Seeman 1996 - "Social ties and health: the benefits of social integration"

"Social ties and health: the benefits of social integration"
Annals of Epidemiology
September 1996; v6, n5; pp 442-451
On the Web
Relevance: Medium-high

An overview of major findings on social ties and health published since the mid-1970s. The upshot is that "social integration does appear to have a highly beneficial effect on post-myocardial infarction prognosis (functioning and longevity)." That is, while social ties do not affect the incidence of heart disease, they do affect recovery from it. Following, I limn the major findings recapitulated by Seeman.

Coronary heart disease (CHD) incidence. "The evidence regarding a possible link between social integration and CHD incidence is not extensive and the evidence is mixed." A Swedish study and a study of HMO members seemed to find a protective function to social integration. However, other studies, such as a Japanese-American study in Hawaii, found no relationship. And one study of Israeli men found that social integration actually increased the risk of angina. Also, the protective effects tend to accrue to very close social ties, such as having a spouse or living alone.

Disease severity. "...structural features of social integration (as indexed by social ties with others) do not appear to be associated with disease severity..." One study of 161 angiography patients found no association between social integration and the extent of coronary atherosclerosis. But there was some positive effect from "instrumental" and "emotional" support (I'm not actually clear about how this all adds up).

Recovery from heart attacks and strokes. Recovery and survival rates are markedly better for those with social ties. Unfortunately for our research project, "no social ties" here means "not married" or "no close confidant," features that are not likely affected by sprawl. 

Mental health. Again, there is a strong connection between social integration and mental health. But, again, the protective affects of social integration are from "intimate ties with spouse, children, and/or supportive significant others," relationships that are not affected by sprawl.

Other physiological effects. Better immune system functioning is related to marital status (and marital attachment). Further, those with high levels of support from close friends and family have lower heart rates and blood pressure, lower cholesterol, and better immune systems. But again, these sorts of close first-order social ties do not appear to be affected by sprawl. Also, these affects appear to only occur in men, not women. The author even postulates that women may be psychologically vulnerable to negative social interactions, which ameliorates the physiological benefits that attach to social ties.


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