Sex and Gender-based Analysis of this topic
Definition
Social support refers to an individual’s feeling of belonging to a social network of friends, family, and/or community that one can turn to for advice and assistance in times of need. The various types of social support include: (1) emotional support (liking, love, empathy); (2) instrumental support (time, money, assistance in-kind); (3) informational support (providing advice, guidance); and (4) appraisal (affirmation, social feedback) [1]. Health Canada identifies social support as a determinant of health [2]. In Canada, social support has been largely measured via the Canadian Community Health Survey (CCHS). Social support levels are classified as low, medium, or high based on responses from the CCHS. The social support rate for each level of support is expressed as a percentage of persons receiving low, medium, or high support out of the total number of people surveyed [3]. Canadian women report higher levels of social support (87%) than men (80%) [4] and women generally report wider social support networks [5].
Sex Issues
Women’s social support is linked to: improved mental health and recovery from illness; increased preventative activities, such as screening; the promotion of health behaviours, such as physical activity, healthy eating; and the reduction mortality rates [5-6]. For example, a number of studies have shown higher uptake of cancer screening by women with strong social networks compared to women with weak social networks [7-8]. Social support can also enforce positive health behaviours such as maintenance of smoking cessation and breast self-examination [9-11]. Social support also appears to improve patient recovery from serious illnesses, such as cardiovascular disease and stroke [9, 12]. Participation in social events often encourages an active lifestyle and may act as a buffer against stress and illness [13].
Since women have longer life expectancies than men, many women outlive their husbands, thus losing marital social support. However, a number of studies suggest that elderly women experience less health benefits from marital social support compared to elderly men [14-16]. A Canadian study in 1994/95 found that social support from marriage/co-habitation led to a 40% lower risk of death among elderly men, but not among women [17-18]. This may be due to the fact that male partners rely on their female partners as a source of social support, whereas women generally have a wider social network outside of the home [19-20]. Research suggests that social support in women increases after the death of a partner, as they seek to expand their network further when widowed [18].
Gender Issues
Women traditionally occupy the role of the caregiver, which connects women to their families and communities and thus, increases their social network. However, women are often the primary social support for their families, including elderly family members [21]. Though paid and unpaid care-giving work can be rewarding, it is often undervalued, poorly paid and can have negative impacts on social well-being and increase stress levels [22-23].
Diversity
Social support in Canadian women generally decreases with increased age; the greatest proportion of those reporting high levels of social support (95%) are aged 20-24 and the lowest (74%) were aged 75 and over [4]. Levels of social support vary across Canada. In the Maritime provinces, 89% of women report high levels of social support, compared to in the territories, such as Nunavut where only 68% of women report high levels of social support [4].
New immigrants may experience low levels of socials support, particularly those who are far from family or in foreign environments where language and culture pose barriers to social participation [21]. Women who work as nannies may experience low levels of social support, since many are separated from their partner and families for extended periods of time. In addition to family and friends, common sources of social support for new immigrants include social service organizations, community centres, and churches, as well as other immigrants who have lived in Canada for some time and can share their knowledge of Canadian culture, customs, and language [24]. Social support has been documented as a key dimension of Aboriginal health [25], yet patterns of morbidity and mortality, such as violence and suicide and discrimination, indicate that access to social support may be limited [26-28].
Critique
Several surveys measure social support in Canada using differing definitions. Due to varying definitions, caution should be taken when comparing data collected by the different surveys. The scope of Canadian social support data available is limited, focusing largely on social support in seniors. Data on subgroup populations, such as Aboriginal populations or non-heterosexual populations, are often unavailable or limited, which can mask social support trends in these populations. A comprehensive data collection on social support, including a breakdown into different types of social support, is needed to improve our understanding of the effect of social support on women’s health.