Family and Social Support

People with greater social support, less isolation, and greater interpersonal trust live longer and healthier lives than those who are socially isolated. Neighborhoods richer in social capital provide residents with greater access to support and resources than those with less social capital.

Why Is Family and Social Support Important to Health?

Social support stems from relationships with family members, friends, colleagues, and acquaintances. Social capital refers to the features of society that facilitate cooperation for mutual benefit, such as interpersonal trust and civic associations [1]. Individual social support and cohesive, capital-rich communities help to protect physical and mental health and facilitate healthy behaviors and choices [2].

Socially isolated individuals have an increased risk for poor health outcomes [3]. Individuals who lack adequate social support are particularly vulnerable to the effects of stress, which has been linked to cardiovascular disease and unhealthy behaviors such as overeating and smoking in adults, and obesity in children and adolescents [2].

Residents of neighborhoods with low social capital are more likely to rate their health status as fair or poor than residents of neighborhoods with more social capital [1], and may be more likely to suffer anxiety and depression [4]. Neighborhoods with lower social capital may be more prone to violence than those with more social capital and often have limited community resources and role models. Socially isolated individuals are more likely to be concentrated in communities with limited social capital [1]. 

Individuals with higher educational attainment and higher status jobs are more likely to have greater social support than those with less education and lower incomes [5]. Adults and children in single-parent households, often at-risk for social isolation, have an increased risk for illness, mental health problems and mortality, and are more likely to engage in unhealthy behaviors than their counterparts [6-10].

Adopting and implementing policies and programs that support relationships between individuals and across entire communities can benefit health. The greatest health improvements may be made by emphasizing efforts to support disadvantaged families and neighborhoods, where small improvements can have the greatest impacts.

References

[1] Kawachi IK, Bruce P, Glass R. Social capital and self-rated health: A contextual analysis. Am J Public Health. 1999;89:1187-1193. 
[2] Egerter S, Braveman P, Barclay C. Stress and health. Princeton: Robert Wood Johnson Foundation (RWJF); 2011. Exploring the Social Determinants of Health Issue Brief No. 3.
[3] House JS. Social isolation kills, but how and why? Psychosom Med. 2001;63:273-274.
[4] Braveman P, Cubbin C, Egerter S, Pedregon V. Neighborhoods and health. Princeton: Robert Wood Johnson Foundation (RWJF); 2011. Exploring the Social Determinants of Health Issue Brief No. 8.
[5] Braveman P, Egerter S, Barclay C. What shapes health-related behaviors?Princeton: Robert Wood Johnson Foundation (RWJF); 2011. Exploring the Social Determinants of Health Issue Brief No. 1.
[6] Fergusson DM, Boden JM, Horwood LJ. Exposure to single parenthood in childhood and later mental health, educational, economic, and criminal behavior outcomes. Arch Gen Psychiatry. 2007;64:1089-1095.
[7] Wille N, Bettge S, Ravens-Sieberer U, BELLA Study Group. Risk and protective factors for children's and adolescents' mental health: Results of the BELLA study. Eur Child Adolesc Psychiatry. 2008;17:133-147.
[8] Rahkonen O, Laaksonen M, Karvonen S. The contribution of lone parenthood and economic difficulties to smoking. Soc Sci Med. 2005;61:211-216.
[9] Ringbäck Weitoft G, Burström B, Rosén M. Premature mortality among lone fathers and childless men. Soc Sci Med. 2004;59:1449-1459.
[10] Weitoft GR, Haglund B, Hjern A, Rosén M. Mortality, severe morbidity and injury among long-term lone mothers in Sweden. Int J Epidemiol. 2002;31:573-580.

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When it comes to developing and implementing solutions to problems that affect communities, evidence matters. The strategies below give some ideas of ways communities can harness evidence to make a difference locally. You can learn more about these and other strategies in What Works for Health, which summarizes and rates evidence for policies, programs, and systems changes.

Offer group educational, social, creative, musical, or physical activities that promote social interactions, regular attendance, and community involvement among older adults
Provide at-risk expectant parents and families with young children with information, support, and training regarding child health, development, and care from prenatal stages through early childhood via trained home visitors
Teach parenting skills in a group setting using a standardized curriculum, often based on behavioral or cognitive-behavioral approaches and focused on parents of at-risk children
Provide home visiting services to low income, first time mothers and their babies, starting during pregnancy and continuing through a child’s second birthday
Provide free and confidential counseling and service referrals via telephone-based conversation, web-based chat, or text message to individuals in crisis, particularly those with severe mental health concerns

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