Researchers have suggested several reasons for why individualistic cultures can adversely impact on health and wellbeing as compared with collectivist cultures. For example, the Western qualities of materialism and individualism are detrimental to health and wellbeing through their influence on values (Eckersley, 2006). Materialistic values have been found to lower self-actualisation, vitality, happiness and wellbeing, and to increase anxiety, physical symptoms, and unhappiness \citep{Kasser_2002,Tatzel_2002}. The physical symptoms were measured using a 9-item measure adapted from \citet{Emmons1991}. Individualistic cultures also place an importance on striving for happiness, while avoiding negative emotions (Ahuvia, 2002; Diener & Suh, 2000; Steptoe et al., 2007; Veenhoven, 1999; Wierzbicka, 1994), whereas this is not always possible. Critically, and as noted above, the work of Iris Maus and colleagues has demonstrated that overvaluing happiness can actually lead to clinical depression \cite{Ford_2015,Ford_2014}. Among collectivist cultures, the focus is on emotional stability, including the presence of both positive and negative affect (Lu, 2001; Ng et al., 2003). An important factor is the difference between the building of social ties between the cultures, with individualistic cultures focused on the self over connections between people, compared with the collectivist cultures whose happiness is more dependent on being part of a cohesive network.
Social cohesion and social capital \cite{Cramm_2012}, and “collective effervescence” \cite{Xygalatas_2015,e1915,b2007}.
Three pathways linking social relationships to health include behavioural, psychological and physiological factors. Social isolation and loneliness are
independently associated with increased risk of inactivity and smoking
(Shanker et al., 2011), substance use among adolescents, along with hazardous drinking and smoking \citep*{Stickley2014}, behavioural factors that increase risk of future ill-health and premature mortality. Loneliness is also associated with decreased self-esteem, greater risk for depression and
feelings of hopelessness, along with an increase in reported sleep
problems \citep*{Steptoe_2004}, psychological factors that further increase risk of future ill-health and premature mortality. Finally, social isolation and/or loneliness is also associated with a dysregulation of cardiovascular, metabolic, and neuroendocrine processes \citep*{Grant2009}, along with higher systolic blood pressure, independent of several factors such as age, gender, cardiovascular risk factors, medications, social support and perceived stress \citep*{Hawkley_2010}. The NIACT \cite{Kemp_2017a} and GENIAL \cite{Kemp_2017} models integrate behavioural, psychological and physiological pathways in an innovative lifespan framework within which pathways to health and ill-health may be understood, bridging the gap between psychological moments and mortality.
Positive emotion plays a key role in an upward spiral dynamic involving social engagement and the vagus nerve. The vagus nerve is vital in the facilitation of social engagement through eliciting positive emotions (Kok & Fredrickson, 2010; Kok et al., 2013), facilitating positive facial expressions (Porges, 2011), prosocial traits and emotions \citep*{Kogan2014}, better emotion recognition (Quintana et al., 2012), positive social interactions \citep{Kok_2010,Kok_2013}, social-support seeking \citep*{Geisler2013} and positive behaviours, including altruistic behaviour \citep*{Bornemann2016}. Individuals with increased vagal tone upon baseline measures increased in levels of social connectedness and positive emotions at a greater rate over a 9-week assessment period compared to those with lower vagal tone. Increases in connectedness and positive emotions predicted final vagal tone measures, independent of vagal tone at baseline. Geisler and colleagues (2013) found cardiac vagal tone, indexed by respiratory sinus arrhythmia (RSA), to be positively correlated with engagement coping and aspects of social wellbeing. Increased RSA also correlated with reduced disengagement strategies for regulating negative emotions and increased use of social emotion-regulation strategies. Individuals who reported zero episodes of anger presented with higher RSA, compared to those who had one or more episodes of anger during the study. This study highlights the importance of vagal function in self-regulatory behaviour and subsequent ability to engage socially. Conversely, low resting-state HRV is associated with prefrontal hypoactivity and amygdala hyperactivity, which facilitates threat perception and increases negativity bias, subsequently impacting on the ability to build connections with others \citep*{Kemp2017}. It is therefore important to include vagal function and emotion regulation as factors that impact on an individual’s ability to build a supportive social network.