Are the salutogenic effects of social supports modified by income? A test of an “added value hypothesis”. Health Psychol, 20, 155-165

Duke University, Durham, North Carolina, United States
Health Psychology (Impact Factor: 3.59). 05/2001; 20(3):155-65. DOI: 10.1037/0278-6133.20.3.155
Source: PubMed


Older adults (54 men, 113 women; M age = 69.5 years) were examined to test the hypothesis that social supports would be more salutogenic (health promoting) for persons with lower incomes than for persons with higher incomes. Interactions of income and social supports (mean of 3 emotional scales of the Interpersonal Support Evaluation List) at study entry predicted changes 15-18 months later in a cardiovascular composite (linear combination of high-density lipoproteins-mean arterial pressure; p < .05), and natural killer cell activity (p < .05). For both outcomes, emotional supports were salutogenic for persons with lower incomes (< or =$29,000/year), but not for persons with higher incomes (>$29,000/year). In contrast, interactions of the Tangible Support Scale with income did not occur. Persons with lower incomes may derive benefits from social supports that go beyond tangible assistance.

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Available from: Peter P Vitaliano
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    • "Longitudinal studies reveal that among low SES adults, high levels of emotional support from social relationships predict decreases in cardiovascular risk and inflammatory activity over an 18 month period. These relationships were specific to low SES individuals, and not evident among those high in SES (Vitaliano et al., 2001). Similarly, among older adults, greater negative interactions in social relationships were associated with a greater risk of heart disease only among low SES, but not high SES, individuals (Krause, 2005). "
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    ABSTRACT: Some individuals, despite facing recurrent, severe adversities in life such as low socioeconomic status (SES), are nonetheless able to maintain good physical health. This article explores why these individuals deviate from the expected association of low SES with poor health, and outlines a "shift-and-persist" model to explain the psychobiological mechanisms involved. This model proposes that in the midst of adversity, some children find role models who teach them to trust others, better regulate their emotions, and focus on their futures. Over a lifetime, these low SES children develop an approach to life that prioritizes shifting oneself (accepting stress for what it is and adapting the self to it) in combination with persisting (enduring life with strength by holding on to meaning and optimism). This combination of shift-and-persist strategies mitigates sympathetic-nervous-system and hypothalamic-pituitary-adrenocortical responses to the barrage of stressors that low SES individuals confront. This tendency vectors individuals off the trajectory to chronic disease by forestalling pathogenic sequelae of stress reactivity, like insulin resistance, high blood pressure, and systemic inflammation. We outline evidence for the model, and argue that efforts to identify resilience-promoting processes are important in this economic climate, given limited resources for improving the financial circumstances of disadvantaged individuals.
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    • "Other SES studies have produced different results. For example, one study found that those with lower incomes actually benefited more from support than those with higher incomes (as indexed by high-density lipoproteins and natural killer cell activity) (Vitaliano et al., 2001). However, half of that sample consisted of spousal caregivers whose caregiving duties likely made them more vulnerable to changes in both their income and social network. "
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    ABSTRACT: Both higher socioeconomic status (SES) and supportive personal relationships confer health benefits, including better immune function. This study assessed the joint impact of SES and social support on the expression of a latent herpesvirus, Epstein-Barr virus (EBV), in a group of highly stressed women. Two-hundred and twenty four women either awaiting further evaluation following an abnormal mammogram or newly diagnosed with breast cancer completed questionnaires and provided blood samples to assess EBV viral capsid antigen (VCA) IgG antibody titers. More highly educated women with more support from friends had lower EBV VCA antibody titers, reflecting a stronger cellular immune response to the latent virus; however, among less educated women, friend support was not associated with EBV antibody titers. As revealed in an ancillary analysis, more highly educated women with more friend support had lower systolic blood pressure (SBP); however, friend support was not associated with SBP among less educated women. Neither depression nor perceived stress mediated these associations. Neither cancer status nor cancer stage among those diagnosed with cancer was significantly related to these outcomes. Lower SES women may not reap the same immunological benefits from friend support when experiencing a stressful life event as their higher SES counterparts.
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    • "This supports earlier evidence that support may be especially important as a buffer for low-resource persons and communities [31]. From a policy perspective, this adds to the evidence that social ties exist even in the most disadvantaged urban communities, and are important resources to reinforce through programs and policies. "
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