Impact of social ties on self-reported health in France: Is everyone affected equally?
Open accessAbstract
AIM: To examine the association of social ties and income with self reported health, in order to investigate if social ties have a greater impact on the health of people on low incomes compared to those financially better off. METHODS: A nationally representative cross-sectional study of 5205 French adults using data from questionnaires which asked about health, income and relationships with family and friends etc. RESULTS: Less than good self-rated health (SRH) is twice as frequently reported by people in the lowest income group than those in the highest income group. People with low incomes are also more likely to have felt alone on the previous day, received no phone call during the last week, have no friends, not be a member of a club, and to live alone. Socially isolated people report lower SRH. Likelihood ratio tests for interaction vs. main effect models were statistically significant for 2 of the measures of social ties, borderline for 2 others and non-significant for one. For 4 of the 5 indicators of social ties, larger odd ratios show that social isolation is more strongly associated with less than good SRH among people on low incomes compared to those with a higher income. CONCLUSION: Social isolation is associated with 'less than good' self-rated health. This effect appears to be more important for people on a low income.
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Participation in social activities has been associated with better health among participants from low socio-economic groups.
“For instance, participation in social activities has been associated with better health among participants from low socio-economic groups [42].”
From Social isolation, cognitive reserve, and cognition in healthy older people (2018) · cites this paper as [42]
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Cites
Self-rated health and mortality: a review of twenty-seven community studies.
Idler, E. L., & Benyamini, Y. (1997) · Journal of Health and Social Behavior · doi:10.2307/2955359 · Cited by 8,598 · see citing works
BERKMAN, L. F., & SYME, S. L. (1979) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a112674 · Cited by 5,341 · see citing works
From social integration to health: durkheim in the new millennium
Berkman, L. F., Glass, T., Brissette, I., & Seeman, T. E. (2000) · Social Science & Medicine · doi:10.1016/s0277-9536(00)00065-4 · Cited by 4,821 · cited 2× · see citing works
“This confirms other findings that the level of satisfaction with social relationships may be more important for health than indicators relating to the structure of a network [17,18].”
BackgroundResult(2005) · doi:10.1093/acprof:oso/9780198565895.001.0001 · Cited by 2,155 · see citing works
Income inequality and population health: A review and explanation of the evidence
Wilkinson, R. G., & Pickett, K. E. (2005) · Social Science & Medicine · doi:10.1016/j.socscimed.2005.08.036 · Cited by 1,786 · see citing works
Miilunpalo, S., Vuori, I., Oja, P., Pasanen, M., & Urponen, H. (1997) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(97)00045-0 · Cited by 1,473 · see citing works
Is Income Inequality a Determinant of Population Health? Part 1. A Systematic Review
Lynch, J. W., Smith, G. D., Harper, S. B., Hillemeier, M. M., Ross, N. A., Kaplan, G. A., & Wolfson, M. C. (2004) · Milbank Quarterly · doi:10.1111/j.0887-378x.2004.00302.x · Cited by 931 · see citing works
The Impact of Inequality: How to Make Sick Societies Healthier
Wilkinson, R. G. (2005) · Cited by 917 · see citing works
Social relations: network, support and relational strain
Due, P. (1999) · Social Science & Medicine · doi:10.1016/s0277-9536(98)00381-5 · Cited by 421 · cited 1× · see citing works
“Most studies looking at social ties do show a positive association with health, but there are ongoing discussions about the exact mechanisms (structural or functional) [23,24].”
BackgroundStatus Syndrome: How Your Social Standing Directly Affects Your Health and Life Expectancy
Vogli, R. D. (2004) · BMJ · doi:10.1136/bmj.329.7462.408 · Cited by 416 · see citing works
Social network interaction and mortality
Orth‐Gomér, K., & Johnson, J. V. (1987) · Journal of Chronic Diseases · doi:10.1016/0021-9681(87)90145-7 · Cited by 351 · cited 1× · see citing works
“shown that the frequency and quality of social relationships are positively associated with health [11-13].”
BackgroundGiles, L. C., Glonek, G. F. V., Luszcz, M. A., & Andrews, G. R. (2005) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2004.025429 · Cited by 324 · cited 1× · see citing works
“shown that the frequency and quality of social relationships are positively associated with health [11-13].”
BackgroundExplaining social class differences in depression and well-being
Stansfeld, S. A., Head, J. A., & Marmot, M. G. (1997) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s001270050014 · Cited by 298 · cited 1× · see citing works
“In the Whitehall II study, higher grade civil servants were in better health and had more friends and received more emotional support than their lower grade colleagues [22].”
BackgroundSocial support and social cohesion
(2005) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780198565895.003.08 · Cited by 249 · see citing works
Berkman, L. F. (2004) · American Journal of Epidemiology · doi:10.1093/aje/kwh020 · Cited by 231 · cited 2× · see citing works
“The French 'Gazel' cohort has indicated the negative influence of poor social integration on male mortality [14].”
BackgroundResultAntonucci, T., Fuhrer, R., & Dartigues, J. (1997) · Psychology and Aging · doi:10.1037/0882-7974.12.1.189 · Cited by 208 · cited 2× · see citing works
“Our study supports the findings of other authors [10- 13, 16 ,17,19,20] that social relationships are closely associated with health.”
BackgroundResultInfluentialAntonucci, T. C., Fuhrer, R., & Dartigues, J. (1997) · Psychology and Aging · doi:10.1037//0882-7974.12.1.189 · Cited by 193 · see citing works
Social isolation and cardiovascular disease: an atherosclerotic pathway?
Knox, S. S., & Uvnäs-Moberg, K. (1998) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(98)00061-4 · Cited by 186 · cited 4× · see citing works
“This population could be biologically stressed due to their low social status, and lack of neuropeptides linked to social bonding, may add to this stress [19,20].”
BackgroundResultInfluentialSocial relations and self-reported health: a prospective analysis of the French Gazel cohort
Melchior, M., Berkman, L. F., Niedhammer, I., Chea, M., & Goldberg, M. (2003) · Social Science & Medicine · doi:10.1016/s0277-9536(02)00181-8 · Cited by 176 · cited 2× · see citing works
“Melchior et al [15] using data from the same cohort, found that a lack of social support and a dissatisfaction with social relations, rather than the size of social network, decreased health.”
MethodResultIn Sickness but Not in Health: Self-ratings, Identity, and Mortality
Idler, E. L., Leventhal, H., Mclaughlin, J., & Leventhal, E. A. (2004) · Journal of Health and Social Behavior · doi:10.1177/002214650404500307 · Cited by 172 · cited 1× · see citing works
“One of the limitations of this study is that although SRH has been shown to be both a robust health indicator and related to mortality [28-30], little is known about how individuals arrive at their SRH replies [ 31 ].”
BackgroundSocial relationships and allostatic load in Taiwanese elderly and near elderly
Seeman, T. E., Glei, D. A., Goldman, N., Weinstein, M., Singer, B., & Lin, Y. (2004) · Social Science & Medicine · doi:10.1016/j.socscimed.2004.03.027 · Cited by 133 · cited 1× · see citing works
“shown that the frequency and quality of social relationships are positively associated with health [11-13].”
BackgroundLes inégalités sociales de santé
Ridde, V. (2000) · La Découverte eBooks · doi:10.3917/dec.fassi.2000.01 · Cited by 130 · see citing works
Antonucci, T., Ajrouch, K., & Janevic, M. (2003) · Social Science & Medicine (1967) · doi:10.1016/s0277-9536(02)00099-0 · Cited by 88 · cited 2× · see citing works
“Also, it should be noted that our findings are very similar to those reported by Antonicci et al [27] who used education attainment as a measure of SES.”
ResultThe Neurobiology of Social Bonds
Kendrick, K. M. (2004) · Journal of Neuroendocrinology · doi:10.1111/j.1365-2826.2004.01262.x · Cited by 80 · cited 3× · see citing works
“This population could be biologically stressed due to their low social status, and lack of neuropeptides linked to social bonding, may add to this stress [19,20].”
BackgroundResultFuhrer, R., Dufouil, C., Antonucci, T., Shipley, M., Helmer, C., & Dartigues, J. (1999) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009776 · Cited by 80 · cited 6× · see citing works
“Antonucci TC, Fuhrer R, Dartigues JF: Social relations and depressive symptomatology in a sample of communitydwelling French older adults.”
BackgroundResultInfluentialIncome Inequality and Health: a review and explanation of the evidence
Wilkinson, R. G., & Pickett, K. E. (2006) · Cited by 47 · see citing works
Neighbourhood social cohesion and health: investigating associations and possible mechanisms
Stafford, M. C., Bartley, M., Boreham, R., Thomas, R. S., Wilkinson, R. G., & Marmot, M. G. (2004) · UCL Discovery (University College London) · Cited by 41 · see citing works
Cambois, E., & Jusot, F. (2007) · Base Institutionnelle de Recherche de l'université Paris-Dauphine (BIRD) (University Paris-Dauphine) · Cited by 13 · see citing works
Une personne sur deux est membre d’une association en 2002
Febvre, M., & Muller, L. (2006) · INSEP-Éditions eBooks · doi:10.4000/books.insep.2345 · Cited by 12 · see citing works
Salem G., Rican S., Jougla E., Atlas de la santé en France. Volume 1 : Les causes de décès
Besancenot, J. (2002) · Périodiques Scientifiques en Édition Électronique · Cited by 1 · see citing works
Flagged first, then by citations
1 of the 31 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Loneliness, social isolation, and behavioral and biological health indicators in older adults.
Shankar, A., McMunn, A., Banks, J., & Steptoe, A. (2011) · Health Psychology · doi:10.1037/a0022826 · Cited by 1,100 · see citing works
Social isolation, cognitive reserve, and cognition in healthy older people
Evans, I. E. M., Llewellyn, D. J., Matthews, F. E., Woods, R. T., Brayne, C., Clare, L., & on behalf of the CFAS-Wales research team (2018) · PLOS ONE · doi:10.1371/journal.pone.0201008 · Cited by 227 · see citing works
Berglund, E., Lytsy, P., & Westerling, R. (2015) · Health and Quality of Life Outcomes · doi:10.1186/s12955-015-0309-2 · Cited by 119 · see citing works
“Several factors have shown associations with SRH, among them low income [27], work related factors [10], pension status [28], psychological and social factors [29].”
BackgroundBerglund, E., Lytsy, P., & Westerling, R. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-492 · Cited by 101 · see citing works
“Several factors have shown associations with SRH, among them low income [14], social isolation [14], work related factors [15], psychological and social factors [15].”
BackgroundLuo, F., Guo, L., Thapa, A., & Yu, B. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.01.022 · Cited by 90 · see citing works
Vonneilich, N., Jöckel, K., Erbel, R. M., Klein, J., Dragano, N., Siegrist, J., & Knesebeck, O. V. D. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-285 · Cited by 76 · see citing works
“While structural aspects of social relations may facilitate the availability of help, social support might more directly affect health behaviour and psychological mechanisms such as feelings of self-esteem and coping [9,15,45].”
BackgroundIncome gradient in health-related quality of life — the role of social networking time
Zhang, S., & Xiang, W. (2019) · International Journal for Equity in Health · doi:10.1186/s12939-019-0942-1 · Cited by 68 · see citing works
“With regard to the effect of absolute income, money involves access to resources that benefit for health, such as medical services [10], better nutrition [11] and resources embedded in social networks [12].”
BackgroundThe biopsychosocial model and quality of life in persons with active epilepsy
Elliott, J. O., & Richardson, V. E. (2014) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2014.09.035 · Cited by 56 · see citing works
“likely to rate their health status as poor (229).”
Wealth and Disability in Later Life: The English Longitudinal Study of Ageing (ELSA)
Torres, J. L., Lima‐Costa, M. F., Marmot, M. G., & de Oliveira, C. M. (2016) · PLoS ONE · doi:10.1371/journal.pone.0166825 · Cited by 49 · see citing works
“Social networks, especially partners, could help to attenuate patterns of health inequalities in functioning among older adults [31].”
BackgroundTypes of social capital resources and self-rated health among the Norwegian adult population
Gele, A. A., & Harsløf, I. (2010) · International Journal for Equity in Health · doi:10.1186/1475-9276-9-8 · Cited by 44 · see citing works
“Among them are psychological mechanisms, including the effect of being integrated into social networks on feelings of self-esteem and the ability to cope [27], and behavioral mechanisms, including the social impact and social regulation of health behaviors by people within the network, and the health benefits of socia…”
BackgroundResultVonneilich, N., Jöckel, K., Erbel, R. M., Klein, J., Dragano, N., Weyers, S., Moebus, S., Siegrist, J., & Knesebeck, O. V. D. (2011) · International Journal for Equity in Health · doi:10.1186/1475-9276-10-43 · Cited by 43 · see citing works
“This is one of the first studies to analyse the effect of SES on the association of social relations and health (see [15,20,39,40]).”
BackgroundBot, S. D. M., Mackenbach, J. D., Nijpels, G., & Lakerveld, J. (2016) · PLoS ONE · doi:10.1371/journal.pone.0165041 · Cited by 34 · see citing works
Social Networks and Health Inequalities
Klärner, A., Gamper, M., Keim-Klärner, S., Moor, I., von der Lippe, H., & Vonneilich, N. (2022) · Springer eBooks · doi:10.1007/978-3-030-97722-1 · Cited by 33 · see citing works
Rapid warming in Tibet, China: public perception, response and coping resources in urban Lhasa
Bai, L., Cirendunzhu, Pengcuociren, Dawa, Woodward, A. J., Liu, X., Baimaciwang, Dazhen, Sang, S., Wan, F., et al. (2013) · Environmental Health · doi:10.1186/1476-069x-12-71 · Cited by 29 · see citing works
“Other studies in developed countries found that people on a low income suffer from poorer health than richer groups in a society because of either material poverty or a lack of social relationships and support [28-30], while our results indicated the neighbour bonding was weakest in those upper-income people.”
ResultFactors associated with self-rated health in primary care
Mildestvedt, T., Herikstad, V. V., Undheim, I., Bjorvatn, B., & Meland, E. (2018) · Scandinavian Journal of Primary Health Care · doi:10.1080/02813432.2018.1499590 · Cited by 27 · see citing works
“In addition, other European studies reported associations between poor social ties and lower SRH [6].”
BackgroundBerglund, E., Westerling, R., & Lytsy, P. (2017) · Planning Practice and Research · doi:10.1080/02697459.2017.1374706 · Cited by 28 · see citing works
“Several factors have been shown to be associated with SRH, among them low income (Heritage et al., 2008), work-related factors (Cannuscio et al.”
BackgroundSocial network resources and self-rated health in a deprived Danish neighborhood
Andersen, P. T., Algren, M. H., Heiberg, R. F., Joshi, R., & Bak, C. K. (2017) · Health Promotion International · doi:10.1093/heapro/dax051 · Cited by 20 · see citing works
Does the mortality risk of social isolation depend upon socioeconomic factors?
Patterson, A. C. (2015) · Journal of Health Psychology · doi:10.1177/1359105315578302 · Cited by 17 · see citing works
“Studies accordingly show that the lack of friends, living alone, and feeling recently lonely correspond with worse self-rated health for people with low rather than high incomes (Heritage et al., 2008), while church attendance and participation in community groups cut mortality risk among poorer but not richer people…”
BackgroundInequalities, social ties and health in France
Héritage, Z. (2008) · Public Health · doi:10.1016/j.puhe.2008.10.028 · Cited by 15 · see citing works
Seifert, N., Seddig, D., & Eckhard, J. (2021) · Aging & Mental Health · doi:10.1080/13607863.2021.1961125 · Cited by 14 · see citing works
da Silva, S. L. A., de Brito, G. E. G., Ygnatios, N. T. M., Mambrini, J. V. D. M., Lima‐Costa, M. F., & Torres, J. L. (2024) · Cadernos de Saúde Pública · doi:10.1590/0102-311xpt144923 · Cited by 13 · see citing works
“Tais resultados foram observados na França 31 e Inglaterra 32 , corroborando a tendência internacional da importância do apoio social.”
Khosravi, R., Azman, A., Ayasreh, E. A., & Khosravi, S. (2018) · International Social Work · doi:10.1177/0020872818797996 · Cited by 8 · see citing works
Akgül, H., GÜVEN, A. Z., Güven, S., & Ceylan, M. (2023) · Children · doi:10.3390/children10091433 · Cited by 7 · see citing works
Park, S. (2023) · Asian Journal Of Social Psychology · doi:10.1111/ajsp.12583 · Cited by 5 · see citing works
Social Status, Social Relations, and Health
Vonneilich, N. (2022) · Springer eBooks · doi:10.1007/978-3-030-97722-1_11 · Cited by 5 · see citing works
Zheng, L. R., Naurin, E., Markstedt, E., Olander, P., Elden, H., & Lindén, K. (2023) · Sex Roles · doi:10.1007/s11199-023-01351-3 · Cited by 4 · see citing works
“Higher income and education provide access to social networks and resources (Bianchi & Vohs, 2016; Heritage et al., 2008; Mirowsky & Ross, 2017; Nie et al., 1996) and support the development of gender egalitarian attitudes (Canzio, 2020) that could encourage a balanced distribution of leisure.”
BackgroundSocioeconomic Inequities in Health
Heaney, C. A., & Hoppe, A. (2017) · doi:10.1002/9781118993811.ch20 · Cited by 4 · see citing works
Gesundheitliche Ungleichheiten und soziale Beziehungen
Vonneilich, N., & Knesebeck, O. V. D. (2020) · Springer eBooks · doi:10.1007/978-3-658-06392-4_14 · Cited by 3 · see citing works
Jørgensen, M., Smith, O. R. F., Wold, B., Bøe, T., & Haug, E. (2023) · SSM - Population Health · doi:10.1016/j.ssmph.2023.101440 · Cited by 4 · see citing works
Alsultan, A. S., Alqazlan, S., Alasmari, A. M., & Alshuayl, M. S. (2025) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2025.105077 · Cited by 2 · see citing works
Positive Effects of Religion and Social Ties on the Health of Former NFL Athletes
Cupery, T., Bush, E. L., Turner, R., Sonnega, A. J., Rosales, T. A., Vissa, K., Whitfield, K. E., Jackson, J. S., & Weir, D. R. (2021) · Journal of Religion and Health · doi:10.1007/s10943-021-01338-y · Cited by 2 · see citing works
Gesundheitliche Ungleichheiten und soziale Beziehungen
Vonneilich, N., & Knesebeck, O. V. D. (2016) · Springer eBooks · doi:10.1007/978-3-658-06477-8_14-1 · Cited by 1 · see citing works
Torres, J. L., Vaz, C. T., Moreira, B. D. S., Braga, L. D. S., Aliberti, M. J. R., Bertola, L., Suemoto, C. K., Lima-Costa, M. F., & de Oliveira, C. M. (2025) · Aging & Mental Health · doi:10.1080/13607863.2025.2471387 · Cited by 1 · see citing works
Sozialer Status, soziale Beziehungen und Gesundheit
Vonneilich, N. (2019) · Springer eBooks · doi:10.1007/978-3-658-21659-7_11 · Cited by 1 · see citing works
Comorbidities in Epilepsy: Range and Impact
Moore, J. L., & Elliott, J. O. (2015) · doi:10.1002/9781118951026.ch2 · Cited by 1 · see citing works
Ortega, J. T., Arias-Núñez, E., Puntí, J., Naranjo-Díaz, M. C., & Palomino-Escrivà, J. (2010) · Enfermería Clínica · doi:10.1016/j.enfcli.2010.01.001
Self-Rated Health Over Time in Greece
Nicolitsas, D. (2024) · Eurasian studies in business and economics · doi:10.1007/978-3-031-55813-9_16
Rahman, A., Tohan, M. M., Islam, A., Saha, B. R., & Kundu, S. (2024) · Archives of Women s Mental Health · doi:10.1007/s00737-024-01528-z
Gizaw, L. (2024) · SSRN Electronic Journal · doi:10.2139/ssrn.5075281
Gizaw, L. (2025) · Social Sciences & Humanities Open · doi:10.1016/j.ssaho.2025.101922
- Authors
- Heritage, Z., Wilkinson, R. G., Grimaud, O., & Pickett, K. E.
- Affiliations
- University of Nottingham (GB)
- École des Hautes Études en Santé Publique (FR)
- University of York (GB)
- Venue
- BMC Public Health
- Published
- 2008-07-18
- Volume
- 8
- Issue
- 1
- Pages
- 243-243
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC2483979
- OpenAlex
- W2109723878
- Cited by
- 41
- References
- 31
- Citations by year
- 2025: 3 · 2024: 4 · 2023: 4 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 4 · 2014: 2 · 2013: 1 · 2012: 1
- FWCI
- 1.77
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Institute for Health and Care Research (CSA/03/07/014)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Health › Public Health and Social Inequalities
- Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
- Keywords
- social ties, social isolation, self-rated health, income, low-income populations, health disparities, loneliness, social networks, living alone
- MeSH terms
- Adult, Cross-Sectional Studies, Female, France, Health Status, Humans, Income, Male, Middle Aged, Surveys and Questionnaires, Social Behavior, Social Isolation, Social Support
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