Social connections/networks, support and health

Durkheim: Egoistic suicide

• Insufficient social integration

  • Weak social ties and attachment to groups

  • Limited sense of belonging and social connectedness

Durkheim: Anomic suicide

• Insufficient social regulation

  • Rapid social, economic, political change →

  • Breakdown of shared norms and social control →

  • Deregulation of values, beliefs, norms

Barney’s and Bott: social network analysis

Characteristic patterns of ties between actors in a social system

Social relationships and health (Berkman)

• Social-structural conditions (culture, SE factors, social change, policies) →

• Social networks (size, density, diversity, reciprocity, quality) + Person-to-person contact →

• Psychosocial mechanisms (social support, influence, and engagement, attachment/bonding) →

• Health pathways (health behaviors, psychological issues, physiology) →

• Health outcomes

Social capital: definition

Refers to resources embedded in social networks: trust, reciprocity, civic engagement

Social capital: importance

• Trust and reciprocity → cooperation

• Supports social engagement and collective action

• Population health link

Social connection: definition

Multifactorial construct encompassing who we are connected to (structure), what relationships provide (function), and how relationships are experienced (quality)

Social connection: Structure

• Network size

• Social integration

• Frequency of contact

• Living alone

• Social isolation

Social connection: Function

Emotional, informational, instrumental support → perceived vs received support → perceived loneliness

Social connection: Quality

Closeness, satisfaction, conflict, strain, inclusion or exclusion

Network-level indicators

Size, composition, density, frequency of contact, geographic dispersion

Relationship-level indicators (properties of individual ties)

Reciprocity, multiplexity, duration, intensity, direction

Types of social support

• Emotional: care, empathy, love, trust, reassurance, comfort, understanding, acceptance expressed

• Instrumental: practical help with tasks or tangible assistance provided (finances, transportation)

• Informational: advice, guidance, information, feedback, ideas aiding understanding of the problem and coping

• Appraisal: affirmation/evaluative feedback that helps a person interpret a situation

Stress buffering hypothesis

• Social support weakens the association between stressful experience and adverse health outcomes

• Critical factor: perceived social support

• Mechanisms: reduced threat appraisal, more effective coping, attenuated stress response

Main effect model

• Social connectedness is beneficial irrespective of whether one is under stress

• Social network:

  • Provides social control over unhealthy behavior, promotes healthy behavior

  • Provides sense of identity, predictability, security, worth

  • Promotes positive affects + reduces impact of negative affects

  • Provides information requires to appropriate HC and health services

Stress-buffering hypothesis vs Main-effect model

• SBH: social support is beneficial for those suffering adversity and stress, BUT doesn’t play a role in health for those without stressful demand

• MEM: the health benefits of connectedness are not restricted to highly stressful circumstances

Health benefits of providing social support

• Meaning and purpose (feeling useful, valued, needed)

• Reduced stress (less stress, more regulation)

• Social roles and reciprocity (stronger bonds, mutual exchange)

• Self-worth and agency (competence, efficacy, significance)

Social networks → health: social-ecological approach

• MACRO: Social Structure (culture, social-economic factors, politics, social change)

• MEZO: Social Networks (structure and characteristics of network ties)

• MICRO: Psychosocial mechanisms (social support, influence, engagement, person-to-person, access to resources)

• Pathways: health behaviors, psychological, physiological pathways)