Will a little PDA keep the doctor away?

Public displays of affection like hand holding, hugging, or smooching on the street corner are coming under the microscope at St. Francis Xavier University, where Karen Blair, an assistant professor of psychology, is trying to determine how they affect human health.

“My overall hypothesis is generally that affection, whether that’s public or private, is going to be good for the relationship and, in turn, good for your mental and your physical health,” Blair said.

She doesn’t expect to see much of a difference for non-marginalized couples. “Whether that’s public or private affection, it’s just going to be good.”

But for same sex or interracial couples, Blair anticipates a difference between how public and private affection operates. For them, she worries public affection might be a stressor that can harm their health.

“If you are with your partner and you’re walking down the street holding hands and somebody gives you a dirty look for that, they’re communicating a form of disapproval,” Blair said.

“Whether it’s disapproval just because they don’t like any type of public display of affection, or if they’re disapproving of a specific type of relationship because it’s perhaps a same-sex relationship, an interracial relationship, an age-discrepant relationship — they’re communicating that through their response. And so what we’re thinking is that when you are in one of those more marginalized kinds of relationships, those types of simple things like just holding hands with your partner in public might bring you into more contact or more awareness of societal disapproval that exists.”

If that’s the case, it might serve as a stressor that can deteriorate physical health, said Blair, who has been studying relationships for more than a decade.

She’s interested in examining social support for relationships.

“It’s just this notion of whether or not you feel that your relationship is approved of, or disapproved of, by your friends and family.”

She’s found that’s really important to relationships. “More so than people might think. And not only does it predict whether you stay together and how happy you are, it also predicts things to do with your mental and your physical health.”

When folks feel friends or family disapprove of their relationship, they wind up having more health problems, Blair said.

“Positive relationships provide a buffer to the stresses of daily life,” she said.

“If you have a really stressful day and you come home and you’re getting along with your partner, that’s probably going to help ease that stress. And when you have less stress, then you just physiologically are a healthier person. But if your relationship’s not good, or if your relationship is a source of stress, then that’s going to create additional stress on top of all your other stressors. It’s going to remove abilities to deal with stress and it just allows for that ability for things to kind of pile up and get out of control. And that’s when you start to see health problems. You get more susceptibility to the common cold, which then just leads to greater health deterioration and eventually opens you up to even larger diseases.”

Now Blair is delving into what it means when complete strangers judge a relationship.

Same sex couples are often hyper aware of their surroundings when they hold hands in public, she said, noting that anti-gay hate crime is often precipitated by a couple holding hands.

“Whether or not they’re holding hands is largely going to depend on whether or not they feel like that could put them in danger.”

Blair’s new research will start this fall with an online survey of as many as 2,500 people asking about the affection in their relationships and where it happens.

“We don’t even have a baseline idea,” she said.

She’s got a grant of nearly $18,000 from the Canadian Institutes of Health Research for the initial work. If she can find more funding, Blair plans to continue the work in the fall of 2018 with daily diary studies where people record whether they’ve exhibited public displays of affection over a three-week period.

“At the same time while they’re doing that, we’d be getting information from their partner and we’d be getting some information about their actual physiological health. So perhaps we might monitor their heart rate variability (and) their sleep schedules,” Blair said, noting she hopes to involve about 100 couples in that portion of the research.

She wants to use an app for the daily diary study and text questions to participants about whether they are with their partner and, if yes, whether they’ve recently touched in any public way.

This is all prep work for a much larger study where Blair hopes to apply to CIHR for a grant of as much as $2 million for a deep dive into the research.

“If we did that then we’d be looking to try an incorporate things like Apple watches, which can give you a fairly basic reading of heart rate activity throughout the whole time that the person’s wearing it.”

The watches could sense when couples are together and at home or in public. “Based on that it would be able to trigger random surveys to say ‘Have you held hands in the last 10 minutes? And if so, here’s the rest of the questions.’”

Blair is also planning observational studies in different locations across the country.

She was in Toronto’s gay village recently counting the number of couples walking by holding hands. Over one 15-minute period, researchers saw nine mixed sex couples walk by holding hands and just one same sex couple.

“Which just blew our minds because that wasn’t what we expected,” Blair said. “We expected, of all places in Canada, in the Toronto gay village, that’s where you would see same sex couples feeling the most comfortable. We expected that to be their baseline. This is where they’re going to do it if they’re going to do it.”

She repeated the experiment one block outside the gay village. “We saw 47 mixed sex couples holding hands in a 15 minute period and we saw one same sex couple.”

Blair wants to repeat the same experiments in different places. “Rural versus urban, Nova Scotia versus Toronto versus British Columbia.”

Some people “with avoidant attachment styles” might not like holding hands in public, she said.

Others might just not like touching their partner’s sweaty palm on a sweltering summer day. “Sometimes you might hold their pinky because you’re like, I like the sentiment, but I’m too hot.”

There’s a practical bent to the research.

“Understanding how people are impacted by social attitudes might help in hopefully changing some of those social attitudes,” Blair said.

“Even just realizing that 10 years after same sex marriage has been legalized, same sex couples in Canada are still not equally comfortable holding hands — that’s still saying something.”

Blair hopes to translate her research into something that’s useful for the average person. She wants to be able to demonstrate what role affection plays in relationships and how it matters.

“If something so simple as holding hands can actually be a stress reducer, if that can make your day go better, if it can improve your relationship, that’s a pretty simple thing to prescribe,” she said.

“Knowing that simple act is actually quite beneficial, then that’s something that’s really cost effective.”

Studying seemingly small social factors that influence our health can provide opportunity to stop health problems long before they happen.

“It’s much more cost effective if we can do anything like that that’s kind of preventative, rather than trying to work backwards and say, ‘OK, now someone’s sick, what does it cost to fix them?’ When we understand more about these little social nuances that actually do have an impact on our health, it helps us to help people build healthier lives.”

To participate in the research, check out this site.

Some of Blair’s past research has been entirely crowd funded. If you want to kick in some dough, check out her lab’s Patreon page.

She points to two videos produced by an Australian bank that illustrate why this is an interesting topic, especially in relation to the health of same sex couples.

“It just kind of follows a bunch of couples who are holding hands and then when they see someone look at them or they walk into a public place, they let go,” Blair said.

“They’re trying to say keep holding hands; be proud of who you are. Don’t worry is the message of the ad.”

While she likes the sentiment, questions remain about whether that’s really sage counsel.

“From a health point of view we actually don’t know if that’s good advice or not,” Blair said.

“Should you keep holding hands when that might put you in danger? Should you keep holding hands if that’s going to increase your vigilance and your stress level? We don’t know the answer to that yet. It’s not that we want people to stop holding hands. We definitely don’t want that either. But we would like to know more about how it’s working.”


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