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The Role of Social Relations in Health Promotion
Abstract
In considering new paradigms for the prevention and treatment of disease and disability, we need to incorporate ways to promote social support and develop family and community strengths and abilities into our interventions. There is now a substantial body of evidence that indicates that the extent to which social relationships are strong and supportive is related to the health of individuals who live within such social contexts. A review of population-based research on mortality risk over the last 20 years indicates that people who are isolated are at increased mortality risk from a number of causes. More recent studies indicate that social support is particularly related to survival postmyocardial infarction. The pathways that lead from such socioenvironmental exposures to poor health outcomes are likely to be multiple and include behavioral mechanisms and more direct physiologic pathways related to neuroendocrine or immunologic function. For social support to be health promoting, it must provide both a sense of belonging and intimacy and must help people to be more competent and self-efficacious. Acknowledging that health promotion rests on the shoulders not only of individuals but also of their families and communities means that we must commit resources over the next decade to designing, testing, and implementing interventions in this area.
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“However, less strenuous leisure activities, such as attending classes or volunteering, also have been associated with better functioning (Berkman et al., 1995;Herzog, Franks, Markus, & Holmberg, 1998) and survival (Glass, Mendes de Leon, Marottoli, & Berkman, 1999) among older adults.”
From Relationship of activity and social support to the functional health of older adults (2000) · cites this paper as Berkman et al., 1995
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Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD): Study design and methods
The ENRICHD investigators (2000) · American Heart Journal · doi:10.1016/s0002-8703(00)90301-6 · Cited by 255
Hertzman, C., Power, C., Matthews, S., & Manor, O. (2001) · Social Science & Medicine · doi:10.1016/s0277-9536(00)00437-8 · Cited by 249
de Leon, C. F. M., Glass, T. A., Beckett, L. A., Seeman, T. E., Evans, D. A., & Berkman, L. F. (1999) · The Journals of Gerontology Series B · doi:10.1093/geronb/54b.3.s162 · Cited by 252
“…unclear how a sense of meaning or purpose in life might translate into concrete health benefits, it perhaps serves to enhance what has been called "generalized (host) resistance," a concept which refers to a person's ability to resist or overcome health hazards (Berkman, 1995; House et al., 1988).”
InfluentialSelf-citationCampbell, C. (2000) · Social Science & Medicine · doi:10.1016/s0277-9536(99)00317-2 · Cited by 250
“The likelihood that people will engage in health-promoting behaviours is influenced by the extent to which they feel in control of other aspects of their lives and the extent to which they live in a supportive social environment (Berkman, 1995; Prieur, 1990).”
BackgroundPoor social integration and suicide: Fact or artifact? A case-control study
DUBERSTEIN, P. R., CONWELL, Y., CONNER, K. R., EBERLY, S., EVINGER, J. S., & CAINE, E. D. (2004) · Psychological Medicine · doi:10.1017/s0033291704002600 · Cited by 246
“Fifth, results may have differed had we used an at-risk control sample; low levels of social interaction and lack of religious participation confer risk for all-cause mortality (Berkman, 1995; McCullough et al. 2000), not just suicide.”
ResultDeclining Disability Among The Elderly
Cutler, D. (2001) · Health Affairs · doi:10.1377/hlthaff.20.6.11 · Cited by 243
“Some literature suggests that persons with better social networks become sick less often and recover from illness more rapidly than do persons with poorer ones.(34) Rationales for this effect include the impact of social engagement on cognitive functioning and a reduced susceptibility to stress among those with strong…”
BackgroundAbbott, S., & Freeth, D. (2008) · Journal of Health Psychology · doi:10.1177/1359105308095060 · Cited by 245
“In any case, Blaxter and Poland (2002, p. 98) argue that ‘simply to ask whether “people” are trusted, or whether neighbours “usually” look out for each other, may be misleading. Our respondents would answer that there are chosen individuals who are trusted, but groups of others who are not.’ The contexts and objects o…”
InfluentialCounting on Kin: Social Networks, Social Support, and Child Health Status
Kana'iaupuni, S. M., Donato, K. M., Thompson-Colon, T., & Stainback, M. (2005) · Social Forces · doi:10.1353/sof.2005.0036 · Cited by 239
Cognitions, coping and social environment predict adjustment to phantom limb pain
Jensen, M. P., Ehde, D. M., Hoffman, A. J., Patterson, D. R., Czerniecki, J. M., & Robinson, L. R. (2002) · Pain · doi:10.1016/s0304-3959(01)00390-6 · Cited by 241
“Much of this research has focused on social support, with both longitudinal and experimental studies supporting a beneficial effect of social support on mortality and on reducing the risk factors of future morbidity and mortality (House et al., 1988; Berkman, 1995).”
The Importance and Impact of Social Support on Outcomes in Patients With Heart Failure
Luttik, M. L., Jaarsma, T., Moser, D. K., Sanderman, R., & van Veldhuisen, D. J. (2005) · The Journal of Cardiovascular Nursing · doi:10.1097/00005082-200505000-00007 · Cited by 235
Cole, S. W., Kemeny, M. E., Taylor, S. E., Visscher, B. R., & Fahey, J. L. (1996) · Psychosomatic Medicine · doi:10.1097/00006842-199605000-00005 · Cited by 235
Social Support and Self-Reported Health Status of Older Adults in the United States
White, A. M., Philogene, G. S., Fine, L. J., & Sinha, S. (2009) · American Journal of Public Health · doi:10.2105/ajph.2008.146894 · Cited by 226
“As suggested in previous research, one’s perception of having adequate emotional support is associated with better self-reported health status in the general population of US community-dwelling older persons.(4) Self-report of perceived low social support is indeed a risk factor for poorer health status for US older p…”
Giordano, G. N., & Lindström, M. (2009) · Social Science & Medicine · doi:10.1016/j.socscimed.2009.10.044 · Cited by 224
Health-related quality of life and health behaviors by social and emotional support
Strine, T. W., Chapman, D. P., Balluz, L. S., & Mokdad, A. H. (2007) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-007-0277-x · Cited by 218
“Much evidence has accrued that social and emotional support is associated with a reduced risk of mental and physical illness, as well as mortality [1, 4–7, 10, 12, 18, 34, 35, 51, 53, 59, 62, 67], and has suggested that it confers benefits in cardiovascular, endocrine, and immune functioning [52, 65].”
BackgroundGoldston, K., & Baillie, A. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.05.005 · Cited by 245
Uchino, B. N., Holt‐Lunstad, J., Uno, D., & Flinders, J. B. (2001) · Journal of Behavioral Medicine · doi:10.1023/a:1010634902498 · Cited by 215
“The quality and quantity of one’s social relationships have been reliably related to morbidity and mortality (Berkman, 1995; Cohen, 1988; House et al., 1988).”
Campbell, C., Williams, B. G., & Gilgen, D. (2002) · AIDS Care · doi:10.1080/09540120220097928 · Cited by 212
Social Support, Physiological Processes, and Health
Uchino, B. N., Uno, D., & Holt‐Lunstad, J. (1999) · Current Directions in Psychological Science · doi:10.1111/1467-8721.00034 · Cited by 205
Unger, J. B., Johnson, C. A., & Marks, G. N. (1997) · Annals of Behavioral Medicine · doi:10.1007/bf02883332 · Cited by 211
“Prospective studies in diverse populations have found that the existence of social networks and interactions with social network members decrease the risk of mortality ( 7-14 ), incidence of cardiovascular disease (6), cancer survival (6), and physical functioning (15-17).”
BackgroundReagan, P. B., & Salsberry, P. J. (2004) · Social Science & Medicine · doi:10.1016/j.socscimed.2004.10.010 · Cited by 207
“…effective channels of communication, to have reciprocal relationships providing mutual support, and to be influenced by positive social norms, all increasing the likelihood that healthy behaviors, such as abstention from drug use, will be adopted (Berkman, 1995; Kawachi, Kennedy & Glass, 1999).”
BackgroundSocial Relations, Health Behaviors, and Health Outcomes: A Survey and Synthesis
Tay, L., Tan, K., Diener, E., & Gonzalez, E. (2012) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.12000 · Cited by 228
Shall we dance? An exploration of the perceived benefits of dancing on well-being
Murcia, C. Q., Kreutz, G., Clift, S. M., & Bongard, S. (2010) · Arts & Health · doi:10.1080/17533010903488582 · Cited by 248
“Further, there is a substantial body of evidence indicating the relationship between positive social relationships and individual health outcomes (e.g. Berkman, 1995).”
BackgroundChallenges in conceptualizing social support
Vangelisti, A. L. (2009) · Journal of Social and Personal Relationships · doi:10.1177/0265407509105520 · Cited by 203
“Perceived support and the availability of support have been linked to greater physical and mental well-being (Berkman, 1995) and, by implication, to more satisfying interpersonal relationships.”
BackgroundOrsega-Smith, E. M., Payne, L. L., Mowen, A. J., Ho, C.-H., & Godbey, G. C. (2007) · Journal of Leisure Research · doi:10.1080/00222216.2007.11950129 · Cited by 203
Promoting well-being: Time for a paradigm shift in health and human services
Prilleltensky, I. (2005) · Scandinavian Journal of Public Health · doi:10.1080/14034950510033381 · Cited by 202
“investigators has also concentrated on the importance of relationships, or what I call relational wellbeing [ 3 ].”
Background
Metadata
- Authors
- Berkman, L. F.
- Affiliations
- Yale University (US)
- Corresponding author
- Berkman, Lisa F.
- ORCID
- Berkman, Lisa F.
- Venue
- Psychosomatic Medicine
- Published
- 1995
- Volume
- 57
- Issue
- 3
- Pages
- 245-254
- ISSN
- 0033-3174 (ISSN-L)
- OpenAlex
- W2066047381
- Cited by
- 1,233
- References
- 71
- Citations by year
- 2026: 18 · 2025: 23 · 2024: 21 · 2023: 36 · 2022: 47 · 2021: 38 · 2020: 26 · 2019: 48 · 2018: 44 · 2017: 37 · 2016: 51 · 2015: 50 · 2014: 59 · 2013: 64 · 2012: 59
- FWCI
- 6.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (7r01ag011042-03)
- National Institute on Aging (1P60 AG10469-01A1, R01 AG11042-01A1, P60AG010469)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Community Health and Development
- Keywords
- social support, interpersonal relationships, health promotion, social isolation, mortality risk, sense of belonging, self-efficacy, neuroendocrine pathways, behavioral mechanisms, disease prevention
- MeSH terms
- Disease Susceptibility, Health Promotion, Humans, Internal-External Control, Interpersonal Relations, Psychophysiologic Disorders, Risk Factors, Self Concept, Social Support, Health Behavior, Survival Rate
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