10.6.1. Social
networks and social environment
10.6.1.1.
Introduction
Social network refers to a set of relationships between
individuals. Social networks represent both a collection of ties between people
and the strength of those ties. Social networks, i.e. social connectedness,
make an important contribution to health, by providing people with emotional
and practical support. Gender, personality and educational level have been
found to be linked to one’s individual social networks. Females tend to have
stronger social networks, receiving more positive feedback, yet they also give
more social support and are more concerned about the people they help compared
to men (Kessler et al., 1985).
The significance of social networks and support to
positive mental health is well acknowledged (Ganster and Victor, 1988). Poor,
low quality social networks are associated with less well-being and poor
physical and mental health. A classic longitudinal study from the North Carelia
region in Finland shows that individuals with poor social networks have
increased rates of premature death and poorer chances of survival after a heart
attack, even when adjusting for known risk factors (Kaplan et al., 1988). The
quality of close relations is important: Individuals experiencing negative
aspects of close relationships were found to have an increased risk of coronary
heart disease (De Vogli et al., 2007). A longitudinal study on the predictors
of parental stress in mothers and fathers of toddlers showed an association
between poor social support and parental stress (Saisto et al., 2008).
Social network is measured by size and quality, existence
and number of intimate support network, composition of the network, the
existence of a spouse, friends, relatives or belonging to associations and
organisations, and the frequency of the contacts. The Scope of network scales
evaluates links with family members outside the household, friends and
neighbours in terms of number and frequency of contacts, for example the
average number of contacts with network members over the last 12 months.
Another dimension that can be measured is social involvement, for example the
frequency of participation in organisations or groups.
The 3-item Oslo social support scale (OSS-3) has been used
to quantify psychological help available in case of crisis or problem (Nosikov
and Gudex, 2003). These three questions cover help from neighbours, how many
people the respondent can count on in case of serious problems and perceived
concern by other people. Possible score range from 3 to 14. Scores 3-8 are
considered to reflect poor social support, scores 9-11 moderate social support
and scores 12-14 strong social support.
Despite some successes reported in social support
interventions made to enhance health, further work is needed to deepen our understanding
of the design, timing and dose of interventions that work, as well as the
characteristics of individuals who benefit the most.
10.6.1.2. Data sources
10.6.1.2.1 The
Mental health indicator pilot study
This pilot study, performed in 2001 (Korkeila et al.,
2003), measured social network in four EU Member States (Finland, France,
Germany, Greece) and Norway. Social support was measured using the OSS-3, and
social isolation was measured by a four-item instrument developed by Statistics
Canda (Beaudet, 1996).
10.6.1.2.2 The
Eurobarometer 58.2 Survey
In 2002, the general population (aged 15 or over)
Eurobarometer 58.2 was conducted in EU15 and candidate countries. The survey
included a revised version of the OSS-3 measure of social support. The basic
sampling design applied in all Member States was a multi-stage, random
(probability) sampling method. The net sample sizes were about 1000 per
country/region, except Luxembourg (about 600) and Northern Ireland (about 300).
Response rates varied from 23% (Great Britain) to 84% (France). In 8 of the
countries/regions the response rate was less than 50%.
10.6.1.2.3. The
SHARE survey
The Survey of Health, Ageing and Retirement (SHARE) of people
aged 50 or over, includes social support variables, e.g. social networks and
volunteer activities (Börsch-Supan et al., 2005). The first wave of
SHARE was implemented in 2004 in 11 EU Member States and 14 EU countries
participated in the second data collection wave in 2006-7.
10.6.2.4 The HBSC
study
The Health Behaviour in School-Aged Children (HBSC) study
has been performed since 1982 at four-year intervals among 11, 13 and 15 year
old school children. The study includes measures of social network (size of
friendship groups, frequency of contacts with friends, and peer support in
school). The HBSC survey covers all EU27 and candidate countries.
10.6.2.5 The
World Values Survey
The World Values Survey, which has been performed in 1990,
1995, 2000 and 2005, has collected data on level of belonging to voluntary
organisations in most European countries.
10.6.1.3. Data
description and analysis
Data on social support in the adult population could be
gathered from the Eurobarometer 58.2 (performed in 2002) only, the
results of which are presented per social support categories.
Table
10.6.1. Social support by
country 2002: % by category
In EU 15, almost 22% of the citizens reported strong
social support, while more than 19% reported poor social support. There was a
major variation between countries, perhaps reflecting the highly varying
response rates between countries. People in some countries such as Ireland,
Spain, Denmark, the Netherlands and Sweden declared low levels of poor social
support; people in other countries such as Belgium, France and Italy reported
high rates of poor social support: 36% in Italy, 30% in France and 28% in
Belgium.
Figure
10.6.1. Frequency of contact
to the most contacted child
The SHARE study showed that the families remain close in
respect to the frequency of contact between parents over the age of 50 and
their children. When considering all age groups, daily contact took place
between the parent and most contacted child in 41-86% of the cases in the
EU-countries, being higher in the Mediterranean countries (Italy, Spain,
Greece) and lower in Scandinavian countries (Denmark and Sweden). In all EU-countries,
the contact was at least several times a week in at least 75% of the cases.
Absent contact was rare in all the participating countries, applying to 1% or
less of cases (Kohb et al., 2005).
The HBSC study offers some valuable data on social networks
of school children. These include school children’s experienced quality of
communication with their parents. Ease of communication with parents is
considered to be an indicator of social support from parents and family
connectedness (Currie et al., 2008).
In general, perceived easiness in communication with
parents decreases with age for both girls and boys. In general, young people of
all age groups and both sexes regard communication with their mother easier
than with their father. Of the current EU countries, the least easy
communication with the mother is reported from the French-speaking area of
Belgium in all age groups between 11 and 15 years and from France in the 15
year old group. 77% of 11 year old girls, 65% of 13 year old girls and 61% of 15
year old girls in the Walloon region report easy communication with their
mother. In contrast, in Greece, 96% of 11 year old girls, in Slovenia and the
Netherlands, 92% of 13 year old girls, and in Slovenia, 88% of 15 year old
girls report easy communication. Also for the boys, the lowest proportion
reporting easy communication was found in Wallonia, together with Luxembourg.
76% of 11 year old boys, 74% of 13 year old boys, and 69% of 15 year old boys
in Wallonia report easy communication (Currie et al., 2008).
Figure
10.6.2. 15-year old girls
in the EU having three or more close friends of the same gender
Figure
10.6.3. 15-year old boys in
the EU having three or more close friends of the same gender
Friendships offer acceptance and group belonging and
assist in developing other relationships later on. European adolescents have
three or more close friends of the same gender in more than 50% of cases, the
proportion dropping slightly with age. In general, more close friends were
reported in North and West Europe compared to South Europe and East Europe for
girls. Boys are more likely to have three or more close friends of the same
gender than girls (Currie et al., 2008).
Figure
10.6.4. Use of electronic
media contact by 15-year-olds in the EU
The HBSC study shows the importance of new media in
relationships. The use of electronic media, mobile telephones and internet for
contact with peers was common and increasing with age, and more common in all
age groups among girls than among boys. Of the EU countries, Lithuanian school
children made a more often use of electronic media for daily contact (59%of the
11 year old girls and 44% of boys, 78% of the 13 year old girls and 56% of
boys). The same proportion of boys using electronic media contact daily was
reported in Denmark (of the 15-year old Danish school girls accounted for 83%
and boys for 70%). Least electronic media contact was used by Hungarian school
children. Among 11 year old Hungarian girls only 13% had used electronic
contacts, among 13 year old Hungarian girls 27% and among 15 year old Hungarian
girls only 33%. (Currie et al., 2008).
To conclude, relatively few data are available from EU on
social networks, an important health determinant. Given the importance of
social networks for health, data need to be collected systematically and at
regular intervals using a common methodology in order to monitor how these
health determinants differ between countries and develop over time.
Safety perception
The perception of safety is naturally related to the crime
rates and the risk for victimization (Van Dijk et al, 2005).
Figure 10.6.5. Exposures to assaults
and threats
and their
time-trends in selected EU countries
However, looking at the subjective perception of safety,
it is especially the occurrence of physical or environmental cues in the
residential environment that leads to insecurity and feelings of not being
safe. Such cues can e.g. be physical incivilities such as deterioration of
neighbourhoods, trash or graffiti (indicating a low community spirit and, in
effect, a low social control), and social incivilities such as conspicuous
youth groups or people with a strange behaviour (questioning the degree to
which social norms and customs may be kept) (Austin et al, 2002).
Overall, people are more likely to maximize the use of
outdoor space if the area is perceived as safe (Shenassa et al, 2006). Street
lighting, police patrols and adequate environmental and building design
improvements show crime reduction effects and increase the confidence of
residents at night-time (Carter et al, 2003).
10.6.1.4. Control
tools and policies
Social networks play an important role in determining
mental health and well-being, but also have a strong influence on general
health. Social cohesion -defined as the quality of social networks and the
existence of trust, mutual obligations and respect in the society -protects
health.
The renewed EU Sustainable Development
Strategy, adopted by the Council in 2006, stresses the need to promote a
democratic, socially inclusive, cohesive, healthy, safe and just society with
respect for fundamental rights and cultural diversity. This creates equal
opportunities and combats discrimination in all its forms. Actions to promote
social inclusion in Europe have already been envisaged. Moreover, the
implementation of the social inclusion strategy will support social networks
among EU citizens.
10.6.1.5. Future
developments
Social networks protect physical and mental health. Their
importance has often been underestimated and neglected in epidemiological
research and health policy making. Social networks and connectedness should be
included in health surveys and epidemiological data analysis, so that their
influence will be understood better and used for a better targeting of
detection, health promotion, prevention and treatment measures.
10.6.1.6.
References
Austin DM, et al (2002): The effects of neighborhood
conditions on perceptions of safety. In: Journal of Criminal Justice 30:
417-427.
Beaudet M (1996). Depression. Health Rep
7:11-22.
Börsch-Supan A, Jürges H. (2005). The Survey of Health, Aging, and Retirement
in Europe – Methodology. Mannheim: Mannheim Research Institute for the
Economics of Aging (MEA), 2005. Available at http://www.share-project.org/new_sites/Documentation/TheSurvey.pdf
Carter SP, et al, (2003): Zoning out crime and
improving community health in Sarasota, Florida: “crime prevention through
environmental design”. In: American Journal of Public Health 93(9): 1442-1445.
Currie C, Gabhainn S, Godeau E, Roberts C, Smith R,
Currie D, Picket W, Richter M, Morgan A, Barnekow V (Eds.). HBSC international report from the 2005/2006 Survey. Copenhagen, WHO Regional Office for Europe, 2008
(Health Policy for Children and Adolescents, No. 5). Available also online at:
http://www.euro.who.int/eprise/main/WHO/InformationSources/Publications/Catalogue/20080617_1.
De Vogli R, Chandola T, Marmot MG (2007). Negative aspects of close relations and
heart disease. Arch Intern Med 167(18):1951-7.
Ganster DC, Victor B (1998). The impact of social
support on mental health and physical health. Br J Med Psychol
61(1):17-36.
Kaplan GA, Salonen JT, Cohen RD, Brand RJ, Syme SL,
Puska P (1988). Social connections and mortality from all causes and from
cardiovascular disease: prospective evidence from Eastern Finland. Am J
Epidemiol 128(2):370-80.
Kessler R, McLeod J, Wethington E. The cost of caring:
a perspective on the relationship between sex and psychological distress. In:
Social support: Theory, research and applications. Editors Sarason et Sarason.
Martinus Nijhoff Publishers, the Netherlands, 1985.
Kohb M, Künemund H, Lüdicke J. (2005): Family
Structure, Proximity and Contact. In: Health, Ageing and Retirement in Europe -
First Results from SHARE. Edited by Axel Börsch-Supan, Agar Brugiavini, Hendrik
Jürges, Johan Mackenbach, Johannes Siegrist, and Guglielmo Weber, Mannheim:
MEA, 2005. Available at: http://www.share-project.org/t3/share/index.php?id=69
Nosikov & Gudex (eds.). EUROHIS: Developing Common
Instruments for Health Surveys. IOS Press, WHO, 2003.
Saisto
T, Salmela-Aro
K, Nurmi
JE, Halmesmäki
E (2008). Longitudinal
study on the predictors of parental stress in mothers and fathers of toddlers. J
Psychosom Obstet Gynaecol. Mar 29:1-10. [Epub ahead of print]
Shenassa, E., Liebhaber, A., Ezeamama, A. (2006): Perceived Safety of
Area of Residence and Exercise: A Pan-European Study. In: The American Journal
of Epidemiology
2006;163:1012–1017
Van Dijk J, Manchin R, Van Kesteren J, Hideg G, Nevala S (2005): The
burden of crime in the EU. A comparative analysis of the European Survey of
Crime and Safety (EU ICS) 2005.
Available
at: (http://www.unicri.it/wwd/analysis/icvs/pdf_files/EUICS%20%20The%20Burden%20of%20Crime%20in%20the%20EU.pdf)
10.6.1.7.
Acronyms
