Structures and Processes of Social Support

This chapter reviews the recent literature on social support and health and its relation to preexisting research and theory in the areas of social networks and social integration. We identify crucial directions for future theoretical and empirical work, focusing on the need to better understand the structures and processes through which social relationships affect human health and well-being. Two elements of social relationship structure are distinguished: (a) social integration, which refers to the existence or quantity of social relationships, and (b) social network structure, referring to the structural properties that characterize a set of relationships. We further identify three social processes through which these structures may have their effects: (i) social support, which pertains to the emotionally or instrumentally sustaining quality of social relationships; (ii) relational demands and conflict, referring to the negative or conflictive aspects of social relationships; and (iii) social regulation or control, referring to the controlling or regulating quality of social relationships. We also consider the social (as well as psychological and biological) determinants of levels and consequences of relationship structures and processes. In conclusion, we discuss the relevance of research and theory on social relationships and health to current demographic trends and public policy concerns.