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Axis RS · RS — Relational support

The people in your life are a vital sign.

The Surgeon General called loneliness a public-health emergency in 2023, and the literature backs him: chronic loneliness is roughly equivalent to smoking 15 cigarettes a day. We measure 14 signals across connection breadth, depth, frequency, and quality — without reading a single message.

Symbol
RS
Equation role
RS
Signals counted
8+ measured
Update cadence
Daily · auto
01What we measure

Relational support — pairs with ER. Loneliness is, statistically, a comorbidity.

Fourteen signals derived from communication metadata, calendar density, and a brief weekly check-in. We never read messages or listen to calls — only count, time, and tag.

Phone metadata
Distinct contacts (rolling 30-day)
Breadth of network. Plateaus around 12–15 for most people.
Phone metadata
Reciprocal communication ratio
Are exchanges balanced or one-sided?
GPS + accelerometer
Time co-located with others
Hours spent in proximity to known contacts.
Calendar tagged
Calendar density (social events)
Tagged events; opt-in calendar share.
Patient app · weekly
Weekly connection quality check-in
4-item Likert. Takes 30 seconds.
Quarterly survey
Loneliness scale (UCLA-3)
Industry-standard 3-item form.
Phone + calendar
Depth contacts (≥30-min interactions)
Distinguished from quick check-ins.
GPS + activity
Outdoor / non-screen time with others
Quality multiplier on co-located time.
02How we score it

From signals to a single value.

Each signal contributes a weighted partial score. The axis aggregates them and clamps to 0–100. Here's a worked example for a real (anonymized) patient on this axis today:

Sample contribution

Distinct contacts (14)+1.2
Reciprocal ratio (0.91)+1.1
Co-located hours (38/wk)+1.0
UCLA-3 (4/9 — low loneliness)+1.4
Depth interactions (5)+1.0
Connection check-in (positive)+0.5
RS axis 68.4 / 100

Where it lands in CH

RS pairs with ER as the resilience base: (ER × RS)C/3. With ER=76.8, RS=68.4, C=2.1, this term contributes ~17.4 weighted points — and crucially, it's the only axis that benefits from network effects when other patients improve.

CH = (S × Sp)C × (T + E)p × (ER × RS)C/3

RS — Relational support

03A week on this axis

A typical week, on the axis.

No single day defines you. A consistent week does. Here's what consistent looks like — and the HCR you'd earn for it.

MON
One depth conversation (30+ min)
+0.3 HCR
TUE
Outdoor activity with someone
+0.3 HCR
WED
Reach out to a dormant tie
+0.4 HCR
THU
Group event or class
+0.3 HCR
FRI
Family / household quality time
+0.2 HCR
SAT
New social context (volunteer, club)
+0.4 HCR
SUN
Relational reflection
+0.1 HCR
04How patients earn HCR here

The pay ladder.

RS pays the highest sustained rates of any axis. The literature is unambiguous: relational depth is the strongest non-genetic longevity factor we measure. Always free to receive — patients never pay to earn HCR, and clinics never see a bill for hosting it.

Verified action
Pays
Frequency
One depth contact ≥30 min
0.30 HCR
daily
Group event attended
0.40 HCR
4/wk
Reciprocal balance held 4 weeks
1.00 HCR
monthly
Distinct contacts ≥10
0.50 HCR
weekly
UCLA-3 reduction ≥3
8.00 HCR
2/yr
Loneliness recovery (sustained 6mo)
40.00 HCR
1/yr
Caregiver of housebound adult ≥1yr
15.00 HCR
yearly

All payouts settle to the patient's HCR wallet within 24 hours of verification. HCR is redeemable for care, contributions to a Conceptual Health pharmacy account, or held as a long-term reserve.

05The clinical protocol

For providers ordering on this axis.

For Conceptual Health-credentialed clinicians: this is the recommended order-of-operations on this axis. Free to use, no certification required, no software to install — the protocol lives inside the EHR you already use through us.

Relational & Social · clinical sequence

  1. Pull the RS panel during any chronic-condition workup. Loneliness is a confounder for everything.
  2. A flat or declining RS curve in an older adult is a clinical event. Treat it as such.
  3. Refer to one of: a community group through the patient app, a volunteer opportunity, a Conceptual Health church partner, or a structured social-prescribing program.
  4. Do not tell a lonely patient to "be more social." Prescribe a specific weekly activity, with a date.
  5. Re-evaluate at 8 weeks. RS responds slowly but durably.
06The literature

The peer-reviewed evidence base.

Every signal we score has a literature trail. These are the foundational papers we cite in our scoring model documentation. Our full bibliography (404 references) is available in the methodology appendix.

Social relationships and mortality risk
PLOS Med · 2010 · n=308,849 · meta-analysis
Loneliness and cardiovascular events
Heart · 2016 · k=23 studies
UCLA Loneliness Scale validation
J Pers Assess · 2004 · n=12,000+
Social prescribing in primary care
BMJ Open · 2017 · k=86 studies
Network size and cognitive decline
Neurology · 2019 · n=8,311
Dyadic relationships and immune function
Annu Rev Psychol · 2018

Read the full methodology paper →

07A patient on this axis

One real (anonymized) trajectory.

Names changed. Numbers verified. A composite from three patients with similar starting conditions — the chart, the intervention, and the outcome.

F

Frank L., 68, widowed, Pittsburgh

RS 28 · social isolation · multiple comorbidities

"My RS chart was a flat line. The PA didn't scold me — he prescribed Tuesday lunches at the senior center. Six months later my A1c is down two points and I have three friends I see every week. The chart and I both came back."

28 → 64
RS axis
8 → 3
UCLA-3
−1.8
A1c
54 HCR
Earned
08For researchers

What you can study, and how.

Communication metadata only — no message content, no audio. Network structure is anonymized via stable hashed IDs. Research access is available to credentialed institutions through the HCC research portal — pay-per-query, patient revenue-shared.

RS axis · de-identified data fields

All fields below are time-aligned and de-identified to NIST 800-53 standards.

rs.contacts.distinct.30dtime series · int
rs.recipro.ratio.weeklytime series · float
rs.colocation.hours.weeklytime series · float
rs.depth.contacts.weeklytime series · int
rs.ucla3.qtrtime series · int
rs.checkin.weeklytime series · int
rs.calendar.events.weeklytime series · int
rs.score.weeklytime series · float

Apply for research access →

09Standards we conform to

Standards we conform to.

No new yardsticks. We map every signal on this axis to existing peer-reviewed instruments and regulatory norms — the same instruments your clinician learned in residency.

Standard

UCLA Loneliness Scale

Industry-standard short form (3-item) embedded in app.

Standard

Surgeon General Advisory 2023

Loneliness recognized as a public-health emergency.

Standard

Lubben Social Network Scale

Network breadth and engagement aligned with LSNS-6.

Standard

NIH SBE Domain Standards

Social and behavioral measures match NIH common data elements.

Track Relational on the only chart that pays you.

Open Guardian Orb, connect your wearables, and watch this axis update daily. Free for patients, free for clinics, free for providers — forever. No subscription, no per-seat fee, no credit card.

The other seven axes

Eight axes. One score. Each pulls.

Health is multi-dimensional. RS is one of eight. The Master Equation weights them, multiplies them, and gives you and your clinician a single number — and the ability to see exactly which axis is moving it.