Social Support System - Park's Textbook of Preventive and Social Medicine

Definition and Context

1. Social Support as a Buffer Against Stress

"The experience of stress, particularly in the absence of a social support system, or when there is a discrepancy between the actual and perceived demands of a stressful situation, may contribute to further disorders. Psychological stress and inadequate coping ability has been implicated as a contributory factor in virtually all diseases. In particular, there are direct links between stress and hypertension and coronary heart disease."

• Social support acts as a buffer - it protects individuals from the harmful effects of stress.
• In transitional societies, migration from rural to urban areas leads to a diminution of the traditional family support system, which is itself a major source of social stress.
• Other stress-inducing societal changes include: exposure to culturally alien ideas through mass media, technological skill mismatches, and unrealistic economic aspirations encouraged by commercial interests.
• The absence of social support magnifies these stressors, especially among young people with little control over their destinies.

2. Social Support in Disease Control (Leprosy as a Model)

1. Medical measures
2. Social support
3. Programme management
4. Evaluation

"Chemotherapy alone is not likely to solve the whole problem of leprosy. The economic and social problems of the patient and his family should be identified and met. This may include social assistance and social support. This may take various forms depending upon the local situation, e.g., assistance to the patient to travel to and from the clinic; help to the needy families in terms of foodgrains, clothes, care of children and their education, and job placement; programmes such as slum improvement, etc. Such care should be provided through voluntary agencies and Departments of Social Welfare."

• Travel assistance to and from the clinic
• Food and material assistance (foodgrains, clothes)
• Child care and educational support for affected families
• Vocational support (job placement)
• Community improvement programs (slum improvement)
• Delivery mechanism: voluntary agencies + Departments of Social Welfare

3. Social Support as a Mode of Intervention

"Any attempt to intervene or interrupt the usual sequence in the development of disease in man. This may be by the provision of treatment, education, help or social support."

1. Health promotion
2. Specific protection
3. Early diagnosis and treatment
4. Disability limitation
5. Rehabilitation

4. Social Support and Child Health

"Other factors affecting the health status of children include community and social support measures, ranging from creches and day care facilities to organized health care systems."

• Creches (formal childcare)
• Day care facilities
• Organized health care systems
• Community-level safety nets

5. Social Support in Community-Based Rehabilitation (CBR)

"A strategy within general community development for the rehabilitation, equalization of opportunities and social inclusion of all people with disabilities. CBR is implemented through the combined efforts of the people with disabilities themselves, their families, organizations and communities, and the relevant governmental and non-governmental health, education, vocational, social and other services."

6. Social Support in Disaster/Mental Health Coping

• Seeking psychosocial support from peers and community health workers
• Consulting counselors and mental health support services
• Participating in group sessions (Yoga, meditation)
• Engaging qualified professionals for recovery and rehabilitation

Summary Table

Key Public Health Significance

1. Social causation - absence of social support is an independent risk factor for disease, particularly cardiovascular and mental disorders.
2. Social gradient - those with weaker support networks (the poor, migrants, isolated elderly) carry greater disease burden.
3. Health equity - strengthening social support is one of the most cost-effective public health interventions.
4. Traditional vs modern societies - urbanization erodes traditional family support structures, creating a new public health challenge in transitional societies like India.