Social Support

Quote:
- “Lacking social connection is as bad for your health as smoking 15 cigarettes a day.”
- Source: Dr. Julianne Holt-Lunstad, U.S. Senate Special Committee on Aging testimony (2017); National Academies (2020).

Definitions:
- Social support and social networks describe how social relationships shape health and well-being.
Conceptualization:
- No single, agreed-upon way to conceptualize or define either concept.
Theories:
- There is no single “Social Support” or “Social Network” theory; they represent interrelated frameworks and approaches.

Types of Functional Support:
- Emotional: Expressions of empathy, love, trust, or caring.
- Instrumental (Tangible): Practical help, goods, services, or financial assistance.
- Informational: Guidance, advice, or problem-solving support.
- Appraisal: Feedback or affirmation that aids self-evaluation.
- Belonging (Companionship): Sense of connection, shared identity, and inclusion.

Components of Social Networks:
- Social networks represent a web of relationships through which care and information move.
- Key Attributes:
- Number and Reach: How many and how far connections extend.
- Density: How interconnected contacts are.
- Tie Strength: Closeness or emotional connection between relationships.
- Multiplexity: When one person fulfills multiple roles in our lives.

Bringing It Together:
- Functional Support (What it Does):
- Emotional: Empathy, reassurance, trust.
- Informational: Guidance, sharing knowledge.
- Instrumental: Help finding reliable sources.
- Appraisal: Feedback and affirmation.
- Belonging: Inclusion and shared identity.
- Structural Support (Where it Comes From):
- Reach: Network connections and their extent.
- Density: Interconnectedness of networks.
- Tie Strength: Closeness and trust.
- Multiplexity: Overlapping roles.
- Structure:
- Patterns that shape how information spreads.

Wethington & Kessler, 1986:
- Perceived Support:
- The belief that help is available if and when needed.
- Strongly linked to better health and well-being outcomes.
- Received Support:
- The actual help provided, such as advice, help, or comfort.
- Beneficial but can backfire if unwanted or poorly timed.

Direct Effects Model (Main Effect):
- Social support benefits health across all levels of stress.
- Connectedness promotes health-promotive behaviors, emotional balance, and biological regulation.
- Support functions as a main effect, enhancing health regardless of stress exposure.
Stress Buffering Model (Moderator Effect):
- Support protects against harmful effects of stress.
- Types of support include emotional, informational, practical which reduce distress and enhance coping.
- Support acts as a moderator, affecting the strength of the relationship between stress and health.

Situation: Five assignments drop at once!
- Support: Jessica organizes an R workshop aiding students.
- Outcome: Students finish assignments with increased competence.
Mediation:
- How it works: Workshop reduces panic and increases control.
Moderation:
- Stronger outcome for students with demanding schedules; weaker for those with lighter loads.

Behavioral Pathways:
- Supports treatment engagement.
- Promotes restorative sleep.
- Encourages protective health practices.
Psychological Pathways:
- Reduces stress and emotional distress.
- Strengthens coping skills and confidence.
- Enhances sense of belonging and meaning.
Biological Pathways:
- Lowers cortisol (stress hormone).
- Reduces blood pressure and cardiovascular strain.
- Strengthens immune function.

Definition:
- Refers to resources, trust, and opportunities accessed through social networks.
- Types of Social Capital:
- Bonding: Support and trust within close groups (family, friends, peers).
- Bridging: Links across different groups sharing ideas and resources.
- Linking: Connections to institutions and power structures.
Importance:
- Shapes who accesses support and resources and those who are excluded.
- Key Theorists: Pierre Bourdieu (1986), Putnam (2000), Woolcock (2001), Aldrich (2012).

Prompt:
- Recall a group that sought to make change or imagine how groups can transition from support to action.

Networks:
- Provide care and can mobilize for collective action.
Example:
- The Treatment Action Campaign in South Africa evolved from small HIV support groups to a national movement affecting policy and drug access.
Impact:
- Social networks can foster resilience and resistance to inequities (Campbell, 2020).

Policy/Structural Level:
- Laws and funding enabling or restricting supportive environments (e.g., workplace leave, housing protections).
Community Level:
- Shared norms, trust, and collective action promoting support (e.g., neighborhood networks, advocacy groups).
Organizational Level:
- Institutions facilitating support (e.g., schools, health clinics, student groups).
Interpersonal Level:
- Support exchanged in relationships (e.g., friends, family).
Individual Level:
- Perceived social support and sense of belonging.

Goal:
- Create a supportive environment where individuals feel valued and connected.
Process:
- Conduct a needs assessment to identify support needs and behaviors, determining who provides what and to whom.
- Key Reference: James House, 1981.

Components of Program:
- Immediate Financial Assistance: Emergency funds provided for essentials to ease stress and build stability.
- Legal Gender Affirmation: Assistance with changing names and gender markers to affirm identity.
- Warm Referrals: Connections to housing, food, and employment support networks.
- Peer-Facilitated Group Sessions: Sessions led by transgender women of color fostering belonging and collective empowerment.
- Mentorship with Microgrant: One-on-one mentoring plus grants to offer guidance and resources towards individual goals.

Process:
- Identify a key stressor or driver of a public health issue.
- Name impacted groups (equity gap).
- Choose a type of support addressing the issue.
- Specify the operational level (Policy, Organizational, Community, Interpersonal, Individual).
- Define outcomes of interest.
Resource: Kristi and Victoria are available for questions.