Do social and family relationships affect self-rated mental and physical health? Evidence from nationally representative samples across 22 countries

BACKGROUND: Evidence linking social and family relationships with perceived health is largely based on single-country studies, limiting understanding of whether these associations generalize across diverse cultural contexts. AIMS: To examine cross-national patterns and test associations between social relationships, retrospectively reported childhood family relationships, and self-rated mental and physical health in nationally representative samples from multiple countries. METHODS: Wave 1 data from the Global Flourishing Study were analyzed, including 204,907 adults from 22 countries. Social relationships were measured via satisfaction with friendships and overall relationship satisfaction. Childhood relationships with mother and father were assessed retrospectively. Self-rated mental and physical health were each measured with single items. Weighted descriptive analyses, correlations, and multivariable regression models adjusted for sociodemographic factors were applied. RESULTS: Greater contentment with friendships and higher relationship satisfaction were consistently associated with better self-rated mental and physical health, while retrospective parental relationships showed similar but weaker associations. Self-rated mental and physical health were strongly interrelated across countries. Strong social relationships serve as a universal pillar of well-being across cultural backgrounds. CONCLUSIONS: Public health strategies should value social connections as essential components of a healthy life. Health policies should recognize social and childhood family relationships as environmental factors shaping perceived mental and physical health.