SOCIAL SUPPORT
What is social support?
Social support has been defined in a number of ways. Initially, it was defined according to
the number of friends that were available to the individual. However, this has been
developed to include not only the number of friends supplying social support, but the
satisfaction with this support (Sarason et al. 1983). Wills (1985) has defined several
types of social support:
esteem support, whereby other people increase one’s own self-esteem;
informational support, whereby other people are available to offer advice;
social companionship, which involves support through activities;
instrumental support, which involves physical help.
The term ‘social support’ is generally used to refer to the perceived comfort, caring,
esteem or help one individual receives from others (e.g. Wallston et al. 1983).
Does social support affect health?
A number of studies have examined whether social support influences the health status
of the individual. Lynch (1977) reported that widowed, divorced or single individuals
have higher mortality rates from heart disease than married people and suggested that
heart disease and mortality are related to lower levels of social support. However, prob-
lems with this study include the absence of a direct measure of social support and the
implicit assumption that marriage is an effective source of social support.
Berkman and Syme (1979) reported the results of a prospective study whereby they
measured social support in 4700 men and women aged 30–69, whom they followed up
for nine years. They found that increased social support predicted a decrease in mortality
rate. This indicates a role for social support in health. Research has also indicated
that birth complications are lower in women who have high levels of social support,
again suggesting a link between social support and health status (Oakley 1992).
Research has also examined the effects of social support on immune functioning and
consequently health. For example, Arnetz et al. (1987) examined the immune function
of 25 women who were either employed (n = 8) or unemployed (n = 17). The unemployed
group received either standard economic benefits only or received benefits as well as a
psychosocial support programme. The results showed that those unemployed subjects
who received the psychosocial support showed better immune functioning than the
subjects who received benefits only. It would seem that social support reduced immuno-
suppression, thus promoting health.
How does social support influence health?
If social support does influence or mediate the stress–illness link, then what are the
possible mechanisms? Two theories have been developed to explain the role of social
support in health status:
STRESS AND ILLNESS 273