The Need
Social disconnectedness is an issue particularly for those with chronic illness and mental health challenges.
Disconnectedness is a critical public health concern, and its consequences are particularly acute for individuals living with chronic illness and mental health challenges. The U.S. Surgeon General’s Advisory (2023) makes clear that lacking social connection significantly increases risk for adverse health outcomes, including a 26% increased risk of premature death associated with loneliness and a 29% increased risk associated with social isolation.
Insufficient social connection is associated with a 29% increased risk of heart disease and a 32% increased risk of stroke (Surgeon General’s Advisory 2023). For individuals already managing chronic conditions, these elevated risks compound existing vulnerabilities.
The Surgeon General Advisory further identifies people with poor physical or mental health as among the groups at highest risk for loneliness and social isolation (date). This is particularly concerning given the bidirectional relationship between social connection and mental health. Social isolation and loneliness are associated with increased risk for anxiety, depression, and dementia, suggesting that individuals with pre-existing mental health conditions may experience worsening symptoms in the context of disconnection. Moreover, the Advisory emphasizes that social connection is not merely a personal preference but a fundamental human need essential to survival. When this need is unmet, biological stress responses are activated, increasing susceptibility to disease and undermining recovery (2023).
For youth and children with mental health or neurodevelopmental disorders, research further indicates reduced social connectedness and increased negative friendship experiences compared to neurotypical peers. In neurodevelopmental populations such as autism spectrum disorder and ADHD, impairments in social communication are associated with lower social connectedness and difficulty maintaining peer relationships. These relational challenges can limit access to protective social support during critical developmental windows, heightening risk for long-term mental and physical health disparities (Diendorfer et. Al., 2021).
The U.S. Surgeon General’s Advisory (2023) emphasizes that while loneliness and social isolation can affect anyone, certain populations experience disproportionate vulnerability due to structural, socioeconomic, and contextual barriers. In addition to individuals with chronic illness and mental health challenges, groups at heightened risk include those experiencing financial insecurity, individuals living alone, single parents, and both younger and older adults.
The Advisory (2023) further identifies racial and ethnic minority populations, LGBTQ+ individuals, rural residents, victims of domestic violence, and individuals experiencing discrimination or marginalization as groups that may face elevated risk (2023). These patterns indicate that disconnectedness is not solely an individual-level concern but is deeply influenced by social, economic, and environmental conditions. Addressing social isolation therefore requires targeted, equity-informed strategies that prioritize populations most exposed to systemic barriers to connection.
In the context of need, both social connection and belonging function as protective determinants of health. Social connection addresses the relational infrastructure that supports individuals (the presence of meaningful, supportive relationships), while belonging addresses the psychological experience (being accepted, valued, and included) that sustains resilience, identity development, and recovery. Interventions that strengthen both objective connection and subjective belonging are therefore critical to mitigating the health and mental health risks associated with disconnectedness.
Health Outcomes
Extensive evidence demonstrates that social connection and belonging are associated with meaningful improvements in physical, mental, and population health outcomes. These benefits operate at both the objective level of relational ties and the subjective level of perceived inclusion and acceptance.
Positive Health Outcomes of Social Connection
Social connection is associated with measurable reductions in morbidity and mortality (Surgeon General’s Advisory 2023):
- Reduced premature mortality: Loneliness increases risk of premature death by 26%, and social isolation by 29%.
- Lower cardiovascular risk: Poor social relationships are associated with a 29% increased risk of heart disease and a 32% increased risk of stroke .
- Reduced hypertension risk: Greater social support is associated with a 36% lower long-term risk of high blood pressure among higher-risk populations.
- Improved mental health outcomes: Connection helps individuals experience reduced threat perception and improved stress response regulation, leading to improved coping and emotional health skill development.
- Broader societal benefits: Social connection is a social determinant of health influencing population health, resilience, educational achievement, economic participation, and community well-being.
Positive Health Outcomes of Belonging
Belonging reflects the subjective experience of being accepted, valued, and meaningfully included. Research conceptualizes belonging as the positive end of the social connectedness continuum, opposite loneliness. Outcomes associated with stronger belonging include (Diendorder et. al., 2021):
- Improved peer and relational experiences: Children and adolescents with stronger social connectedness report more positive and fewer negative friendship experiences.
- Psychological protection: As the inverse of loneliness, belonging reduces the distress associated with perceived social isolation.
- Enhanced emotional regulation and resilience: Through reinforcing perceived support and inclusion, belonging strengthens protective social and psychological processes that buffer stress and promote well-being.
Together, social connection and belonging function as foundational protective determinants of health. Social connection strengthens the external relational infrastructure that supports individuals, while belonging fortifies the internal psychological experience that sustains resilience and recovery. Interventions that address both dimensions are therefore essential to improving individual and population-level outcomes.
How Gaming Can Support Connection and Belonging
Online gaming as a socially accommodating space
Online gaming environments can serve as socially accommodating spaces for youth who experience social anxiety, emotional sensitivity, or shyness. Research indicates that mediated gaming environments reduce traditional social barriers through affordances such as visual anonymity and flexible communication, enabling socially inhibited individuals to engage more comfortably. Studies show that emotionally sensitive players report meaningful differences in gaming-related friendship networks, including the formation of new friendships and the strengthening of existing ones . Evidence of modality switching further suggests that online gaming environments support and reinforce offline friendships rather than replace them (Kowert, Domahidi, Quandt, 2014). In this way, platforms such as Minecraft can lower entry barriers to interaction while expanding relational networks.
Gaming as a source of social support for vulnerable youth
Online video games are increasingly recognized as positive social spaces that allow youth to maintain connection even when physical proximity is not possible. This is particularly beneficial for youth with major depressive disorder, autism spectrum disorder, or social anxiety disorder, for whom gaming environments can foster connection while building confidence and social competence (Fishman accessed 2026).
Given that neurodevelopmental populations frequently experience impaired social communication and reduced peer connectedness, structured online gaming platforms offer an accessible and interest-aligned pathway to strengthen peer interaction and expand social support networks (Diendorfer et. al., 2021).
Online communities as drivers of belonging
Belonging is a critical developmental need in adolescence, and today many young people find community through online platforms, including gaming spaces. When youth engage in supportive and healthy online communities, the benefits can be profound. Marginalized youth or those exploring aspects of identity may find affirming spaces online where they can connect with peers who share similar experiences and interests. When adolescents feel they belong, both online and offline, this sense of inclusion confers protection from negative social outcomes (Yue et. al, 2024)). Collaborative platforms such as Minecraft, which focus on shared creation and teamwork, are well positioned to foster this collective identity and perceived inclusion.
The importance of intentional design and safeguards
While online communities can generate meaningful connection, research also highlights risks when spaces are unmoderated or allow harmful norms to proliferate. The positive impact of gaming on social connection therefore depends on intentional design, facilitation, and moderation. Structured Minecraft environments that embed inclusive norms, peer support mechanisms, and adult oversight can maximize protective benefits while mitigating exposure to harmful content. When designed as safe, pro-social digital environments, innovative gaming platforms can function as scalable social infrastructure that strengthens connection and belonging among youth most at risk for isolation.
Cited Works
Diendorfer, T, Seidl, L, Mitic, M, Mittmann, G, Woodcock, K & Schrank, B 2021, ‘Determinants of social connectedness in children and early adolescents with mental disorder: a systematic literature review’, Developmental Review, vol. 60, 100960. https://doi.org/10.1016/j.dr.2021.100960
Kowert, R., Domahidi, E., & Quandt, T. (2014). The relationship between online video game involvement and gaming-related friendships among emotionally sensitive individuals. Cyberpsychology, Behavior, and Social Networking, 17(7), 447–453. https://doi.org/10.1089/cyber.2013.0656
Office of the U.S. Surgeon General. (2023). Our epidemic of loneliness and isolation: The U.S. Surgeon General’s advisory on the healing effects of social connection and community. U.S. Department of Health and Human Services.
Yue, Z., Bickham, D. S., Schwamm, S., Powell, N., & Rich, M. (2024). Young people’s sense of belonging online. Boston Children’s Hospital Digital Wellness Lab.