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Question Description

A brief explanation of the effects of social support on the health condition.

In1979, Berkman and Syme published the results of their seminal study linking social relationships to mortality. These researchers linked questions about the extent of peoples’ social connections to overall mortality and found that people who were less socially integrated had higher mortality rates. This paper was influential because it was able to rule out possible alternative explanations (e.g., results due to poorer initial health status) and hence provided the most compelling empirical link sat the time between social relationships and mortality. Subsequent research has confirmed the reliable links between social support and better physical health outcomes (see reviews by Berkman et al.,2000; Cohen,1988; House et al.,1988; Seeman,11996; Uchino2004). Epidemiological studies indicate that individuals with low levels of social support have higher mortality rates; especially from cardiovascular disease. Studies linking relationships to disease mortality represent the first wave of research on social support and health. The structure and functions associated with our relationships provide insight into how social support may influence disease processes. Depicted inFig.1is a broad model based on different theoretical perspectives (Berkman et al.,2000; Cohen,1988;Gore,1981;Lin,1986; Thoits,1995; Umberson,1987)and the available literature linking social support to physical health (see Uchino,2004for more detail).Accordingly, structural and functional measures of support may ultimately influence morbidity and mortality through two distinct but not necessarily independent pathways. One pathway involves behavioral processes including health behaviors and adherence to medical regimens as out lined by social control and social identity theorists (Lewis andRook,1999; Umberson,1987). According to this view, social support is health-promoting because it facilitates healthier behaviors such as exercise, eating right, and not smoking; as well as greater adherence to medical regimens. This can happen in a direct (e.g., health-related informational support) or indirect (e.g., life meaning) manner (DiMatte 2004; Lewis and Rook,1999; Umberson,1987). In fact, health behaviors are one of the few variables that appear to explain at least part of the variance between social support and mortality (e.g., Kaplan et al.,1994).

Description of two populations that are at risk for reduced social support and explain why.

Numerous epidemiological studies have reported that poor social support is associated with the onset and relapse of depression, negative treatment response to dysthymia, seasonality of mood disorder, and the presence of depression comorbid in several medical illnesses, such as multiple sclerosis, cancer, and rheumatoid arthritis (Ozbay, et al., l2007). The Vietnam War may serve as an important example of failed social support during times of high stress and trauma. Johnson and colleagues found that many Vietnam veterans experienced homecoming as a highly stressful experience. These veterans reported “being insulted, feeling angry, resentful, and alone.” In this cohort of treatment-seeking, outpatient veterans with PTSD, homecoming stress was the strongest predictor of the frequency and intensity of their PTSD symptoms. The authors concluded that the lack of social support confirmed the veterans’ perception of rejection and lead to feelings of detachment (Ozbay, et al., l2007). In addition, social isolation and lack of social support are likely acute and chronic stressors affecting biological and behavioral mediators, such as increasing allostatic overload or unhealthy behaviors. Such mediating pathways are postulated to have long-term negative effects on health, causing increases in disease susceptibility and risk of mortality across many leading causes of death among elders. The role of social disconnection is particularly salient among populations with greater susceptibility to morbidity and mortality, such as older adults. The lack of social support for this population incurs real societal costs, such as longer hospital or nursing home stays when older persons lack caregivers who can help them recover at home (White et al., 2009).

Finally, explain two ways you might bridge the gap between the need for and utilization of social support for the populations you selected.

Community-based supports and services (CBSS) are designed to help community-dwelling older adults remain safely in their homes and delay or prevent institutionalization. CBSS provide (and act as a link to) specific resources for older adults and their caregivers that include wellness programs, nutritional support, educational programs about health and aging, and counseling services for caregivers, as well as general assistance with housing, finances, and home safety (Siegler et al., 2015).CBSS also provide opportunities for community and civic engagement through various volunteer programs and can enhance individuals’ skills and attitudes “to live in and gain more control over local aspects of their communities”. More than 20% of older adults (i.e., those aged 60 and above) currently receive CBSS. Older adults who use these services need them: over 90% of service users have multiple chronic conditions and corresponding activity of daily living (ADL) deficits. With the rapid aging of our population, even as overall health improves the number of older adults who could benefit from CBSS is expected to increase significantly in the coming years(Siegler et al., 2015).Another way I might bridge the gap between the need for and utilization of social support for the Vietnam War veterans is that military service members and veterans who have deployed to combat zones face elevated risks of mental health problems. While most who return from deployment are able to reintegrate successfully into civilian life, a sizable percentage experience mental health problem, including posttraumatic stress disorder (PTSD), major depression, and anxiety. These conditions can also increase the risk of physical health problems and, if left untreated, can result in significant declines in quality of life, job outcomes, family relationships, and overall well-being. The families of service members and veterans, especially those who are in a caregiving role for a wounded, ill, or injured veteran, also face greater risks of mental health problems. There are three main systems of care for these individuals and their families (Tanielian et al., 2014). The Military Health System (MHS), the Veterans Health Administration (VHA), and nonmilitary private and community health care providers. In recent years, these systems have responded to the growing recognition of the need to expand access and improve the quality of mental health care for service members, veterans, and their families through such solutions as collaborative care models and telemental health. Despite these efforts, challenges persist in fashioning sustainable, collaborative systems of care that address mental health issues among service members, veterans, and their families. Privately funded centers and programs have sought to fill gaps in treatment and services and expand community capacity (Tanielian et al., 2014).

References:

Ozbay, F., Johnson, D. C., Dimoulas, E., Morgan, C. A., Charney, D., & Southwick, S. (2007). Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont (Pa.: Township)), 4(5), 35–40.

Siegler, E. L., Lama, S. D., Knight, M. G., Laureano, E., & Reid, M. C. (2015). Community-Based Supports and Services for Older Adults: A Primer for Clinicians. Journal of geriatrics, 2015, 678625. https://doi.org/10.1155/2015/678625

Tanielian, T., Farris, C., Epley, C., Farmer, C. M., Robinson, E., Engel, C. C., Robbins, M., & Jaycox, L. H. (2014). Ready to serve: Community-based provider capacity to deliver culturally competent, quality mental health care to veterans and their families. Santa Monica, CA: R AND Corporation, RR-806-UNHF. Retrieved fromhttps://www.rand.org/pubs/research_reports/RR806.h…

Uchino, B. N. (2006). Social Support and Health: A Review of Physiological Processes Potentially Underlying Links to Disease Outcomes. Journal of Behavioral Medicine, 29(4), 377–387. https://doi-org.ezp.waldenulibrary.org/10.1007/s10865-006-9056-5

White, A. M., Philogene, G. S., Fine, L., & Sinha, S. (2009). Social support and self-reported health status of older adults in the United States. American journal of public health, 99(10), 1872–1878. https://doi.org/10.2105/AJPH.2008.146894