Applications of social support theory to health education: implications for work with the elderly

The large body of evidence linking social support and health provides an important supplement to earlier theory and research suggesting the more direct role social contacts may play in influencing health behavior. Three major hypotheses have been set forth concerning the precise mechanism of action through which social support may work to maintain health and decrease susceptibility to illness. Each of these theoretical positions is described and its empirical base examined. The particular relevance of social support theory for work with the elderly is discussed. The concept of social marginality, and such network properties as strength of ties, reciprocity and network size are examined in light of their implications for the design of programs aimed in part at fostering social support among the elderly. Several examples of innovative health education programs are used to illustrate the relevance of different theoretical principles in practice settings. Attention finally is focused on the need for looking beyond social networks to the social policy and environmental contexts within which they operate. Facilitating change in those social and institutional policies which mitigate against network development and maintenance among the elderly is suggested as an important task for health education theorists and practitioners.