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Social Identity In Common Health Behaviours

The social identity approach to health highlights how identifying with community group memberships can positively influence an individual's health-related behaviours, well-being, attitudes, and values.

By emphasising belonging and support, the social identity approach stresses how vulnerable individuals benefit from group affiliation, contributing to improved health outcomes. Comparisons and context influence identity activation (Tajfel & Turner, 1979), reinforcing how group membership shapes behavior and self-concept. Despite growing research interest, a gap remains in understanding how social identity interacts with specific health-related activities within precise group settings. Most studies focus on broad community support, making it difficult to assess causality and isolate smaller factors (Haslam et al., 2022). Additionally, limited research explores how these associations differ across varying levels of illness severity, which remains important for informing health policies and interventions (Jetten et al., 2012).

By spotlighting the role of social identity and group support, interventions can address poor health behaviors and promote healthier populations. This article explores common areas such as mental health, chronic physical health, and aging. It also examines the application of the social identity approach in substance addiction support, particularly through Alcoholics Anonymous (Ogilvie et al., 2023).

Furthermore, the article explores negative impacts of group identities when harmful norms are promoted, using anorexia as an example (Lai et al., 2021). This article is a very broad overview, and cannot cover every topic in detail. Methodological limitations, such as causality and generalisability, are critiqued to question future research and interventions (Jetten et al., 2012).

Development

Social Identity Approach

See: Social Identity Approach

Broken down, social identity theory explains that when we become part of a group, that this membership becomes part of our self-identity. Individuals see themselves as part of the “ingroup”, and make comparisons with outsider “outgroups” (Tajfel & Turner, 1979). Rather than defining themselves by “I”, individuals shift to identifying as “we”, to emphasise the collective identity (Jetten et al., 2012). Identification with a group gives a sense of belonging and increases self-esteem, which explains why individuals seek out group membership.

The second part of the approach is self-categorisation theory, which examines how our different identities become more significant in specific contexts (Turner et al., 1987). As a cognitive mechanism, this theory stresses that identity is flexible and changes depending on circumstances such as who we are with, and where we are.

Flow diagram of Tajfel and Turner's (1979) Social Identity Approach (Haslam, 2001)

Contemporary Approach to Health Behaviour

Recently, there has been increasing awareness and research interest in the role that the social identity approach plays in shaping attitudes, intentions, and behaviours related to personal health and well-being (Jetten et al., 2012). Research consensus suggests there is an interplay between social identity and various physical and mental health behaviours (de Hoog & Pat-El, 2024). Given that health-related behaviours strongly impact life outcomes, understanding this phenomenon is vital for improving population health and overall life expectancy.

Engagement in health-related behaviours is highly dependent on whether these behaviours align with the group prototype with which an individual identifies (Haslam et al., 2021). Health-related behaviours can be both negative and positive, serving either as a source of harm or way of improvement (Jetten et al., 2012). This phenomenon is recognised as the ‘social cure’, which suggests that health has a social dimension, and that group identification and interaction can contribute to improved well-being in individuals suffering from injuries, illness, and stress (de Hoog & Pat-El, 2024).

However, the diverse combinations of group identities, illness types, attitudes, and behaviours suggest that it is challenging to study every major and minor health behaviour in detail with sufficient research to draw comprehensive conclusions about consistency and cross-cultural effects (de Hoog & Pat-El, 2024).

Common Health Behaviours

The overall pattern in the literature suggests that there is a positive relationship between general health-related behaviours and rate of social identification. Major examples within the literature are listed below.

Mental and Physical Health

Existing literature consistently supports the positive influence of group membership on mental health. However, this section cannot comprehensively cover all types of mental illnesses or groups, but provides a general overview. Research illustrates that group recovery-focused identity produces increased mental resilience by creating a sense of belonging and improving access to emotional support, information, and practical resources such as therapies and community programs, ultimately acting as a protective factor in mental well-being (Cruwys et al., 2013; Haslam et al., 2022). In relation to depression, Cruwys et al.’s (2013) longitudinal study of 4,087 participants found that increased group memberships, particularly in sporting and physical activity groups, reduced the risk of depression relapse.This suggests that social identity can play both curative and protective roles in mental health outcomes.

However, research acknowledges that the success of identity-based interventions depends on the type of support provided and the degree of vulnerability experienced by individuals (Steffens et al., 2019). For example, therapeutic interventions focused on positive decision-making have shown stronger associations with social identity than group activities like reminiscence games (Steffens et al., 2019). In particularly vulnerable populations, issues such as isolation and loneliness may arise due to difficulties in finding meaningful groups that offer shared identity and support (Haslam et al., 2022).

Despite these limitations, the overall evidence highlights that creating meaningful group-based connections within communities improves well-being and quality of life (Haslam et al., 2022). These benefits include reduced stress, anxiety, and depressive symptoms, suggesting important implications for intervention approaches in mental health disorders. While all treatment options should be considered, findings indicate that community-based group support can promote social values centred on recovery and well-being (Steffens et al., 2019).

Chronic Illness

Group identity plays a key role in normalising long-term health conditions by constructing a collective “us” mindset, shielding against stigma and social discrimination (Jetten et al., 2012). This shared identity encourages proactive health behaviours like medication adherence and therapy attendance (Bossy et al., 2016). Research shows that group identity enhances mental and physical outcomes, particularly for conditions with invisible symptoms (Cameron et al., 2018). While social identity may not immediately improve behaviours, it supports long-term treatment adherence and goal achievement.

For example, strong identification with survivor networks after traumatic brain injury improves mood (Jetten et al., 2012). Group-based networks for Type 2 Diabetes patients reduce self-stigma, enhance personal independence, and improve coping (Bossy et al., 2016). Cameron et al. (2018) found that chronic-health group membership generates meaningful social identification, boosting confidence, reducing distress, and enhancing belief in success. However, understanding this approach remains complex due to the variability of chronic illness experiences. In such cases, some individuals may withdraw from support networks or experience negative comparisons, particularly when conditions coexist (Bossy et al., 2016; Cameron et al., 2018).

Ageing Health

The social identity approach continues to influence health-related behaviours and attitudes into old age and retirement. Group support networks are especially valuable for ill and vulnerable groups in aiding adjustment to retirement (La Rue et al., 2022). Identity strength increases with the number of community groups identified with, particularly when older adults engage with peers of similar age and participate in multiple neighbourhood groups, promoting active ageing (Moyano-Diaz & Mendoza-Llanos, 2021).

Research focuses on physical health, showing that groups with positive views of ageing enhances self-esteem and encourages proactive health behaviours such as physical activity, improved nutrition, and reduced sedentary behavior, which may delay mortality (Moyano-Diaz & Mendoza-Llanos, 2021; Haslam et al., 2023). Multiple group memberships are linked to improved life satisfaction and mental well-being, enhancing resilience to age-related challenges like illness and loss, while stronger identification with local communities reduces negative rumination and increases positive emotions (Moyano-Diaz & Mendoza-Llanos, 2021).

However, the role of identity in ageing becomes complicated by cognitive health decline, particularly in neurodegenerative conditions like dementia (Jetten et al., 2012). Some research suggests that group interventions primarily benefit individuals with memory loss, while others argue these interventions are effective regardless of memory status (Jetten et al., 2012). Group reminiscence and games reduce social isolation and enhance well-being, despite mixed effects on cognitive performance, and community membership also provides access to caregiving networks, health information, and emotional support (Haslam et al., 2023). However, studying social identity in the elderly is challenging due to cognitive decline, such as reduced processing speed, affecting categorisation ability and behaviour adherence over time (Jetten et al., 2012).

Applied Contexts

Group support programs that apply social identity values have shown significant potential in improving health-oriented behaviours. Members feel empowered to follow prototypical group actions, driven by a sense of communal belonging and shared purpose.

Weight Management

Weight-loss focused groups adopt shared norms (Arigo et al., 2021). In-person and online communities provide emotional support, food advice, and motivation, forming the sense of shared 'healthy' self-identity. Research emphasises that within weight-loss support communities, individuals categorise their ingroup as health-conscious, providing further motivation to lose weight (Arigo et al., 2021). Gallin et al. (2023) showed that group norms emphasising healthy eating impacted food socialisation behaviours, as those who strongly identified with their weight-loss groups demonstrated greater motivation to adopt group behaviours.

Alcohol Addiction

Alcoholics Anonymous (AA) groups operate globally, offering an open group approach where membership is based on a desire to stop drinking (Taylor et al., 2019). Alcohol recovery groups apply the 'Social Identity Model of Cessation Maintenance', where individuals’ identities shift to being recovery-focused (Frings & Albery, 2015). Membership of these groups, which emphasise abstinence, resilience, and accountability, shields against relapse (Frings & Albery, 2015; Ogilvie et al., 2023).

Studies have shown that involvement in AA activities is linked to improved treatment outcomes, mediated by stronger identification with the group (Taylor et al., 2019). Ogilvie et al. (2023) conducted interviews with 182 recovering alcoholics from 11 countries, finding that group membership provided a platform for identity transformation and mutual support, enhancing sobriety goals. Participants reported stronger connections to others in similar situations, leading to greater accomplishment of recovery goals compared to those without group membership (Ogilvie et al., 2023).

Criticism

Negative Behaviour

While much of the literature highlights the role of social identity in promoting positive health behaviours, concerns remain about dangerous negative outcomes. Group identity can foster harmful behaviours due to the formation of norms and value echo chambers (Osler & Krueger, 2021). A key example is pro-anorexia communities, where undereating and starvation is normalised and encouraged. These groups thrive on sharing “thinspiration,” maintaining rigid beliefs about eating behaviours, and weight loss, strengthening the anorexic identity (Lai et al., 2021).

Members engage in harmful practices such as calorie counting, sharing diet tips, and showing hostility toward outsiders, including friends, families, and medical professionals (Osler & Krueger, 2021). These dynamics illustrate that group environments should promote support, well-being, and healthy communication to mitigate harmful norms (Lai et al., 2021).

Methodological Concerns

A key methodological issue in the field is the reliance on correlational research, which does not show causation. Many studies observe associations between group identity and health behaviours, but these links can be confounded by other variables, making causal relationships difficult to establish (Moyano-Diaz & Mendoza-Llanos, 2021). Methodological inconsistencies also complicate research, especially in assessing the effectiveness of different treatment interventions. For instance, memory loss in aging populations presents a challenge, as cognitive declines affect self-identity and the ability to adhere to group norms (Jetten et al., 2012).

Emerging questions around the relationship between social identity and health behaviours require further investigation, particularly regarding how group-based interventions can be tailored to diverse populations and contexts (Haslam et al., 2022). Additionally, ethical concerns are prevalent, especially in health-related research involving sensitive information about disabilities and mental health. Studies often require participants to disclose private and potentially distressing details about their well-being, raising questions of participant safety and the need for rigorous ethical protocols (Ogilvie et al., 2023; Taylor et al., 2019).

The diversity of health conditions, their varying severities, and differing coping mechanisms add further complexity to research. Factors such as age, gender, and cultural values play significant roles in shaping health experiences, making generalisability a key challenge to avoid ethnocentric and gender biases (Cameron et al., 2018; Lai et al., 2021).

This article only provided a broad overview of several health topics and could not cover everything in sufficient detail. Future articles should break these topics down further to examine individual differences in group behaviour, ensuring accurate representation and inclusive research outcomes.

References

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