Relational Health is the Foundation of Our Total Wellness

What is Relational Health?

Relational health is defined as the capacity for and ongoing engagement in growth, fostering empathetic and empowering interpersonal interactions. Early relational health from positive, nurturing and stimulating early relationships builds the foundations for a lifetime of relational health. On the other hand, poor relational health leads to social-emotional impairment, and psychological distress.

man standing beside his wife teaching their child how to ride bicycle

They are dyadic, responsive and contingent. They include the child and adult caregiver and depend on back and forth, dynamic interactions. They are not unidirectional or static or just about the teaching the child.
— They are positive and supportive. They are not mean, disrespectful or stress-inducing.
— They are consistent and stable. Healthy relationships are consistent and predictable, helping children acquire a sense of trust and mastery of the world around them, and the people within it. They are not unpredictable.
— They are secure and safe. Healthy relationships provide the safety required for children to explore, experiment and take risks. They do not leave children or adults vulnerable or exposed.
— They are essential and core to our evolved biology. Nurturing relationships are
developmentally-expected and children actively seek and expect social interaction from the earliest moments of their lives. They are not peripheral, modern or nice to have, but essential to build capacities.
— They are resilient, can withstand adversity and—if ruptured—can be healed. They are not brittle but they are also not unbreakable.
— Their form and dynamics vary across development, culture, and individuals, but there appear to be consistent themes. They are not one-size-fits-all.
— They can involve a range of individuals. Children benefit from developmentally-nurturing relationships with non-parental adults, including early childhood professionals, neighbors, grandparents, and other extended family members. They are not just about mom and not just about parents.
— They begin to form early. First, prenatally as parents prepare for the birth and
thereafter from the earliest moments of infancy. From the moment of birth, young children can begin to form relationships with caregivers in ways that do not depend on language alone. They do not wait until the child can talk but rather develop by complex non-verbal, imitative, and sensory interactions.

Why do Healthy Relationships Matter?

woman and girl lying in bed while holding book

They build the foundations for future health, development and well-being. Healthy early relationships affect virtually everything in life that follows. They serve as the foundation for an individual’s cognitive, social, emotional, physical, and behavioral development, during childhood and across the lifespan. They also play a key role in shaping future relationships.
They are meaningful and enjoyable. Above and beyond their instrumental effects on development, engaging in healthy relationships is intrinsically meaningful and satisfying for both children and adults. Both parties derive in-the-moment enjoyment and reward from these relational experiences.
They buffer adversity. Resilience develops through healthy relationships.
Relationships can provide the personalized protection that buffers children from
developmental disruptions associated with adversity. They also directly build the
core capacities (such as the ability to manage and regulate emotions and behavior) that enable individuals to respond to challenges.

What Affects and Threatens These Relationships?

Challenges to the health and well-being of caregivers. While healthy and positive relationships are possible even in situations of adversity and challenges to well-being, factors that affect the health and well-being of the adult affect their ability to engage in healthy relationships. Mental health challenges are a prime example—unstable mental health puts a strain on developing and maintaining healthy relationships.
Significant adversity in the lives of the caregiver/s or child. Things like poverty, taxing work schedules, racial discrimination, unstable housing, other relationship difficulties, or congenital health/behavior issues of the child, affect the care, attention and focus that can be brought to a relationship. These can be attention disrupters (things that reduce relational energy, for example, dealing with the intense stress from domestic abuse) or attention diverters (things that direct attention elsewhere, for example, dealing with the scheduling challenges caused by low wage work).
Systems, structures, policies and practices. Systems and the policies that shape them can facilitate, passively impede, or actively block the ability to form and maintain healthy relationships. For example, work leave polices, child welfare programs, criminal justice policies, and healthcare systems currently do not leave space for relationships and are built in ways that impede their formation and maintenance. Current work leave policies (or the lack thereof) passively impede relational health by not providing sufficient time or attention with which these relationships can be formed. Child welfare policies and family justice practices more actively block relational health by positioning separation as the system’s default response. On the other hand, health systems that treat the family rather than separating children and adults can foster and more actively support relational health.
Structural inequities that affect health, well-being and the opportunities for healthy relationships (racism, discrimination, poverty). Experiencing racism and other forms of discrimination can negatively impact health and well- being and represent a significant drain on capacity to engage in healthy relationships. These effects may come from the systems level (systemically excluding certain groups from quality healthcare for example) or the interpersonal level (experiencing discrimination in one’s everyday life can drain the energy and attention available for healthy relationships).
American cultural norms that value individualism and undervalue relationships and interpersonal connections. In emphasizing the individual and de-emphasizing relationships, current American culture creates a context in which relationships are undervalued and systems are built in ways that don’t acknowledge their importance or make room for them, let alone actively support them, nor develop them from the start.

What Needs to be Done to Support Healthy Relationships?

1. Infuse systems with a relational perspective and create space and support for healthy relationships. Systems can be changed to facilitate rather than impede
healthy relationships. Paid family leave, lower caregiver-child day care ratios,
family healthcare, and changes to insurance systems that incentivise early support to relational health rather than later remediation of health and behavior problems are examples of such changes.
2. Support adult health and well-being. Actions that build wellness and resiliency in adults have a positive impact on healthy relationships. For example, higher quality and more affordable mental health services create wellness in the adult which can transfer to the child through healthier relationships. When adults are healthy, resilient and thriving, they are positioned to have healthy relationships with children.
3. Address sources of stress in caregivers’ lives. Policies that address sources
of stress in the lives of caregivers—such as poverty, racism, mental and physical
illness, domestic violence, and lack of employment opportunities can facilitate the formation of healthy relationships. Examples of such policies might include
affordable/healthy housing policies and a higher minimum wage.
4. Acknowledge and leverage cultural and community strengths to foster close, caring, stable and responsive relationships. Many communities that are
marginalized by the dominant culture (and often are living on low incomes), face
structural challenges, but they are also invested with considerable social strengths when it comes to healthy relationships. Strong values around the importance of close and supportive bonds as well as cultural norms and practices that provide space for healthy relationships are assets that are currently not fully realized to promote relational health, but should be.
5. Provide support and training across agencies for both staff, caregivers and
families to improve their ability to engage in healthy relationships. Programs
(video coaching, childcare provider training, home visiting) can increase
the capacity of adults to engage in healthy developmental relationships
and improve relational health.


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