Do You Have a Healthy Number of Friends?

The Friend Who Keeps You Young

Do You Have a Healthy Number of Friends? | Johns Hopkins Medicine

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Adopting a pet may seem a selfless act, but there are plenty ofselfish reasons to embrace pet ownership. Research has shown that owning apet provides an amazing array of health benefits, says Jeremy Barron, M.D.,medical director of the Beacham Center for Geriatric Medicine at JohnsHopkins.

Not ready for a full-time furry friend in your home? Offer to walk a neighbor’s dog, cat-sit for a friend, or donate time at a local animal shelter—even short interactions provide enough pet exposure to reap some of these rewards.

Reduce stress

Research has shown that simply petting a dog lowers the stress hormone cortisol , while the social interaction between people and their dogs actually increases levels of the feel-good hormone oxytocin (the same hormone that bonds mothers to babies).

In fact, an astonishing 84 percent of post-traumatic stress disorder patients paired with a service dog reported a significant reduction in symptoms, and 40 percent were able to decrease their medications, reported a recent survey.

Lower blood pressure

The cortisol-lowering and oxytocin-boosting benefits of petting also help keep your blood pressure at bay. “Petting and holding an animal allows you to appreciate the beauty of nature,” explains Barron. “It’s relaxing and transcendental.”

Increase physical activity

How many people are willing to go outside at the crack of dawn and exercise in the rain or snow? Dog owners often have no choice—they have to walk their pet, thus providing them with an excuse-proof daily dose of exercise.

Boost heart health

The American Heart Association released a research report endorsing dog ownership as a way of warding off cardiovascular disease .

Ease loneliness and depression

A 2011 study found that pet owners had better self-esteem. Another study determined that pets provided greater social support than humans in mitigating depression. “Caring for a pet provides a sense of purpose to the owner,” says Barron. Plus, pets are a good social catalyst for meeting people who share your animal interests.

Help specific health concerns

Beyond simple companionship, dogs have long been wonderful helpers to those without sight or with mobility issues. Dogs are even being used to help detect conditions from seizures to cancer.

Cardiovascular (car-dee-oh-vas-cue-ler) disease: Problems of the heart or blood vessels, often caused by atherosclerosis—the build-up of fat deposits in artery walls—and by high blood pressure, which can weaken blood vessels, encourage atherosclerosis and make arteries stiff. Heart valve disorders, heart failure and off-beat heart rhythms (called arrhythmias) are also types of cardiovascular disease.

Cortisol (kor-tuh-sol): A hormone produced by the adrenal glands on top of the kidneys and involved in the stress response. It rises in the mornings, inducing wakefulness and also rises during stress. Sleep deprivation, caffeine and alcohol can also raise cortisol levels. Chronically high levels have been linked with low immunity, weight gain and other health problems.

Oxytocin (ok-si-toh-suhn): In men, a hormone released from the pituitary gland that aids penile erection and ejaculation. In women, it stimulates milk production and the uterus to contract.

In both genders, it influences social bonding, which is why it also is sometimes referred to as a bonding or love hormone. As a medicine, oxytocin is sometimes given to pregnant women to induce or speed labor.

Post-traumatic stress disorder (PTSD): A disorder in which your “fight or flight,” or stress, response stays switched on, even when you have nothing to flee or battle.

The disorder usually develops after an emotional or physical trauma, such as a mugging, physical abuse or a natural disaster.

Symptoms include nightmares, insomnia, angry outbursts, emotional numbness, and physical and emotional tension.

Social support: The help you receive from others in your life. Family, friends, peers and other people who care about you and for you make up your social support system or network.

While dogs give you the most benefits of any other pet, they also requiremore time and financial commitment.

Dogs cost an average of $227 per yearin vet bills, and the larger the dog, the more you will have to spend onfood (not to mention more time spent exercising the dog).

If you havemobility issues, also keep your fall risk in mind when deciding the sizeand type of dog you bring into your home.


The Global Health Security Index

Do You Have a Healthy Number of Friends? | Johns Hopkins Medicine

1. Prevention: Prevention of the emergence orrelease of pathogens2. Detection and Reporting: Early detection and reporting for epidemics of potential international concern3. Rapid Response: Rapid response to and mitigation of the spread of an epidemic4.

Health System: Sufficient and robust health system to treat the sick and protect health workers5. Compliance with international norms: Commitments to improving national capacity, financing plans to address gaps, and adhering to global norms6. Risk Environment: Overall risk environment and country vulnerability to biological threats.

NOTE: All data are normalized to a scale of 0 to 100, where 100 = best health security conditions.

The average overall GHS Index score is 40.2 a possible 100. While high-income countries report an average score of 51.9, the Index shows that collectively, international preparedness for epidemics and pandemics remains very weak.


  1. Data Highlights:

    • 40.2: average overall Global Health Security Index score of a possible score of 100
    • 116: high- and middle-income countries not scoring above 50


    • National governments should commit to take action to address health security risks.
    • Health security capacity in every country should be transparent and regularly measured, and results should be published at least once every two years.
    • Leaders should improve coordination, especially linkages between security and public health authorities, in insecure environments.
    • New financing mechanisms should be established to fill preparedness gaps, such as a new multilateral global health security matching fund; and expansion of World Bank International Development Association (IDA) allocations to include preparedness.
    • The Office of the United Nations (UN) Secretary-General should designate a permanent facilitator or unit for high-consequence biological events.
    • Countries should test their health security capacities and publish after-action reviews, at least annually.
    • Governments and donors should take into account countries’ political and security risk factors when supporting health security capacity development.
    • The UN Secretary-General should call a heads-of-state-level summit by 2021 on biological threats including a focus on financing and emergency response.

    Read more on the Report & Model page.

  2. Data highlights:

    • 81% of countries score in the bottom tier for indicators related to deliberate risks (biosecurity)
    • 66% score in the bottom tier for indicators related to accidental risks (biosafety).
    • Fewer than 5% of countries provide oversight for dual-use researchZero: Number of countries that have legislation or regulations in place that require companies to screen DNA synthesis
    • 92% of countries do not show evidence of requiring security checks for personnel with access to dangerous biological materials or toxins


    • Governments and international organizations should develop the capabilities to address fast-moving pandemic threats.
    • Governments should include measurable biosecurity and biosafety benchmarks in national health security strategies and track progress on an annual basis.
    • A dedicated international normative body should be developed to promote the early identification and reduction of biological risks associated with advances in technology.
    • Public and private organizations should invest a percentage of their sustainable development and health security portfolios in the area of biosecurity.
    • Funders and researchers should provide incentives to identify and reduce biological risks associated with advances in technology and should invest in technical innovations that can improve biosecurity.
    • Leaders should prioritize the development of operational linkages between security and public health authorities for biological crises.
    • Countries and international organizations should prioritize the development of national biosurveillance capabilities and a global biosurveillance architecture.

    Read more on the Report & Model page.

  3. Data highlights:

    • 85% show no evidence of having completed a biological threat–focused International Health Regulations (IHR) simulation exercise with the World Health Organization (WHO) in the past year
    • Fewer than 5% show a requirement to test their emergency operations center at least annually
    • 77% do not demonstrate a capability to collect ongoing or real-time laboratory data
    • 24% show evidence of a nationwide specimen transport system
    • 89% do not demonstrate a system for dispensing medical countermeasures during a public health emergency
    • 19% demonstrate at least one trained field epidemiologist per 200,000 people


    • Countries should test their health security capacities and publish after-action reviews, at least annually. By holding annual simulation exercises, countries will show commitment to a functioning system. By publishing after-action reviews, countries can transparently demonstrate that their response capabilities will function in a crisis and can identify areas for improvement.
    • Health security financing, evaluations, and planning should prioritize functional capability and regular exercises.

    Read more on the Report & Model page.

  4. Data Highlights:

    • 5% score in the top tier for financing
    • One country, Liberia, has published a description of specific funding from its national budget for gaps identified in existing assessments and/or national action plans
    • 10% show evidence of senior leaders’ commitment to improve local or global health security capacity


    • Health security preparedness financing should be tracked by a specific, globally recognized entity and briefed annually to heads of state.
    • Domestic financing for health security should be urgently increased, made transparent, and tied to benchmarks within national action plans.
    • Decision makers should create new health security preparedness financing mechanisms that incentivize measurable improvements, such as a such as a new multilateral global health security matching fund, and expansion of IDA allocations to include preparedness.
    • International leaders should examine the availability of financing to support rapid and complete outbreak response. The UN should track and publish outbreak-related costs and contributions.

    Read more on the Report & Model page.

  5. Data Highlights:

    • Higher overall score: Countries with effective governance and political systems
    • 55% score in the bottom and middle tiers for political and security risks indicators
    • 15% score in the highest tier for public confidence in government
    • 23% score in the top tier for political system and government effectiveness, representing approximately 14% of the global population


    • Plans should be developed to assist countries with challenging risk environments and to bolster preparedness in countries bordering those at increased risk.
    • National governments and donors should assess political and security risk factors when making resources available to support capacity development.
    • The UN Security Council should urgently convene a series of meetings aimed at the development of rapid response capabilities, strategies, workforce, and protections necessary for outbreaks that originate in or spread to countries with high political or security risks.

    Read more on the Report & Model page.

  6. Data Highlights:

    • Lowest scoring category: for health systems, average score of 26.4; 131 countries in the bottom tier; weaknesses among even high-income countries
    • 27% demonstrate the existence of an updated health workforce strategy
    • 3% show a public commitment to prioritizing healthcare services for healthcare workers who become sick as a result of participating in a public health response
    • Low scores: physician and nurse/midwife density per 100,000 population
    • 11% show plans to dispense medical countermeasures during health emergencies


    • Decision makers should measure and take into account health system capabilities as an integral part of all health security planning, investments, and financing strategies.
    • Leaders should take steps to build and maintain robust healthcare and public health workforces that play a major role in biological crises.
    • National Action Plan for Health Security (NAPHS) should take into account specific benchmarks to improve and finance the overall health system and its workforce.

    Read more on the Report & Model page.

  7. Data Highlights:

    • 30% demonstrate existence of mechanisms for sharing data among relevant ministries for human, animal, and wildlife surveillance
    • 8% demonstrate a cross-ministerial unit dedicated to zoonotic disease
    • 51% offer field epidemiological training programs that explicitly include animal health professionals
    • 62% have not submitted a report to the World Organisation for Animal Health on the incidence of human cases of zoonotic diseases for the past calendar year


    • National public and animal health authorities should coordinate during the development of NAPHS and should incorporate a One Health approach as part of pandemic planning and national disaster preparedness and response efforts.
    • Countries should identify an agency and grant it authority to coordinate training and information sharing among human, animal, and environmental health professionals for outbreak preparedness and response.
    • Decision makers should consider infectious disease risks when developing policies and plans related to climate change, land use, and urban planning.

    Read more on the Report & Model page.

  8. Data Highlights:


    Four Seasons Hotels and Resorts Collaborates with Johns Hopkins Medicine International on Enhanced Health and Safety Program at Properties Worldwide

    Do You Have a Healthy Number of Friends? | Johns Hopkins Medicine

    Four Seasons Hotels and Resorts, the world’s leading luxury hospitality company, has entered into a collaboration with Johns Hopkins Medicine International, the global division of health care and research leader Johns Hopkins Medicine, to validate its new global health and safety program, Lead With Care, and provide ongoing, real-time guidance on the evolving COVID-19 situation. Grounded in the principles of care, trust and service, the Lead With Careprogramwill be reviewed and validated by Johns Hopkins Medicine experts and implemented by dedicated teams at Four Seasons properties around the world.

    “Within this new environment, our singular goal is to provide guests, residents and employees with the confidence and assurance that their health and safety is our first priority,” says John Davison, President and Chief Executive Officer, Four Seasons Hotels and Resorts. “We are incredibly proud to work alongside the renowned experts at Johns Hopkins Medicine International, leveraging their global expertise to strengthen our already stringent health and safety measures through our new Lead With Care program.”

    Continues Davison: “For nearly 60 years, Four Seasons has set the global standard for excellence in hospitality and service.

    Lead With Care is a continuation of this high standard, building upon the strong foundation of trust and confidence that we have established through decades of experience.

    This new program is abfering genuine care and the highest levels of service, enhancing procedures to protect our guests, residents and employees, while also ensuring that they feel safe and reassured.”

    Four Seasons and Johns Hopkins Medicine International COVID-19Advisory Board

    Johns Hopkins Medicine International and Four Seasons have established a dedicated COVID-19 Advisory Board, bringing together Four Seasons leadership and top experts from Johns Hopkins Medicine International to inform health and safety decisions the latest scientific knowledge.  

    Evolving in lockstep with rapidly changing discoveries, the COVID-19 Advisory Board will create, enhance and review current procedures, along with virtual and in-person training to guide implementation of Lead With Care across Four Seasons global portfolio.

    This builds upon the early experience of Four Seasons Hotel New York, as well as Four Seasons hotels in Riyadh and Mumbai, in providing accommodation to high-risk medical personnel fighting on the frontlines of the COVID-19 pandemic. Four Seasons Hotel New York was transformed into a safely zoned environment in a matter of days, implementing enhanced procedures to safely house guests, as well as properly train all employees.

    Lead With Care: Four Seasons Enhanced Global Health and Safety Program

    Grounded in health care expertise and enabled by access to leading technologies and tools, the Lead With Care program is focused on providing care, confidence and comfort to all Four Seasons guests, employees and residents within the new COVID-19 environment. The new program outlines clear procedures that educate and empower Four Seasons employees to take care of guests and each other.

    “Along with already-commonplace measures such as more sanitizers, masks and heightened cleaning and hygiene, our collaboration with Johns Hopkins equips our property teams with access to leading international experts and real-time COVID-19 information, enhancing our tools and training to deliver an experience grounded in safety and trust,” says Christian Clerc, President, Global Operations, Four Seasons Hotels and Resorts. “While the Four Seasons experience may look different in this new environment, it will ultimately feel the same – our dedicated people will continue to deliver the same intuitive service and personalised care for which Four Seasons is known and trusted for the world over.”

    Four Seasons collaboration with Johns Hopkins Medicine International will ensure the review and validation of the Lead With Care program in two phases.

    Phase one of the collaboration – Review and Validation – involves a comprehensive review of Four Seasons existing health and safety procedures along with enhanced protocols in response to the current situation at a global, regional and property level.  Working closely with Johns Hopkins Medicine experts ensures Four Seasons is at the forefront of the latest research findings and recommendations.

    Phase two – Ongoing Guidance – provides Four Seasons with ongoing collaboration with the Johns Hopkins Medicine International team, including direct access to curated critical updates, relevant COVID-19 research outcomes, and expert advice to ensure real-time adjustments to operating procedures. Customised through on-property Hygiene Officers, this will allow Four Seasons to respond quickly and anticipate future needs, providing assurance that all appropriate infection control safety measures have been taken.

    Four Seasons and Johns Hopkins will also establish a joint Response Team where senior experts in infectious diseases from Johns Hopkins will provide on-demand response and guidance to hotels facing COVID-19 situations.

    Lead With Care Backgrounder

    To support the development of procedures to be verified by Johns Hopkins, as well as the procurement of supplies and equipment for Lead With Careimplementation, Four Seasons will be working closely with EcoLab and International SOS – partners who were also critical in the transformation of the Four Seasons hotels in New York, Riyadh and Mumbai that housed medical personnel.

    While guests will see many of the enhanced Lead With Care procedures, behind-the-scenes measures will also take place through employee training, additional food handling protocols, and enhancements to ventilation systems and other back-of-the-house operations.

    In addition, Four Seasons continues to invest in its award-winning App and Chat that further allows guests to control how they engage with others – limiting face-to-face interactions while maintaining the highest levels of personal service.

    Since its launch in 2017 the popular Four Seasons Chat – one of the only in the industry to be supported by actual employees on property, versus chatbots – has received 10+ million messages and averages approximately 580,000 messages a month.

    Features include the ability to make and manage reservations, request luggage pickup, airport transfers, room service, restaurant and spa reservations, and much more.

    Wait-free check-in and check-out is also offered, while Four Seasons Chat integration offers instant translation of 100+ languages giving guests the flexibility for contactless engagement throughout their stay.

    Additional details about the Lead With Careenhanced global health and safety program can be found below:

    Enhanced Cleanliness:

    • Each Four Seasons property appointing a Hygiene Officer focused on implementing enhancements to already stringent procedures;
    • Rooms disinfected daily with EPA approved products and will have blacklight inspection by room attendants;
    • Focused re-training programs for Housekeeping teams on all cleaning protocols are being implemented across the portfolio;
    • Public areas cleaned hourly with extra attention to frequented areas including front desk counters and public restrooms;
    • The COVID-19 Advisory Board exploring an array of options to equip properties with the latest tools and technology, including electrostatic spraying, ozone technology for air purification and/or UV technology for HVAC systems.

    Heightened Guest Safety and Comfort:

    • Lead With Care kits placed in each guest room providing masks, hand sanitizer and sanitization wipes, with additional masks supplied on demand;
    • Social distancing measures embedded in all services for guest protection, including appropriately spaced fitness equipment, modified spa menu and services, contactless check-in and housekeeping services;
    • Restaurants and bars may operate with reduced capacity to ensure adequate space and socially distant set-up;
    • Nearly all restaurants providing a-la-carte service with digital menus wherever possible;
    • In Room Dining offering contactless delivery outside guestrooms along with sustainable, single-use packaging;
    • Four Seasons App and Chat providing guests with real-time, contactless interactions with employees from their own device on nine global platforms and in 100+ different languages.

    Empowered Employees:

    • Lead With Care training building on Four Seasons legendary service model and diligent attention to detail, ensuring Lead With Careprocedures are delivered in a thoughtful, attentive manner that balances guest safety with personal reassurance and comfort;
    • Training focused on educating and empowering employees to deliver the enhanced health and safety program with confidence, passing on this care to each and every guest and resident;
    • The COVID-19 Advisory Board advising on the global training program for all employees including: ensuring employees have a well-informed understanding of the disease and its transmission, providing guidance on appropriate social distancing and use of personal protective equipment, as well as physical and mental health monitoring and support;
    • Grounded in emotional intelligence, employees are undergoing behavioural training, ensuring empathetic, personalised care and connection are not lost in the absence of close contact and limited face to face interaction.

    About Johns Hopkins Medicine International

    Johns Hopkins Medicine International is the Johns Hopkins Medicine entity entrusted with global advancement of the mission: to improve the health of the community and the world by setting the standard of excellence in medical education, research and care.

    Johns Hopkins Medicine International develops high-impact collaborations throughout the world by leveraging Johns Hopkins' extensive knowledge of medicine, nursing, public health, medical education, research and health care administration to improve health and health care delivery.

    Johns Hopkins Medicine International also facilitates personalised, culturally appropriate care for Johns Hopkins Medicine’s global patients, as well as specialised concierge health care services.