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Social networks, stress and health-related quality of life

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Abstract

Although evidence suggests that social networks reduce the risk of mortality and are negatively associated with severe mental disability, little is known about their relationship to everyday functioning and health-related quality of life (HRQoL). In addition, the importance of social networks in the presence of chronic stress remains unclear. We examined the association between social networks and aspects of mental functioning (mental health, vitality and role-emotional functioning) and the relationship between social networks and mental functioning in the presence of stressors. Multiple linear and logistic regression models were used to examine data in 47,912 middle-aged and older healthy women. The Medical Outcomes Study Short-form Health Survey measured dimensions of quality of life. We observed strong associations between levels of social networks and multivariate-adjusted quality of life scores, particularly in potentially high stress situations. Compared to the most socially integrated, women who were socially isolated had reductions in mental health and vitality scores of 6.5 and 7.4 points, respectively and a 60% increased risk of limitation in role-emotional functioning. Social networks are positively associated with mental functioning in women. This association is strongest for women reporting high levels of home and work stressors.

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References

  1. Durkheim E. Suicide: A Study in Sociology. Glencoe, IL: Free Press, 1897.

    Google Scholar 

  2. Pearlin L. Social structure and processes of social support. In: Cohen S, Syme S, eds. Social Support and Health. Orlando, Fl: Academic Press, 1985: 43-60.

    Google Scholar 

  3. Kessler RC, McLeod JD. Social support and mental health in community surveys. In: Cohen S, Syme L, eds. Social Support and Health. New York: Academic Press, 1985: 219-240.

    Google Scholar 

  4. Thoits P. Conceptual, methodological and theoretical problems in studing social support as a buffer against life stress. J Health Soc Behav 1982; 23: 145-159.

    Google Scholar 

  5. Wills TA. Supportive functions of interpersonal relations. In: Cohen S, Syme L, eds. Social Support and Health. New York: Academic Press, 1985: 61-78.

    Google Scholar 

  6. Berkman LF, Syme SL. Social networks, host resistance and mortality: a nine-year follow-up study of Alameda County residents. Am J Epidemiol 1979; 109: 186-204.

    Google Scholar 

  7. Kawachi I, Colditz GA, Ascherio A et al. A prospective study of social networks in relation to total mortality and cardiovascular disease in men in the USA. J Epidemiol Commun Health 1996; 50: 245-251.

    Google Scholar 

  8. Falk A, Hanson B, Isacsson S, Ostergren P. Job strain and mortality in elderly men: social network, support, and influence as buffers. Am J Public Health 1992; 82: 1136-1139.

    Google Scholar 

  9. Hanson B, Isacsson S, Janzon L, Lindell S. Social network and social support influence mortality in elderly men. The prospective population study of ‘Men born in 1914,’ Malmo, Sweden. Am J Epidemiol 1989; 130: 100-111.

    Google Scholar 

  10. Olsen O. Impact of social networks on cardiovascular mortality in middle aged Danish men. J Epidemiol Commun Health 1993; 47: 176-180.

    Google Scholar 

  11. Orth-Gomer K, Johnson J. Social network interaction and mortality: a six year follow-up study of a random sample of the Swedish population. J Chronic Dis 1987; 40: 949-957.

    Google Scholar 

  12. Schoenbach VJ, Kaplan BH, Fredman L, Kleinbaum DG. Social ties and morality in Evans County, Georgia. Am J Epidemiol 1986; 123: 577-591.

    Google Scholar 

  13. House JS, Robbins C, Metzner HL. The association of social relationships and activities with mortality: prospective evidence from the Tecumseh Community Health Study. Am J Epidemiol 1982; 116: 123-140.

    Google Scholar 

  14. Blazer DG. Social support and mortality in an elderly community population. Am J Epidemiol 1982; 115: 684-694.

    Google Scholar 

  15. Sherbourne CD, Meredith LS, Rogers W, Ware JE. Social support and stressful life events: age differences in their effects on health-related quality of life among the chronically ill. Qual Life Res 1992; 1: 235-246.

    Google Scholar 

  16. Lefcourt HM. Personal and social characteristics that alter the impact of stressors. In: Humphrey JH, ed. Human Stress: Current Selected Research, Vol 3. New York: AMS Press, 1989: 1-13.

    Google Scholar 

  17. Seeman TE, Berkman LF. Structural characteristics of social networks and their relationship with social support in the elderly: who provides support. Soc Sci Med 1988; 26: 737-749.

    Google Scholar 

  18. Romans-Clarkson S, Walton V, Herbison G, Muller P. Psychiatric morbidity among women in urban and rural New Zealand: psychosocial correlates. Br J Psychiatr 1989; 156: 84-91.

    Google Scholar 

  19. Romans S, Walton V, McNoe B, Herbison G, Mullen P. Otago Women's Health Survey 30-month follow-up. I: onset patterns of non-psychotic psychiatric disorder. Br J Psychiatr 1993; 163: 733-738.

    Google Scholar 

  20. Goldberg E, Van Natta P, Comstock GW. Depressive symptoms, social networks and social support of elderly women. Am J Epidemiol 1985; 121: 448-456.

    Google Scholar 

  21. Heller K, Mansbach WE. The multifaceted nature of social support in a community sample of elderly women. J Soc Issues 1984; 40: 99-112.

    Google Scholar 

  22. Levitte MJ, Antonucci TC, Clark MC, Totton J, Finley GE. Social support and well-being: preliminary indicators based on two samples of elderly. Int J Aging Human Devel 1985; 21: 61-77.

    Google Scholar 

  23. Palmore E, Cleveland WP, Nowlin JB, Ramm D, Siegler IC. Stress and adaptation in later life. J Gerontol 1979; 34: 841-851.

    Google Scholar 

  24. Schaefer C, Coyne JC, Lazarus RS. The health-related functions of social support. J Behav Med 1981; 4: 381-406.

    Google Scholar 

  25. Froland C, Brodsky G, Olson M, Stewart L. Social support and social adjustment: implications for mental health professionals. Commun Mental Health J 1979; 15: 82-93.

    Google Scholar 

  26. Burt RS. A note on strangers, friends and happiness. Soc Networks 1987; 9: 311-331.

    Google Scholar 

  27. Acock AC, Hurlbert JS. Social networks, marital status, and well-being. Soc Networks 1993; 15: 309-334.

    Google Scholar 

  28. Guralnik JM, Kaplan GA. Predictors of health aging: prospective evidence from the Alameda County study. Am J Public Health 1989; 79: 703-708.

    Google Scholar 

  29. Fontaine KR, Cheskin LJ, Barofsky I. Health-related quality of life in obese persons seeking treatment. J Family Pract 1996; 43: 265-270.

    Google Scholar 

  30. Seeman TE, Berkman LF, Charpentier PA, Blazer DG, Albert MS, Tinetti ME. Behavioral and psychosocial predictors of physical performance: MacArthur studies of successful aging. J Gerontol A Biol Sci Med Sci 1995; 50: M177-M183.

    Google Scholar 

  31. Simonsick EM, Lafferty ME, Phillips CL et al. Risk due to inactivity in physically capable older adults. Am J Public Health 1993; 83: 1443-1450.

    Google Scholar 

  32. Kaplan GA, Lazarus NB, Cohen RD, Leu DJ. Psychosocial factors in the natural history of physical activity. Am J Prevent Med 1991; 7: 12-17.

    Google Scholar 

  33. LaCroix AZ, Guralnik JM, Berkman LF, Wallace RB, Satterfield S. Maintaining mobility in late life. II. Smoking, alcohol consumption, physical activity, and body-mass index. Am J Epidemiol 1993; 137: 858-869.

    Google Scholar 

  34. Hirdes JP, Maxwell CJ. Smoking cessation and quality of life outcomes among older adults in the Campbell's survey on well-being. Can J Public Health 1994; 85: 99-102.

    Google Scholar 

  35. Berkman LF, Seeman TE, Albert M et al. High, usual and impaired functioning in community-dwelling older men and women: findings from the MacArthur Foundation research network on successful aging. J Clin Epidemiol 1993; 46: 1129-1140.

    Google Scholar 

  36. Branch LG. Health practices and incident disability among the elderly. Am J Public Health 1985; 75: 1436-1439.

    Google Scholar 

  37. Passik SD, Breitbart WS. Depression in patients with pancreatic carcinoma. Diagnostic and treatment issues. Cancer 1996; 78: 615-626.

    Google Scholar 

  38. Kornblith AB, Thaler HT, Wong G et al. Quality of life of women with ovarian cancer. Gynecol Oncol 1995; 59: 231-242.

    Google Scholar 

  39. Verma KB, Asthana M. Mental health of cancer patients. Psychol Rep 1994; 74: 914.

    Google Scholar 

  40. Duncan PW, Samsa GP, Weinberger M et al. Health status of individuals with mild stroke. Stroke 1997; 28: 740-745.

    Google Scholar 

  41. Wilkinson PR, Wolfe CD, Warburton FG et al. A long-term follow-up of stroke patients. Stroke 1997; 28: 507-512.

    Google Scholar 

  42. Strawbridge WJ, Cohen RD, Shema SJ, Kaplan GA. Successful aging: predictors and associated activities. Am J Epidemiol 1996; 144: 135-141.

    Google Scholar 

  43. Lyons RA, Lo SV, Littlepage BN. Comparative health status of patients with 11 common illnesses in Wales. J Epidemiol Commun Health 1994; 48: 388-390.

    Google Scholar 

  44. Bourdel-Marchasson I, Dubroca B, Manciet G, Decamps A, Emeriau JP, Dartigues JF. Prevalence of diabetes and effect on quality of life in older French living in the community: the PAQUID Epidemiological Survey. J Am Geriatr Soc 1997; 45: 295-301.

    Google Scholar 

  45. Moen P, Robinson J, Fields V. Women's work and care-giving roles: a life course approach. J Gerontol 1994; 49: S176-S186.

    Google Scholar 

  46. McDaniel JL, Via BG. Aging issues in the workplace. Assisting workers who provide eldercare. AAOHN J 1997; 45: 261-269.

    Google Scholar 

  47. Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Hennekens CH, Speizer FE. Moderate alcohol consumption and the risk of breast cancer. N Engl J Med 1987; 316: 1174-1180.

    Google Scholar 

  48. Stampfer MJ, Willett WC, Colditz GA, Rosner B, Speizer FE, Hennekens CH. A prospective study of postmenopausal estrogen therapy and coronary heart disease. N Engl J Med 1985; 313: 1044-1049.

    Google Scholar 

  49. Kaplan R, Bush JW. Health-related quality of life measurement for evaluation research and policy analysis. Health Psychol 1982; 1: 61-80.

    Google Scholar 

  50. Shumaker SA, Naughton MJ. The international assessment of health-related quality of life: a theoretical perspective. In: Shumaker SA, Berzon RA, eds. The International Assessment of Health-related Quality of Life. Theory, Translation, Measurement and Analysis. New York: Rapid Communications, 1995; 3-10.

    Google Scholar 

  51. Stewart AL, Ware JE. Measuring Functioning and Well-being: The Medical Outcomes Study Approach. Durham, NC: Duke University Press, 1992.

    Google Scholar 

  52. Brazier JE, Harper R, O'Cathain A, Thomas KJ, Usherwood T, Westlake L. Validating the SF-36 Health Survey Questionnaire: new outcome measure for primary care. BMJ 1992; 305: 160-164.

    Google Scholar 

  53. McHorney CA, Ware JE, Raczek AE. The MOS 36-item Short-form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993; 31: 247-263.

    Google Scholar 

  54. McHorney CA, Ware JE, Lu JFR, Sherbourne CD. The MOS 36-item Short-form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care 1994; 32: 40-63.

    Google Scholar 

  55. Jenkinson C, Coulter A, Wright L. The SF-36 Health Survey Questionnaire: normative data from a large random sample of working age adults. BMJ 1993; 306: 1437-1440.

    Google Scholar 

  56. Stewart AL, Greenfield S, Hays RD et al. Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study. J Am Med Assoc 1989; 262: 907-913.

    Google Scholar 

  57. Karasek R. Job Content Questionnaire; Los Angeles: Department of Industrial and Systems Engineering, University of Southern California, 1985.

    Google Scholar 

  58. Karasek R, Theorell T. Healthy Work: Stress, Productivity and the Reconstruction of Working Life. New York: Basic Books, 1990.

    Google Scholar 

  59. Johnson J, Hall E. Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population. Am J Public Health 1988; 78: 1336-1342.

    Google Scholar 

  60. Lerner DJ, Levine S, Malspeis S, D'Agostino RB. Job strain and health-related quality of life in a national sample. Am J Public Health 1994; 83: 1580-1585.

    Google Scholar 

  61. Unden A, Orth-Gomer K, Elofsson S. Cardiovascular effects of social support in the work place: twenty-four-hour ECG monitoring of men and women. Psychosomat Med 1991; 53: 50-60.

    Google Scholar 

  62. Schnall PL, Pieper C, Schwartz JE, Karasek RA. The relationship between "job strain", workplace diastolic blood pressure and left ventricular mass index: results of a case-control study. J Am Med Assoc 1990; 263: 1929-1935.

    Google Scholar 

  63. Van Egeren LF. The relationship between job strain and blood pressure at work, at home, and during sleep. Psychosomat Med 1992; 54: 337-413.

    Google Scholar 

  64. Alfredsson L, Theorell T. Job characteristic of occupations and myocardial infarction risk. Effect of possible confounding factors. Soc Sci Med 1983; 17: 1497-1503.

    Google Scholar 

  65. Homer CJ, James SA, Siegal E. Work-related psychological stress and risk of preterm, low birthweight delivery. Advances 1990; 7: 13-16.

    Google Scholar 

  66. Giovannucci E, Colditz G, Stampfer MJ et al. The assessment of alcohol consumption by a simple self-administered questionnaire. Am J Epidemiol 1991; 133: 810-817.

    Google Scholar 

  67. Wolf AM, Hunter DJ, Colditz GA et al. Reproducibility and validity of a self-administered physical activity questionnaire. Int J Epidemiol 1994; 23: 991-999.

    Google Scholar 

  68. Fischer C, Jackson R, Stueve C, Gerson K, Jones L, Baldassare M. Networks and Places: Social Relations in Urban Settings. New York: Free Press, 1977.

    Google Scholar 

  69. Mitchell KE, Tricket EJ. Task force report: social networks as mediators of social support: an analysis of the effects and determinants of social networks. Commun Men Health J 1980; 16: 27-44.

    Google Scholar 

  70. Moos RH, Mitchell RE. Social network resources and adaptation: a conceptual framework. In: Wills TA, ed. Basic Processes in Helping Relationships. San Diego, CA: Academic Press, 1982; 213-232.

    Google Scholar 

  71. Kanner AD, Coyne JC, Schaefer C, Lazarus RS. Comparison of two modes of stress measurement: daily hassles and uplifts versus major life events. J Behav Med 1981; 4: 1-39.

    Google Scholar 

  72. Cohen S, Wills TA. Stress, social support and the buffering hypothesis. Psychol Bull 1985; 98: 310-357.

    Google Scholar 

  73. Ganster DC, Fusilier MR, Mayes BT. Role of social support in the experience of stress at work. J Appl Psychol 1986; 71: 102-110.

    Google Scholar 

  74. Jackson PB. Specifying the buffering hypothesis: support, strain, and depression. Soc Psychol Quart 1992; 55: 363-378.

    Google Scholar 

  75. Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey. Manual and Interpretation Guide. Boston, MA: The Health Institute, New England Medical Center, 1993.

    Google Scholar 

  76. Brook RH, Ware JE Jr, Rogers WH et al. Does free care improve adults' health? Results from a randomized controlled trial. N Engl J Med 1983; 309: 1426-1434.

    Google Scholar 

  77. Landsbergis PA, Schnall PL, Warren K, Pickering TG, Swartz JE. Association between ambulatory blood pressure and alternative formulations of job strain. Scand J Health Work Environ 1994; 20: 349-363.

    Google Scholar 

  78. Amick B, Kawachi I, Coakley E, Lerner D, Levine S, Colditz G. The relationship of job strain and iso-strain and health status in a cohort of U.S. women. Scand J Health Work Environ, 1998; 24:60-67.

    Google Scholar 

  79. Thalji L, Haggerty CC, Rubin R, Berckmans TR, Pardee BL. National Survey of Functional Health Status: Final Report. Chicago, IL: National Opinion Research Center, 1991.

    Google Scholar 

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Achat, H., Kawachi, I., Levine, S. et al. Social networks, stress and health-related quality of life. Qual Life Res 7, 735–750 (1998). https://doi.org/10.1023/A:1008837002431

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