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Social Support and Health

Social support is a variable based on the concept that resources provided through social relationships can enhance psychological adjustment and assist coping with problems. This entry discusses the relation of social support to physical and mental health. This topic is relevant to human relationships because research has shown that persons with higher support have lower rates of illness, and theory on how social support operates to reduce risk for illness involves concepts from research on human relationships and health psychology. In this entry, we discuss the conceptualization of social support, summarize evidence on the relation of social support to health outcomes, and outline possible mechanisms for the protective effect of social relationships. In addition, we highlight concepts from relationships research that may be useful for understanding social support processes.

Conceptualizing Social Support

There have been two approaches to conceptualizing and measuring social support in health outcome research. One approach examines how many persons an individual knows and/or considers as friends (i.e., the size of his or her social network). This measure of network size is often termed social integration because these structured relationships reflect the degree of a person's integration in the community. Other aspects of network structure include the existence of particular social roles (e.g., marriage, children, member of a community organization), the proportion of network members who know each other, and an individual's participation in regular activities with other persons.

Another approach involves determining the extent to which a person's relationships (irrespective of number) provide particular supportive functions. Typical questions ask whether a person would have a particular function available if needed. One function measured in many studies is emotional support—the perception that an individual has persons available who can provide confiding, sympathy, and understanding in times of trouble. Other functions include instrumental support, defined as providing tangible goods (e.g., providing tools, loaning money) or services (e.g., transportation, child care) when needed, and informational support, defined as providing useful advice and guidance. Data show that network size is not highly correlated with availability of supportive functions; a large social network may provide relatively little emotional and instrumental support, whereas a few relationships may provide a great deal of these. Hence, these two aspects of social relationships are measured separately.

Social Support and Health

In typical studies of mortality, social relationships are measured at one point in time in a large sample; researchers then determine whether each person is living at a subsequent time point, typically 5 to 10 years later. Results have shown that persons with larger social networks are less likely to die over the study period. This protective effect has been observed in more than 80 studies, conducted with samples including different ethnic groups and national populations, and has been found for mortality from several diseases, including heart disease and cancer. The effect of social integration on mortality is found with statistical control for a number of variables, including gender, socioeconomic status, and initial health, so this effect is not just attributable to certain types of persons (e.g., males, poor people) having larger or smaller networks. Some data have suggested that women may derive more benefit from close relationships that involve confiding and intimacy, whereas men derive more benefit from a looser network of worksite and community alliances (e.g., work mates, sports and outdoor activities, voluntary organizations). However, significant effects for social integration and social support have been observed across groups, and overall the similarities are more striking than the differences.

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