Social Support and Health

For centuries, theorists and philosophers have postulated that social relationships are important determinants of health and well-being. Widespread scientific interest in the role of social relationships and health was kindled in the latter part of the 20th century by epidemi-ological investigations which documented that level of social integration, measured as number of social relationships and connections to social groups, prospectively predicted morbidity and mortality outcomes (see House et al, 1988, for review; see also Ikeda and Kawachi, this volume). Interest in social relationships as determinants of health was further flamed by the fact that the magnitude of the relationship between social integration and mortality was comparable to standard risk factors, such as smoking and a sedentary lifestyle. As epidemiological evidence mounted that greater social integration was associated with better health outcomes, attention shifted toward understanding the mechanisms through which the social environment affects physical health. In two early reviews, Cobb (1976) and Cassell (1976) argued that supportive aspects of social ties were important components of the salubrious impact of social integration and activity. As we review below, a

Department of Medicine, Division of Geriatrics, UCLA School of Medicine, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095-1687, USA e-mail: [email protected]

large and growing body of evidence supports the hypothesis that not only the existence of social connections but also the supportive qualities of social relationships are linked to physical health outcomes, such as disease morbidity and mortality, and considerable effort is being devoted to understanding the behavioral, psychosocial, and biological pathways that underlie these links.

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