Social Networks and Social Su... Health Article

SOCIAL NETWORKS AND SOCIAL SUPPORT

It is widely recognized that social relationships and affiliations have powerful effects on physical and mental health. Although many social scientists from Emile Durkheim on have written about the critical role of social relationships in health outcomes, it was not until the 1970s that epidemiologists turned their attention to this issue.

In the first of these studies, in Alameda County, California (Berkman et al., 1979), men and women who lacked ties to others were 1.9 to 3.1 times more likely to die than those who had many contacts. A 1982 study in Tecumseh, Michigan (House et al., 1982), showed a similar association for men, but not for women, between social connectedness and participation and mortality risk. In the same year, D. Blazer reported similar results from a sample of elderly men and women in Durham County, North Carolina.

Schoenbach et al. (1986), in a study in Evans County, Georgia, used a measure of contacts modified from the Alameda County study and found risks to be significant in older white men and women even when controlling for risk factors, although some racial and gender differences were observed. In Sweden, the Goteborg study (Welin et al., 1985) showed that, in different cohorts of men, social isolation proved to be a risk factor for dying, independent of biomedical risk factors. A 1987 report by Orth-Gomér and Johnson reported significantly increased risks for men and women who have been socially isolated. Finally, in a study of men and women in eastern Finland, Kaplan and associates (1988) demonstrated that an index of social connections predicts mortality risk for men but not for women, independent of cardiovascular risk factors.

Several more recent studies, including the Established Populations for the Epidemiologic Study of the Elderly (EPESE) studies, confirm the continued importance of social relationships into late life. Furthermore, studies of large cohorts of men and women in a large health maintenance organization (Vogt et al., 1992) and male health professionals (Kawachi et al., 1996) suggest that social networks are, in general, more strongly related to mortality than to the incidence of disease. Studies in Danish men (Pennix et al., 1997) and Japanese men and women (Sugisawa et al., 1994) also indicate that social isolation and social support are related to mortality. Social networks and support have been found to predict a broad array of health outcomes, from survival after heart attacks to disease progression, functioning, and the onset and course of infectious diseases.