Social support. What does it mean to you?
It is an important question because there is a clear and consistent association between social support and improved health.
In this week’s Archives of Internal Medicine, is a study looking at lonely people? They found that lonely participants have a higher risk of death. They are also more likely to experience a decline in their activities of daily living compared to people who do not see themselves as lonely. They also found that lonely people are more likely to have readmissions to the hospital, poorer quality of life, longer recovery time and a greater chance of medical complications.
Support can come in many forms. It can be emotional, tangible, informational and companionship support. But support can also be structural or financial and it can be perceived versus received support. Support can come from friends, co-workers, neighbors — and let’s not forget pets.
Simply put participants were asked if the felt left out, felt isolated, or lacked companionship.
So how does social support help? Theories exist. The direct effects theory says that social support is beneficial at all times in the lifespan. The buffering hypothesis argues that support is more beneficial at times of stress including illness.
One can imagine how poor support could influence nutrition, medication non-compliance or decreased mobility. Those who don’t feel supported experience feelings differently. They may be depressed and depression has worse mental and physical health outcomes. In this study, depression was more likely seen in those that were lonely. But loneliness itself without depression predicted death and functional decline.
In another study published in the same journal are a study on living alone and its association with an increased risk of death and cardiovascular death in a study of patients at risk of vascular disease or with vascular disease. One in 7 Americans lives alone. Social isolation can alter neurohormonal mediated emotional stress and influence both health behavior and access to care.
In this global study, living alone was associated with higher 4-year mortality and cardiovascular death. Interestingly, this was seen in ages 45 to 80 but not in those greater than 80.
It is important to recognize how loneliness and living alone can influence health outcomes as we can help modify these risk factors.