Social support, volunteering and health around the world: cross-national evidence from 139 countries

High levels of social capital and social integration are associated with self-rated health in many developed countries. However, it is not known whether this association extends to non-western and less economically advanced countries. We examine associations between social support, volunteering, and self-rated health in 139 low-, middle- and high-income countries. Data come from the Gallup World Poll, an internationally comparable survey conducted yearly from 2005 to 2009 for those 15 and over. Volunteering was measured by self-reports of volunteering to an organization in the past month. Social support was based on self-reports of access to support from relatives and friends. We started by estimating random coefficient (multi-level) models and then used multivariate logistic regression to model health as a function of social support and volunteering, controlling for age, gender, education, marital status, and religiosity. We found statistically significant evidence of cross-national variation in the association between social capital variables and self-rated health. In the multivariate logistic model, self-rated health were significantly associated with having social support from friends and relatives and volunteering. Results from stratified analyses indicate that these associations are strikingly consistent across countries. Our results indicate that the link between social capital and health is not restricted to high-income countries but extends across many geographical regions regardless of their national-income level.     

Mothering and anxiety: Social support and competence as mitigating factors for first-time mothers

This study investigated anxiety as a phenomenon distinct from depression and evaluated several variables that influence anxiety in first-time mothers. This explored the relationship between maternal sense of competence (both of mothering and efficacy) and perceived social support (from family, friends, and significant others) and first-time mothers’ postpartum anxiety, when depression, socioeconomic status (SES), and marital status were controlled for. The population studied were 86 first-time mothers made up of women with children 24 months or younger in two populations of Kentucky and Michigan. The constructs of maternal sense of competence and perceived social support were found to be significant in explaining first-time mothers’ anxiety. The study concluded that a combined association of perceived social support and maternal sense of competence were associated with a 34% (change in R-squared = .339) decrease of a first-time mothers’ anxiety. However, not all types of social support, or maternal competence appeared to be equally important with regards to maternal anxiety: social support from friends and family and maternal sense of competence in regard to productivity appeared to be most significant. Lastly, some recommendations for health practitioners who work with mothers are provided.     

Social relationships and inflammatory markers: an analysis of Taiwan and the U.S

We evaluated the association between two aspects of social relationships and six inflammatory markers in Taiwan and the U.S. These two countries share similar levels of current life expectancy, but exhibit important differences in social structure. The data comprised population based samples from Taiwan (aged 53+; n=962) and the U.S. (aged 35-86; n=990) collected between 2003 and 2009. Circulating levels of interleukin-6 (IL-6), C-reactive protein (CRP), fibrinogen, and soluble forms of intercellular adhesion molecule 1, E-selectin, and IL-6 receptor (sIL-6R) were measured in fasting blood samples. A social integration score was based on marital status, contact with family and friends, church attendance, and other social participation. A perceived social support index was based on questions regarding the availability of care and support from family and friends. Linear regression models tested the association between these two measures and each inflammatory marker controlling for sociodemographic characteristics, obesity, medication use, and baseline health status. After adjusting for potential confounders, social integration had a significant but weak inverse association with CRP in Taiwan. Perceived social support was significant in two of 12 models, and the coefficient was positive (i.e., higher support was associated with higher CRP and sIL-6R in the U.S.). We found no evidence that the coefficients for social relationship measures varied by sex or age. Our results yielded limited evidence of a weak association between two dimensions of social relationships and six inflammatory markers in Taiwan and the U.S. Given that the literature suggests a strong link between social relationships and mortality, and that inflammation plays an important role in the leading causes of death, we had expected to find consistent and moderately strong associations between social relationships and inflammatory markers. The small effect sizes and lack of robustness across markers were surprising.     

Effect of social networks on 10 year survival in very old Australians: the Australian longitudinal study of aging

STUDY OBJECTIVES: To examine if social networks with children, relatives, friends, and confidants predict survival in older Australians over 10 years after controlling for a range of demographic, health, and lifestyle variables. DESIGN: Prospective longitudinal cohort study (the Australian longitudinal study of aging) SETTING: Adelaide, South Australia. PARTICIPANTS: 1477 persons aged 70 years or more living in the community and residential care facilities. MAIN RESULTS: After controlling for a range of demographic, health, and lifestyle variables, greater networks with friends were protective against mortality in the 10 year follow up period. The hazard ratio for participants in the highest tertile of friends networks compared with participants in the lowest group was 0.78 (95%CI 0.65 to 0.92). A smaller effect of greater networks with confidants (hazard ratio = 0.84; 95%CI = 0.71 to 0.98) was seen. The effects of social networks with children and relatives were not significant with respect to survival over the following decade. CONCLUSIONS: Survival time may be enhanced by strong social networks. Among older Australians, these may be important in lengthening survival.     

Correlates of wellbeing of spousal and children carers of disabled people over 65 in Spain

BACKGROUND: The aim of this study was to evaluate the associations between carer's wellbeing and stressors and to assess if these associations are different for spousal and children carers of disabled elderly. METHODS: Information was collected by home interviews of a population sample of carers (N = 195), who were providing assistance in activities of daily living to a community-dwelling population over 65. Associations between indicators of wellbeing (number of depressive symptoms, number of physical symptoms, self-perceived health and life satisfaction) and caring stressors were examined, controlling for carer's socio-economic characteristics and health status. Hierarchical logistic regressions were used to fit the data. Religion and social support were included as resources and spousal and children differential associations were tested. RESULTS: The four indicators of wellbeing are moderately correlated, indicating a common underlying concept. Spousal carers have lower socio-economic status, poorer health and lower levels of wellbeing than children carers. However, children carers bear a significantly greater burden. In the multivariate analysis of the associations between wellbeing and stressors, the similarities between spouse and adult child carers are more striking than the differences. Emotional support was consistently associated with higher levels of wellbeing while the associations of religiosity and instrumental support with wellbeing did not reach statistical significance. CONCLUSION: As formal care services are being developed in Spain, their ability to work in a supportive way with family networks should be taken into account. Research should be carried out on patterns of formal care interventions that use the resources in the natural support network of the family.     

The Role of Social Networks and Support in Postpartum Women's Depression: A Multiethnic Urban Sample

Objectives: This study examined the relationship of social support, and of social networks, to symptoms of depression in a multiethnic sample of women having recently given birth. Methods: Women at community health centers in a Northeastern city were randomly sampled from groups stratified by race/ethnicity (African American, Hispanic, and White) and postpartum interval. Mother's score on the Center for Epidemiologic Studies of Depression Scale (CES-D) was the dependent variable. Main independent variables included the Medical Outcomes Study (MOS) Social Support Survey and a social network item. Univariate statistics assessed the relationship between CES-D score and each of the independent variables. Multivariate linear regression models included core sociodemographic variables alone, the core model with each of the social support and social network variables added separately, and all variables together. We evaluated interactions between race and social support, race and social networks, and social support and social networks. Results: The multivariate models with MOS Social Support and core variables indicated that each 10-point increase in the MOS Social Support Survey was related to a 2.1-unit lower score on the CES-D (95% CI −2.4, −1.7). The inclusion of the social network variable into the core model showed that having two or more friends or family members available was associated with a 13.6-point lower mean score on the CES-D (95% CI −17.5, −9.6), compared to women reporting none or only one available person. Conclusions: Both social support and social networks were statistically significant and independently related to depressive symptomatology.     

Exploring relationships among social integration,social isolation,self-rated health,and demographics among Latino day laborers

Objectives. Research indicates social integration and social isolation are related to health, and Latino day laborers (LDLs) tend to be socially isolated and, thus, at high risk for adverse health consequences. relationships among social isolation, social integration, self-rated health (SRH), and demographics were examined in a sample of LDLs to contribute to the literature on social networks and health in this and other migrant populations.

Design. We analyzed data from 324 LDLs who participated in Proyecto SHILOS (Salud del Hombre Inmigrante Latino), a Houston-based survey of Latino immigrant men’s health. Based on the literature, we hypothesized SRH would be (1) positively associated with social integration and (2) negatively associated with social isolation. All proposed measures were first entered into a correlation matrix to identify significant bivariate relationships (p?≤?.05, two-tailed). Associations between variables that were directly correlated with SRH and variables that were, in turn, proximally associated with these variables were then used to develop a structural equation path model of SRH. Individual paths in the model were measured for significance, and goodness of fit was assessed by the model chi-square, the Comparative Fit Index, and the Root Mean Square Error of Approximation.

Results. Inconsistent with the first hypothesis, SRH was negatively associated with social integration, as measured by the number of trusted friends. Consistent with the second hypothesis, SRH was negatively associated with social isolation, as measured by needing someone to talk to. More frequent contact with family was also negatively associated with social isolation.

Discussion. Our findings suggest social integration may not always protect and promote health. Therefore, assessing the quality of LDLs’ different relationships, not just the quantity, is vital. Future studies should further analyze the effects that social resources have on perceptions of social isolation and health in LDLs and other migrant populations.     

Descriptive epidemiology of a depressive syndrome in a Western Canadian community population.

OBJECTIVE: To evaluate cross-sectional associations between depressive episodes and a set of potential biopsychosocial determinants in Calgary, Canada. METHODS: Random digit dialling (RDD) was used to select a sample consisting of 2,542 household residents in Calgary. These subjects were interviewed over the telephone using the Composite International Diagnostic Interview (CIDI) short form for major depression, and a questionnaire evaluating a variety of biopsychosocial variables. RESULTS: The prevalence of major depression was associated with biological (family history of major depression, alcohol consumption, street drug use), psychological (ratings of stress, recent life events) and social factors (social support, marital status, income, level of education). CONCLUSION: This study confirms that major depression is correlated with a diverse set of potential determinants in community populations, and that the impact of these determinants may differ between different populations. Prospective studies will be needed to further investigate these associations.     

Depressive symptoms and their correlates among immigrant Mexican women in the United States

Correlates of depressive symptomatology and caseness are examined for a survey sample of N = 1825 poor Mexican immigrant women in San Diego County, California. The Center for Epidemiologic Studies--Depression (CES--D) checklist is tested against a variety of demographic variables as well as health status and service utilization rates. Statistically significant associations were found between CES--D and education, years in the United States, income, marital status and number of adults in household. Also significant were associations with health status, confidant support and recent, traumatic life event. Utilization rates point to medical doctors as the major source of formal treatment and a heavy reliance on family and friends. The implications of the high disorder rates for diagnosis and treatment among immigrants are discussed.     

The role of social support on health throughout the lifecycle

The role of social supports throughout the lifecycle has dynamic implications on health and psychosocial wellness. Establishment of a stable supportive family early in life seems to be a consistent support drawn upon throughout the lifecycle. Other social support predictors which may affect health include high-quality supports from friends, total network size, age, gender, marital status, income, and threatening life events. Implications of social supports throughout the lifecycle should encourage health educators of all types to promote quality social supports within the family, schools, and community.     

Community social support for Cuban refugees in Texas

Social support has been linked to positive health outcomes for many populations across multiple health issues. The interactional approach defines social support as a complex, transactional process between the person and his or her social environment. Being part of a community enhances the likelihood of social bonding, leading to increased perceived support. In this study, the authors describe recently arrived adult Cuban refugees' perceptions of community-level support in Texas. Practical and emotional support needs included jobs and companionship away from everyday problems. The two major sources of practical support were resettlement agencies and other Cubans. The two major sources of emotional support were other Cubans and English-speaking friends. There were no local Cuban clubs or associations where Cubans could meet. Besides receiving support, many Cubans were also supporting other Cubans locally and in Cuba, and some experienced discrimination.     

HIV-Related Sexual Risk among African American Men Preceding Incarceration: Associations with Support from Significant Others,Family, and Friends

We evaluated the association between social support received from significant others, family, and friends and HIV-related sexual risk behaviors among African American men involved in the criminal justice system. Project DISRUPT is a cohort study among African American men released from prison in North Carolina (N?=?189). During the baseline (in-prison) survey, we assessed the amount of support men perceived they had received from significant others, family, and friends. We measured associations between low support from each source (<median value) and participants’ sex risk in the 6 months before incarceration. Low levels of social support from significant others, family, or friends were associated with poverty and homelessness, mental disorders, and substance use. Adjusting for age, poverty, and other sources of support, perceiving low support from significant others was strongly associated with multiple partnerships (fully adjusted odds ratio (OR) 2.64, 95% confidence interval (CI) 1.29–5.42). Low significant other support also was strongly associated with sex trade involvement when adjusting for age and poverty status (adjusted OR 3.51, 95% CI 1.25–9.85) but further adjustment for low family and friend support weakened the association (fully adjusted OR 2.81, 95% CI 0.92–8.55). Significant other support was not associated with other sex risk outcomes including concurrent partnerships, anal sex, or sex with an STI/HIV-infected partner. Low family support was associated with multiple partnerships in analyses adjusting for age and poverty (adjusted OR 1.98, 95% CI 1.05–3.76) but the association weakened and was no longer significant after adjusting for other sources of support (fully adjusted OR 1.40, 95% CI 0.65–3.00); family support was not correlated with other risk behaviors. Friend support was not significantly associated with sex risk outcomes. Indicators of overall support from any source were not associated with sex risk outcomes. Helping inmates maintain ties may improve economic security and well-being during community re-entry, while supporting and strengthening relationships with a significant other in particular may help reduce sex risk. Studies should evaluate the protective effects of distinct support sources to avoid masking effects of support and to best understand the influence of social support on health.     

Gender differences in the relationship of widowhood and psychological well-being among low income elderly

The present study examined the influence of widowhood on the psychological well-being of low income elderly women and men while controlling for a number of mediating variables. Both widows and widowers were found to have lower psychological well-being than their married counterparts once health and social network differences were controlled. Health status and social networks were the major predictors of psychological well-being. Married women reported many more stress related ailments than any other group. Among women, friends contributed more to psychological well-being than family contact. Among men, family rather than friends were more highly correlated with psychological well-being. Implications for clinical practice and future research are discussed.     

The biocultural context of social networks and depression among the elderly

The association between the size and structure of social networks and the prevalence of depressive symptoms was examined in a population-based study of 1615 men and women age 65 years and older. Age was significantly associated with marital status, social network index quartile, and the social relationship to the primary source of support. Women and men differed with respect to current marital status, number of close friends and relatives, frequency of face-to-face contact, and participation in voluntary associations and religious institutions. Regardless of their marital status, women were also less likely than men to point to a spouse as their primary source of support. Beck Depression Inventory mean scores and rates of depressive symptoms were inversely associated with social network index and participation in voluntary associations and religious institutions for both men and women. Individuals with no primary source of support or who depended on a relative had significantly higher than expected mean scores and rates of depressive symptoms. Both social network index and social distance to primary source of support were independently associated with depression after controlling for age, sex, and number of chronic conditions. Participation in voluntary associations, social distance from primary source of support, church membership, and number of close friends were also significant independent predictors of depressive symptoms. Results indicate that depressive symptoms are inversely associated with the size of social networks. The structure of these networks, in turn, is influenced by biological factors such as age, physical disability, and mortality of network members, and by culturally-determined rules that define the individuals and institutions available for support. However, these rules appear to differ for men and women.     

A multilevel analysis of the association between social networks and support on leisure time physical activity: evidence from 40 disadvantaged areas in London

There has been extensive conceptual and empirical work on the associations between social relations and health in recent years. However, the specific pathways through which social interactions impact on health have not been fully elucidated. The aim of this paper is to estimate associations between Leisure Time Physical Activity (LTPA) and social networks and support. Using data from a cross-sectional household survey in 40 disadvantaged lower super-output areas in London, we applied a multilevel model to investigate psychosocial and environmental determinants of physical activity in these populations. Our findings present a strong case for the influence of individual-level social networks on the level of LTPA, although the associations between the types of social support and LTPA were insignificant. We also found that crime rate was an important area-level correlates of LTPA.     

The relationships of social participation and community ratings to health and health behaviors in areas with high and low population density

Previous studies have linked social participation and community levels of trust with improved health status. We examined the associations between levels of community participation, self-reported community ratings (trust), and health within a public health surveillance survey conducted in Kansas (N=4601). Independent variables were individual ratings of their communities (excellent, very good, good/ fair, poor), and their involvement in community groups or organizations in the last 5 years (yes/no). Dependent variables were self-rated health status, depressive symptoms, physical activity, smoking, obesity, and binge drinking. After controlling for age, gender, race/ethnicity, education, and having a medical doctor, self-rated health status (p<0.001) and physical activity (PA) (p<0.001) were positively, and smoking (p<0.001) and depressive symptoms (p<0.001) were negatively associated with community ratings. Only PA (p<0.001) remained associated with community involvement in a multivariate analyses. Multilevel analysis using county-level data showed no significant interactions between population density and dependent variables. Individuals from rural areas had the highest community involvement but relatively low levels of community ratings. Our findings suggest that individuals in rural areas, especially in densely settled rural areas, may face increased risks of poor health.     

Men, women and friends — are there differences in relation to mental well-being?

This is a study on associations between the number of close friends and mental well-being in a nationwide sample of the Finnish general population (n = 1603). Mental well-being was assessed by means of the 12-item General Health Questionnaire. A total of 3% of the sample had no close friends and another 3% had only one. Over half of the sample (52%) reported having five or more friends. The overall prevalence of mental distress was 15% in men and 21% in women. According to multivariate analyses the risk of mental distress was increased in men among those with no friends (odds ratio [OR]: 2.70) and among those who had one (OR: 4.32) or two to four friends (OR: 1.75), as compared with those who had more friends. In women, having only one friend (OR: 2.30), insufficient family support (OR: 1.63) and insufficient support from relatives (OR: 1.77) associated with the risk of mental distress. These results suggest that mental well-being might be promoted if mentally distressed men seeking professional help were supported in building up and maintaining social networks and mentally distressed women were supported in harmonizing their family life. This revised version was published online in June 2006 with corrections to the Cover Date.     

General social support and physical activity: an analysis of the Ontario Health Survey

In spite of the many benefits of regular physical activity, the majority of Canadians are sedentary. This paper examines the relationship between general social support and physical activity levels. An analysis of data on 29,135 individuals from the 1990 Ontario Health Survey was conducted. Hierarchical multiple regression was used to determine the relationship between measures of general social support, derived from factor analysis, and physical activity levels. Sociodemographic and perceived health status measures were included as control variables. The results showed that general social support, in the form of Social Quantity and Social Frequency (number of friends/family members and frequency of contact), was significantly associated with higher levels of physical activity. Conversely, support in the form of Familial Structure (marital/cohabitation and parental status) was significantly associated with lower levels of physical activity. The findings indicate the types of general social support that facilitate or hinder participation in physical activity.     

Social Networks and Social Support Among Black Urban Elderly

In recent years, that has been a growing interest in social networks and social support among the black urban elderly. This article reports from a community survey on the size, interaction, availability and adequacy of support and roles of kin and non-kin network members. The findings reveal frequent contact among family, relatives, friends, and neighbors. Black elderly utilize network members differentially for emergency and non-emergency situations. Implications for social work in health care are discussed.     

Risk factors to health in diabetic children: a prospective study from diagnosis

This study explored associations between health status and psychosocial, family, and demographic factors among 42 children with recently diagnosed diabetes mellitus. Health status was assessed using glycosylated hemoglobin (HbA1), a measure of the children's level of metabolic control. Four groups of variables were investigated as possibly relating to metabolic control: demographics, family social climate, child's self-concept, and compliance with the treatment regimen. Metabolic control was associated with race, number of parents in the home, family cohesion, and socioeconomic status. Multiple regression analysis indicated that children from black and single-parent families were at higher risk for poorer disease control and that this pattern persisted 2 and 3 years after diagnosis. These findings can help identify families that may benefit from more effective interventions involving social work practice.