Skip to main content

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.