Social cohesion, social support, and health among Latinos in the United States
Introduction
An extensive literature supports a relationship between community level social connection (e.g., social cohesion) and health, both in terms of its relationship to mortality at the community level (Lochner, Kawachi, Brennan, & Buka, 2003) and to self-rated health on an individual level (Browning & Cagney, 2002). Common indicators of community-level connection include participation in civic activities and willingness to help neighbors (Macinko & Starfield, 2001). A wide social epidemiology literature (Kawachi & Berkman, 2000) similarly examines the healthful effects of qualitative social support from social networks, including friends and family. However, there is little empirical work comparing different types of social connections to health, particularly how individual and community level supports differentially affect health (Wen, Cagney, & Christakis, 2005).
A related area of interest explores how mechanisms of social connection operate in relationship to physical and mental health for United States residents from Latino cultures. Individual level social support factors have been cited as mediating variables for both better health (Finch & Vega, 2003) and mental health (Galea et al., 2004) for low-income, immigrant Latinos. Recent critiques have identified conceptual concerns with the ways that the relationships between health and social factors for Latinos are defined and analyzed, particularly how measures of acculturation are applied in these analyses (Hunt, Schneider, & Comer, 2004). These authors note that acculturation measures vary widely across studies and the role of sociodemographic factors such as language and education in facilitating access to structural health benefits (e.g., health information) and positive health outcomes is not adequately explored (Borrayo & Jenkins, 2003).
The focus of this paper is to examine relationships between three domains of social connection and self-rated physical and mental health in a sample of Latinos across three domains of social connection, considering the role of socioeconomic status (SES) and language in facilitating these connections. At the individual level, we look at two domains: family connections (both family support and family conflict) and friend support. At the community level, we look at neighborhood social cohesion. We include measures of education, income and Spanish language proficiency and language used when thinking in our analyses to strengthen our understanding of these mechanisms in the context of social connection.
Section snippets
Physical and mental health for Latinos
Overall, Latinos have lower mortality rates compared to other ethnic groups with the same socioeconomic status (SES) (Abraido-Lanza, Chao, & Florez, 2005; Franzini, Ribble, & Keddie, 2001). However, for many specific disorders, low education and income have inverse relationships with health among Latinos (Hunninghake, Weiss, & Celedon, 2006; Reynolds, 2004). In mental health, no consistent patterns have been identified. Lower-income immigrant Latinos have been found to be at lower risk for
Description of the sample
The data set for this analysis is from the National Latino and Asian American Study (NLAAS), a nationally representative household survey of Latinos and Asians based on a stratified area probability sample design (Alegría et al., 2004; Heeringa et al., 2004). Data collection was conducted by the University of Michigan's Institute for Social Research (ISR) between May 2002 and November 2003. The analytic sample consists of 2554 Latinos from four distinct subgroups: 577 Cuban; 495 Puerto Rican;
Descriptive results
The weighted sample population included almost equal numbers of males and females with about half younger than 35 years of age (Table 1). A quarter of the population had less than 9 years of education, with only 10% reporting a college degree or more. The population was also predominantly low to middle income with 56% making less than $35,000 per year. The majority were foreign born (59%), with 57% identifying their ethnicity as Mexican. Over half (54%) of the weighted sample interviewed in
Discussion
Although all social connection scales have a significant relationship with self-rated physical and mental health in bivariate relationships (Table 2), we find no support for our hypothesis that neighborhood social cohesion has an association with self-rated physical and mental health, independent of the other types of social connection, after accounting for sociodemographic characteristics. It appears that for both self-rated physical and mental health, the healthful effects of social
Conclusion
Language and other sociodemographic factors are strongly associated with how Latinos establish social linkages. The fact that neighborhood social cohesion did not play a role in facilitating physical or mental health could be due to the individual level measurement of this variable. More objective measures of social cohesion might find a unique community level effect for self-rated physical and mental health. However, our results are consistent with another recent study that included objective
Acknowledgements
The NLAAS data used in this analysis were provided by the Center for Multicultural Mental Health Research at the Cambridge Health Alliance. The project was supported by NIH Research Grant #U01 MH62209 funded by the National Institute of Mental Health and SAMHSA/CMHS and OBSSR. We would like to thank four anonymous reviewers for very helpful comments. We also thank Antonio Polo for helpful comments in the interpretation of the analysis, and Vanessa Oddo for her assistance with manuscript
References (73)
- et al.
Do healthy behaviors decline with great acculturation?: Implications for the Latino mortality paradox
Social Science & Medicine
(2005) - et al.
Explaining variation in health status across space and time: Implications for racial and ethnic disparities in self-rated health
Social Science & Medicine
(2003) - et al.
When being alone might be better: Neighborhood poverty, social capital, and child mental health
Social Science & Medicine
(2003) - et al.
Socioeconomic, cultural, and personal influences on health outcomes in low income Mexican-origin individuals in Texas
Social Science & Medicine
(2004) - et al.
Hispanic ethnicity and post-traumatic stress disorder after a disaster: Evidence from a general population survey after September 11, 2001
Annals of Epidemiology
(2004) - et al.
Mental health and social capital in Cali, Colombia
Social Science & Medicine
(2004) - et al.
Should “acculturation” be a variable in health research? A critical review of research on US Hispanics
Social Science & Medicine
(2004) - et al.
Social capital and neighborhood mortality rates in Chicago
Social Science & Medicine
(2003) Positive pregnancy outcomes in Mexican Immigrants: What can we learn?
Journal of Obstetric, Gynecologic, and Neonatal Nursing
(2004)- et al.
Family, friend or foe? Critical reflections on the relevance and role of social capital in health promotion and community development
Social Science & Medicine
(2005)