Cited by 1,233Health disparities and outcomesHealth, psychology, and well-beingCommunity Health and Development

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The Role of Social Relations in Health Promotion

Berkman, Lisa F.·1995·Psychosomatic Medicine

DOI 10.1097/00006842-199505000-00006

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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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Dimensions of Social Support and Depression in Patients at Increased Psychosocial Risk Recovering from Myocardial Infarction
Lett, H. S., Blumenthal, J. A., Babyak, M. A., Catellier, D., Carney, R. M., Berkman, L. F., Burg, M. M., Mitchell, P. H., Jaffe, A. S., & Schneiderman, N. (2009) · International Journal of Behavioral Medicine · doi:10.1007/s12529-009-9040-x · Cited by 52
“Several reviews and meta-analyses have concluded that the presence of low social support or depression is associated with increased mortality and morbidity in patients with coronary heart disease (CHD) [1-9].”
Self-citation
Creating contexts for effective homebased care of people living with HIV/AIDS
Campbell, C., & Foulis, C. A. (2004) · Curationis · doi:10.4102/curationis.v27i3.993 · Cited by 52
“Communities with high levels of local participation are said to provide their members with the increased likelihood of health-enhancing social support (Berkman, 1995; Yen and Syme, 1999), and the reduction of health-damaging stress and anxiety (Wilkinson, 1999).”
Background
Unraveling the Relationship Between Family-Supportive Supervisor and Employee Performance
Wang, P., Walumbwa, F. O., Wang, H., & Aryee, S. (2013) · Group & Organization Management · doi:10.1177/1059601112472726 · Cited by 51
“, 2009), social support research suggests that emotional support is the most important and effective type of social support (Berkman, 1995; Sarason, Sarason, Brock, & Pierce, 1996; Semmer et al., 2008). In a meta-analysis, Viswesvaran, Sanchez, and Fisher (1999) reported that emotional, non-tangible support has a stro…”
Background
Interpersonal Trust and Quality-of-Life: A Cross-Sectional Study in Japan
Tokuda, Y., Jimba, M., Yanai, H., Fujii, S., & Inoguchi, T. (2008) · PLoS ONE · doi:10.1371/journal.pone.0003985 · Cited by 51
“There is growing interest in psychosocial factors with positive attitudes, such as trust, optimism, and sociability, as determinants for subjective well-being [3,4,5,6].”
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Adapting a natural (lay) helpers model of change for worksite health promotion for women
Tessaro, I. A. (2000) · Health Education Research · doi:10.1093/her/15.5.603 · Cited by 51
“Byrd network (Berkman, 1995), and, for women, Health Sciences Center, West Virginia University, Morgantown, WV 26506, and 1Center for Health acknowledging and utilizing the strength of their Promotion and Disease Prevention, 2Department of interpersonal networks (Marshall et al.”
Background
Social Relationships and Cardiovascular Disease Risk Factors: Findings from the Third National Health and Nutrition Examination Survey
Ford, E. S., Ahluwalia, I. B., & Galuska, D. A. (2000) · Preventive Medicine · doi:10.1006/pmed.1999.0606 · Cited by 88
Measuring social activities and social function in long‐term cancer survivors who received hematopoietic stem cell transplantation
Syrjala, K. L., Stover, A. C., Yi, J. C., Artherholt, S. B., & Abrams, J. R. (2009) · Psycho-Oncology · doi:10.1002/pon.1572 · Cited by 54
“For example, studies have found that more social ties and greater social integration were associated with better resistance to illness [3], lower mortality [4], longer survival from myocardial infarction [5], lower risk of cancer recurrence [6], and improved cancer survival [7].”
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The effect of social participation on the subjective and objective health status of the over-fifties: evidence from SHARE
Leone, T., & Hessel, P. (2015) · Ageing and Society · doi:10.1017/s0144686x15000148 · Cited by 50
The Effectiveness of Transition Strategies for Youth With Disabilities
King, G. A., Baldwin, P. J., Currie, M. L., & Evans, J. (2006) · Children s Health Care · doi:10.1207/s15326888chc3502_4 · Cited by 51
“It is important to restructure naturally occurring networks and resources for support because these form the basis for long-term behaviors (Berkman, 1995).”
The long-run effect of education on obesity in the US
Kim, Y. (2016) · Economics & Human Biology · doi:10.1016/j.ehb.2015.12.003 · Cited by 50
“See, for example, Berkman (1995) for a review.”
Background
Social Network Status and Depression Among Adolescents: An Examination of Social Network Influences and Depressive Symptoms in a Chinese Sample
Okamoto, J. M., Johnson, C. A., Leventhal, A. M., Milam, J. E., Pentz, M. A., Schwartz, D., & Valente, T. W. (2011) · Research in Human Development · doi:10.1080/15427609.2011.549711 · Cited by 50
“The link between social isolation and decreased psychological well-being has been well established (for reviews, see Berkman, 1995; House, Landis, & Umberton, 1988), historically dating back to Durkheim’s work in sociological theory (see Gibbs & Martin, 1958; Inkeles, 1959).”
Background
Psychosocial risk factors for heart disease in France and Northern Ireland: The Prospective Epidemiological Study of Myocardial Infarction (PRIME)
Sykes, D. H., Arveiler, D., Salters, C., Ferrières, J., McCrum, E. E., Amouyel, P., Bingham, A., Montaye, M., Ruidavets, J., Haas, B., et al. (2002) · International Journal of Epidemiology · doi:10.1093/ije/31.6.1227 · Cited by 50
Subliminal activation of social ties moderates cardiovascular reactivity during acute stress.
Carlisle, M., Uchino, B. N., Sanbonmatsu, D. M., Smith, T. W., Cribbet, M. R., Birmingham, W. C., Light, K. C., & Vaughn, A. A. (2011) · Health Psychology · doi:10.1037/a0025187 · Cited by 53
“Prior work on social relationships and cardiovascular function has demonstrated the benefits of positive social support and detriments of negative relationships on health (Berkman, 1995; De Vogli et al., 2007; Friedman et al., 1995).”
Gender-related differences in the multi-pathway effect of social determinants on quality of life in older age—the COURAGE in Europe project
Tobiasz‐Adamczyk, B., Gałaś, A., Zawisza, K., Chatterji, S., Haro, J. M., Ayuso‐Mateos, J. L., Koskinen, S. V. P., & Leonardi, M. (2017) · Quality of Life Research · doi:10.1007/s11136-017-1530-8 · Cited by 56
Beyond the Individual: Social and Cultural Influences on the Health-Seeking Behaviors of African American Men
Eley, N. T., Namey, E., McKenna, K., Johnson, A. C., & Guest, G. (2019) · American Journal of Men s Health · doi:10.1177/1557988319829953 · Cited by 58
“Greater clarity on the mechanisms and effects of these types of social relationships in relation to African American men’s health will allow the field to capitalize on social influences that promote positive health-seeking behaviors (Berkman, 1995).”
Background
Clustering patients according to health perceptions
Sewitch, M. J., Leffondré, K., & Dobkin, P. L. (2004) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(03)00508-7 · Cited by 48
“Not only does the inability to connect with physicians place these individuals at risk of poorer health outcomes [45], but they are also unlikely to benefit from the health-promoting effects of social support [46–48], which, in turn, increases their risks of depression [49] and increased use of health services [50,51].”
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The best of times, the worst of times: The place of close relationships in psychology and our daily lives.
Perlman, D. (2007) · Canadian Psychology/Psychologie canadienne · doi:10.1037/cp2007003 · Cited by 48
“Berkman and Syme (1979) conducted one of the most classic of these.”
Background
Reentering the Community after Prison: Perspectives on the Role and Importance of Social Support
Kjellstrand, J., Clark, M. G., Caffery, C., Smith, J., & Eddy, J. M. (2021) · American Journal of Criminal Justice · doi:10.1007/s12103-020-09596-4 · Cited by 61
Child development as a determinant of health across the life course
Hertzman, C., & Power, C. (2004) · Current Paediatrics · doi:10.1016/j.cupe.2004.05.008 · Cited by 48
Social Environments and the Genetics of Aging: Advancing Knowledge of Protective Health Mechanisms
Ryff, C. D., & Singer, B. H. (2005) · The Journals of Gerontology Series B · doi:10.1093/geronb/60.special_issue_1.12 · Cited by 48
The role of psychosocial factors in irritable bowel syndrome
Gaynes, B. N., & Drossman, D. A. (1999) · Best Practice & Research Clinical Gastroenterology · doi:10.1053/bega.1999.0038 · Cited by 48
Poverty, Income Inequality and HealthPreprint
Judge, K., & Paterson, I. (2001) · RePEc: Research Papers in Economics · Cited by 48
Sober-Living Houses and Changes in the Personal Networks of Individuals in Recovery
Mueller, D. G., & Jason, L. (2014) · Health Psychology Research · doi:10.4081/hpr.2014.988 · Cited by 48
Mothers on the margins: Implications for eradicating perinatal HIV
Lindau, S. T., Jerome, J. S., Miller, K., Monk, E., Garcia, P., & Cohen, M. H. (2005) · Social Science & Medicine · doi:10.1016/j.socscimed.2005.05.012 · Cited by 47
“Social status, social support, and embeddedness of individuals in a social network have been shown by social scientists to significantly influence health status and disease outcomes (Berkman, 1995; House, Landis, & Umberson, 1988).”
Background
Gender differences in social network characteristics and psychological well-being among Hong Kong Chinese: The role of future time perspective and adherence to Renqing
Yeung, D. Y.-L., Fung, H. H.-L., & Lang, F. R. (2006) · Aging & Mental Health · doi:10.1080/13607860600735820 · Cited by 47
“, 1994) and buffering the impact of stressors (e.g., Ferraro & Su, 1999; Berkman, 1995).”
Background
Differences between immigrants at various durations of residence and host population in all-cause mortality, Canada 1991–2006
Omariba, D. W. R., Ng, E., & Vissandjée, B. (2014) · Population Studies · doi:10.1080/00324728.2014.915050 · Cited by 45
Adjusting to living with multiple sclerosis: The role of social groups
Tabuteau-Harrison, S., Haslam, C., & Mewse, A. J. (2014) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2014.993403 · Cited by 52
“Growing research suggests social factors play an important role in maintaining health and adjusting to a range of clinical conditions; from post-myocardial infarction (Berkman, 1995), MS (Mohr, Goodkin, Nelson, Darcy, & Weiner, 2002), and stroke (Boden-Albala, Litwak, Elkind, Rundek, & Sacco, 2005).”
Background
Measuring Social Participation in the Health and Retirement Study
Howrey, B. T., & Hand, C. L. (2018) · The Gerontologist · doi:10.1093/geront/gny094 · Cited by 47
Toward a Social Psychophysiology of Cardiovascular Reactivity: Interpersonal Concepts and Methods in the Study of Stress and Coronary Disease
Smith, T. W., Gallo, L. C., & Ruiz, J. M. (2003) · Wiley eBooks · doi:10.1002/9780470753552.ch13 · Cited by 45
The Importance of Belonging for Adolescents in Secondary School Settings
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“from infectious diseases (Berkman, 1995).”
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Inequality in Healthcare Utilization in Italy: How Important Are Barriers to Access?
Matranga, D., & Maniscalco, L. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031697 · Cited by 44
The Mediating Effects of Work Characteristics on the Relationship between Transformational Leadership and Employee Well-Being: A Meta-Analytic Investigation
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“Additionally, TFL leaders provide support and individualized coaching through their actions, thereby decreasing emotional distress and preventing negative mental health states [24,33,34].”
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Health, Social Relations, and Public Policy
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Family relations, sense of coherence, happiness and perceived health in retired Taiwanese: Analysis of a conceptual model
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The Impact of Dementia on Relationships, Intimacy, and Sexuality in Later Life Couples: An Integrative Qualitative Analysis of Existing Literature
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“Close relationships, including marriage, have been found to have a positive effect on an individual’s quality of life, life expectancy, and mental and physical health (Berkman, 1995; Myers, 1999; Perlman & Vangelisti, 2006).”
Background
Hostility and perceived social support: interactive effects on cardiovascular reactivity to laboratory stressors
Chen, Y. Y., Gilligan, S., Coups, E. J., & Contrada, R. J. (2005) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm2901_6 · Cited by 44
“Similarly, individuals who are not well integrated within a network of social ties, or who perceive low levels of social support, are more likely to experience negative CHD outcomes ( 3 ,4).”
Background

Authors: Berkman, L. F.
Affiliations: Yale University (US)
Corresponding author: Berkman, Lisa F.
ORCID: Berkman, Lisa F.
Venue: Psychosomatic Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1995
Volume: 57
Issue: 3
Pages: 245-254
ISSN: 0033-3174 (ISSN-L)
DOI: 10.1097/00006842-199505000-00006
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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The Role of Social Relations in Health Promotion

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