Social support: a strategic concept

The concept of social support is defined as the belief that one is cared for and loved, esteemed and valued. It is a strategic concept in not only giving understanding to the maintenance of health and the development of (mental and somatic) health problems, but also their prevention.

Types and sources of social support can vary. Four main categories of social support are emotional, appraisal, informational and instrumental support. Social support is closely related to the concept of social network, the ties to family, friends, neighbours, colleagues, and others of significance to a person. Within this context, social support is the potential of the network to provide help.

It is important for public health policy to collect information on social support in the population, to enable both risk assessment and the planning of preventive interventions at different levels. There are several valid instruments to collect such information.

Percentage of population receiving poor support varies between countries

Surveys indicate that Italy, France, Belgium, Greece and Finland record the highest percentages of the population receiving poor support, whereas the lowest percentages are reported by Sweden, Ireland, Northern Ireland, Spain, the Netherlands and Denmark. Women report receiving more social support than men.

Lack of social support increases the risk for health problems

Lack of social support is shown to increase the risk of both mental and somatic disorders, and seems to be especially important in stressful life situations. Poor social support is also associated with enhanced mortality. Social support may affect health through different pathways: health behavioural, psychological and physiological pathways.

Social support is determined by individual and environmental factors

Social support is determined by factors at both the individual as well as the social level. Social support in adulthood may be to some extent genetically determined. Personality factors that might be associated with perceived social support are interpersonal trust and social phobia. The position of a person within the social structure, which is determined by factors such as marital status, family size and age, will influence the probability of them receiving social support. The occurrence of social support depends on the opportunities that a person creates to interact with other people. The structure of the community determines the extent to which people live in a social context conducive to social support.

Preventive interventions stimulate social support at different levels

There are three types of preventive interventions aimed at stimulating social support: universal, selective or indicated interventions. The ultimate goal of universal interventions is to promote health. They are aimed at providing social support at the group or community level. Selective preventions aim to strengthen social skills and coping abilities with, for example, social skills training. Social support groups and self-help groups are other examples of selective prevention programs. Indicated prevention programmes aim to reduce the risk of people who already have symptoms of psychological stress, developing a mental disorder.