Berton H. Kaplan

Social support and health

IN HUMAN COMMUNICATION SYSTEMS, what is the function of social support in the etiology, precipitation, course and recovery from disease? In what way does social support ameliorate stress? In what ways does social support act to promote health? While many researchers30 have speculated on the importance of social support and a few have proclaimed it to be significant in myocardial infarction8 49 there is little strong empirical evidence to confirm the role it may play in health and illness. This is not surprising: attempts at conceptualization and measurement have been inadequate, discipline-bound (or study-bound), and usually formulated for post-hoc interpretation of unexpected, but striking findings.

Self-Help Quit Smoking Interventions: Effects of Self-Help Materials, Social Support Instructions, and Telephone Counseling.

Smokers requesting self-help materials for smoking cessation (N = 2,021) were randomized to receive (a) an experimental self-quitting guide emphasizing nicotine fading and other nonaversive behavioral strategies, (b) the same self-quitting guide with a support guide for the quitters family and friends, (c) self-quitting and support guides along with four brief counselor calls, or (d) a control guide providing motivational and quit tips and referral to locally available guides and programs. Subjects were predominantly moderate to heavy smokers with a history of multiple previous quit attempts and treatments. Control subjects achieved quit rates similar to those of smokers using the experimental quitting guide, with fewer behavioral prequitting strategies and more outside treatments. Social support guides had no effect on perceived support for quitting or on 8- and 16-month quit rates. Telephone counseling increased adherence to the quitting protocol and quit rates.

Exploratory Case‐Control Analysis of Psychosocial Factors and Adult Periodontitis

We explored the association between social factors and adult periodontitis by comparing self-reported information for daily strains and symptoms of depression in 71 cases and 77 controls. Cases and controls were selected from among 1,426 participants in the Erie County Risk Factor Study. We found differences among those who scored higher than their peers on measures of social strain. The odds ratio (OR) and 95% confidence interval (95% CI) for the association between case status and Role Strain score of 2.27 or more was 2.84, 95% CI = 1.08 to 7.46. We also examined serum antibody, dichotomized at the median, for three periodontal pathogens (Bacteroides forsythus [IgG Bf], Porphyromonas gingivalis [IgG Pg], Actinobacillus actinomycetemcomitans [IgG Aa]), and assessed interaction between antibody levels and a Depression score derived from the Brief Symptom Inventory. IgG Pg and IgG Aa were both strongly associated with case status (OR = 4.52, 95% CI = 1.99 to 10.3 and OR = 5.29, 95% CI = 2.34 to 12.0, respectively). IgG Bf was associated with periodontal disease but only among individuals who had higher scores for Depression (OR = 6.75, 95% CI = 1.25 to 36.5). Smoking status was associated with case status (OR = 4.95, 95% CI = 1.86 to 13.2). We assessed these findings prospectively by examining factors associated with more extensive disease among the 71 case subjects after 1 year of follow-up. We found baseline smoking status and IgG Bf among individuals scoring high on Depression at baseline to be associated with more extensive disease (8.1% or more of the sites showing further breakdown). In this population an elevated Depression score may be a marker for social isolation, which could play a role in immune function during periods of social strain. This exploratory analysis has served to identify specific lines of inquiry concerning psychosocial measures as important environmental factors in adult periodontitis. J Periodontol 1996;67:1060-1069.

Functional versus Structural Social Support and Health Care Utilization in a Family Medicine Outpatient Practice

Three hundred forty-three family-practice patients were surveyed by questionnaire and medical record audit to evaluate the relationships between social support and medical care utilization. Social support was not associated with laboratory test ordering. The mean number of office visits per year was higher for patients with low versus high confidant support (4.71 vs. 3.81, P < 0.10) and affective support (5.21 vs. 3.60, P < 0.05). Mean total charges in 1 year were higher for patients with low versus high confidant support (

The Impact of Religion on Men's Blood Pressure

232 vs.

Frequency of church attendance and blood pressure elevation

148, P<0.05) and affective support (

Prevalence of self-reported depressive symptoms in young adolescents.

244 vs.

Social support and depression as risk factors for loss of physical function in late life

154, P < 0.05). Poor confidant and affective support were both associated with longer visits. Structural measures of social support were not related significantly to any utilization indicator. These findings were maintained in multiple-regression models controlling for physical health and seven demographic characteristics. Second-order regression models revealed interaction by race, employment status, and sex. Blacks showed no effect of confidant support on office visits. Poor confidant support resulted in

Patterns of change in hostility from college to midlife in the UNC alumni heart study predict high-risk status

201 more in total charges for the unemployed (P= 0.003) versus

Social Health and the Forgiving Heart: The Type B Story

49 more for the employed (P = 0.15). Women with low affective support had