another friend and neighbor, at the bottom of her basement stairs, collapsed and hemorrhaging with a broken hip. Kathy saved Sara’s life that morning. Whatever differences you may have with your neighbors are generally not more important than the things you share— like the desire to live in a safe, friendly, and familiar neighborhood. Keep in mind that neighbors can be friends regardless of age differences, and try not to take personally the political signs they might put up in their yards.
My son Jimmy and his husband Darren used to live in Manhattan, New York, and hardly knew their neighbors. But about two years ago they bought a brownstone apartment in a gentrified Brooklyn neighborhood. Now they live in a storybook setting where they walk their dog, Theo, to Prospect Park a few blocks away every morning to frolic with her canine playmates. They’ve gotten to know folks who are routinely out pushing baby strollers, or walking their dogs; they see familiar kids playing on the sidewalks after school and neighbors out doing errands. Living in a real neighborhood has become a wellspring of joy for Darren, Jimmy, and Theo.
Having friendly relationships with your neighbors can be beneficial for both your mental and physical health.
1. Social support. Neighbors can provide a sense of community and social support. Having someone nearby to talk to and share experiences with can help reduce feelings of loneliness and isolation.
2. Physical activity. Being friends with your neighbors encourages you to be more physically active. You may be more likely to garden, take a walk, or participate in other outdoor activities if you have someone to interact with.
3. Safety. Knowing your neighbors and having a good relationship with them can help create a sense of safety and security in your community. You may feel more comfortable leaving your home and your children in the neighborhood if you know your neighbors are looking out for you.
4. Reduced stress. Having a positive relationship with your neighbors can help reduce stress levels and allow you to feel more comfortable asking them for help with tasks such as caring for your plants or pets when you go on vacation.
Being friends with your neighbors is a unique opportunity to strengthen personal bonds and improve your sense of belonging. Like Mr. Fred Rogers said, “All of us, at some time or other, need help. Whether we’re giving or receiving help, each one of us has something valuable to bring to this world. That’s one of the things that connects us as neighbors—in our own way, each one of us is a giver and a receiver.”
In Good Health,
James O'Keefe, MD