Module 1
2. Social Activities Foster Good Health
In
the study, published in the March/April issue of the American
Journal of Health Behavior,
researchers analyzed responses from more than 3,000 adults who
participated in the National Survey of Midlife Development in 1995.
The survey asked about their physical health, activities, and their
emotional and mental health.
In their analysis, researchers defined "complete health" not as merely the absence of physical or mental disease but as enjoying a high level of physical and mental well-being.
About 19% of the participants were completely healthy and a similar number reported complete ill health.
The study showed, as expected, that behaviors such as quitting smoking and exercising regularly were frequently associated with complete health.
But they say the more interesting finding was that adopting healthy behaviors often wasn't enough to produce overall physical and mental health. Some people in the intermediate range exercised regularly but were also mentally unhealthy.
In addition, the prevalence of ill health was highest among those who rarely or never attended church and lowest among those that attended church regularly. Members of civic groups or those who volunteered regularly were also more likely to be completely healthy and less likely to report complete ill health than others.
Researchers say the results show that health promotion efforts should also target social behavior modifications as well as personal health choices in fostering better overall mental and physical health.
In one longitudinal study, social participation was shown to predict incidence of first-time acute myocardial infarction (MI same as having a Heart Attack, even after adjusting for demographic and health variables. In this study, those who had lower social involvement were 1.5 times more likely to have a first MI.
Other
studies also found support for social integration’s protective
effect on MI morbidity. These researchers found that those with
moderate or low social integration were almost twice as likely to be
readmitted to the hospital post-MI then those with high social
integration. In fact, social integration
showed a positive dose-response association that was equivalent to
other known predictors of re-hospitalization.
Beyond
cardiovascular disease, other studies have taken a less structural
approach and focused on perceived and received support, particularly
emotional support. One such population survey showed that for elderly
women, low perceived emotional support predicted higher mortality.
One
study found that feelings of social usefulness in the elderly
predicted lower disability and mortality. Similarly, a study on
church-based support showed that providing support, not receiving it,
reduced the effects of one’s financial strain on mortality. These
findings are consistent with a recent ambulatory study that showed
giving support was related to lower systolic and diastolic blood
pressure.
Interestingly,
those who reported giving more support also reported getting more
support. The authors postulate that giving and receiving support have
unique pathways to stress: giving is mediated by increased efficacy,
leading to lower stress, while receiving support has a direct effect
on stress.
Taken
together, studies such as these suggest that there is something
potentially unique about giving support. It may be that people
experience positive affect while helping others, which may improve
their health, or it may suggest that it is in the context of a
high-quality relationship in which one feels valued and can
reciprocate by providing support that benefits occur. Future research
will be needed to examine these intriguing findings in the recent
literature.
Social support is also related to broader types of health behavior, including fruit and vegetable consumption, exercising, and smoking cessation.
One study contrasted partner support (aiding and reinforcing a partner’s own efforts) with partner control behaviors (inducing change in one’s partner). Results showed that supportive behaviors predicted better mental health, while control behaviors predicted worse mental health and health behavior in their partners. Consistent with social control models, these data suggest that effective support may need to act as a more gentle guiding force that will motivate behavioral change for the better.
As
we learn more about the effectiveness of social support in affecting
health outcomes, it becomes appealing to use this information to
directly help clinical populations. This may explain why the largest
proportion of recent research in social support and health involved
interventions, with many focused on chronic disease populations such
as cancer patients.
Support
groups may be particularly useful because of the gaps they may fill
in the support needs of patients. For instance, one qualitative study
in cancer support groups identified the unique role of such groups to
be sources of available community, information, and acceptance; in
contrast to waning support from overburdened family and friends.
Additionally, these are situations in which patients can offer
support to others and patients report that belonging to these groups
provided an element of support that augmented other-network support.
This type of intervention has also been shown to work in child patient populations. For instance, children with cystic fibrosis were involved in a randomized intervention trial that educated the children about their disease and taught them relevant social skills. Those in the treatment group improved their quality of life and peer relationships, and decreased their loneliness and the perceived impact of the disease. These findings are especially important due to the potential isolation faced by children in some chronic disease contexts.
In another intervention. recent research is examining these issues by focusing on telephone and internet-based support interventions. Although no physical health outcomes were measured, one study found that an education and coping intervention over the phone for patients awaiting lung-transplant increased quality of life and lowered depression.
Additionally, using a randomized control design, other researchers studied a telephone support group and found it to reduce depression in older caregivers compared to no-intervention control group caregivers.