Social relations: network, support and relational strain

Abstract

We introduce a conceptual framework with social relations as the main concept and the structure and the function of social relations as subconcepts. The structure of social relations covers aspects of formal relations and social network. The function of social relations covers social support, social anchorage and relational strain. We use this conceptual framework to describe social relations in the Danish population, with questionnaire data from the Danish Longitudinal Health Behaviour Study including a random sample of each of the age groups 25-, 50-, 60- and 70-year olds, N=2,011. The postal questionnaires were answered by a random sample in each of the age groups. The results show marked age and gender differences in both the structure and the function of social relations. The social network, measured as weekly contacts, weakens with age and so does instrumental support. Emotional support is unrelated to this decline in contact frequency and appears to be at the same level for younger and older individuals. Relational strain, measured as conflicts, declines with age for all kinds of social relations. The weakening of the social network with age does not seem to affect the level of emotional support and in turn seems to be partly compensated for by a simultaneous decline in relational strain.

Introduction

Research on social relations has attracted much attention in the area of public health and social medicine. There is now documentation that people with strong social relations have a lower morbidity and mortality (Berkman and Syme, 1979; Orth-Gomér and Johnson, 1987; Hanson, 1988; House et al., 1988; Östergren, 1991; Olsen, 1993; Kawachi et al., 1996). Further, they have a better possibility of recovery or survival after illness (Ruberman et al., 1984; Waxler-Morrisson et al., 1991; Glass and Maddox, 1992; Vogt et al., 1992). Several intervention studies show that it may increase patients' recovery or survival to strengthen their social relations (Prince and Frasure-Smith, 1984; Spiegel et al., 1989; Nielsen, 1993).

Despite the enormous interest in this area of research the conceptualisation still lacks a strong consensus. The main concepts which are used are social support and social network. However, the literature includes numerous related concepts, e.g. social relations, social integration, social participation and social anchorage.

House and Kahn (in Cohen and Syme, 1985) introduced a conceptualisation, in which ``the domain of social support'' included three concepts. The first concept is social relationships. It included measures of the existence, number and frequency of social relations. Social network is seen as the structural element or the description of interactions within these social relations, including elements such as density, dispersion, duration, homogeneity and reciprocity. According to House and Kahn social support is the functional aspect of the social relationships, and is further divided into four categories: informational, instrumental, emotional and appraisal support. This conceptualisation is clear and consistent in most respects, though it may cause confusion that social support is seen both as a general concept and as the concept concerning the functional aspects.

O'Reilly (1988)introduced the use of social network as the main concept, defined as: ``An analytic concept, used to describe the structure of linkages between individuals or groups of individuals. Such networks have a variety of functions of which the provision of social support is but one. Social support is provided through the behaviours or actions of members of a network and communicated through the network's structure''. In this definition the concept `social network' has two dimensions, i.e. the structure and the function. The type of individuals in the social network and the frequency of contacts between these individuals are examples of factors which are included in the structure of the social network. The function of the social network is equivalent to the social support concept and thus covers the qualitative and behavioural aspects of the social network.

O'Reilly made an important contribution when he stated the importance of a clear conceptual definition and recommended the use of social network as the main concept. If social network is defined as ``the structure of linkages between individuals or groups of individuals'' the concept of social network will then have two characteristics: (1) the overall concept which covers both structure and function of the relations and (2) the structural component of social network, i.e. one of two key concepts, social support being the other.

One important reason to clarify and separate the concepts in this area of research is that theories and empirical findings indicate that different mechanisms are responsible for the influence of social relations on health.

We suggest social relations as the main concept, since it covers none of the other key concepts. Fig. 1 illustrates our conceptual framework.

We define the structure of social relations as: the individuals with whom one has an interpersonal relationship and the linkages between these individuals. The structure has two dimensions: the formal relations and the informal social relations, i.e. the social network. Formal relations are social relations due to ones position and roles in society. It includes professionals and acquaintances. Social network is individuals and linkages between individuals with whom one has a close family relation and/or affection. This means that friends and close colleagues are part of the social network, but also that one's parents or siblings are always a part of the social network. A dentist, teacher or lawyer belongs to the formal relations, along with acquaintances like neighbours and the parents of one's best friend. We consider terms like reciprocity, density, duration and social participation to be aspects of each of the structural concepts.

The distinction between formal relations and social network is important, as it is an interesting empirical question as to what extent formal relations can replace social network.

We define the function of social relations as the interpersonal interactions within the structure of the social relations. The function covers the qualitative and behavioural aspects of the social relations. The functional dimension of social relations includes social support, relational strain and social anchorage. Cohen and Syme (1985)define social support as the resources provided by other persons. We find this definition useful. Social support can be defined as having a negative aspect, as used by Marmot et al. (1991)in the Whitehall II study. This implies the following redefinition of the social support concept: social support is the level of resources provided by other persons.

Given this definition, social strain becomes another important dimension of the function of social relations. Most incidents of violence and sexual harassment take place among people who know each other well, mainly within families. Among older people it is found that social relations may create severe strain at some point, for example by obstructing an effort of the social- or health service system towards an elderly patient (Due, 1990). Also, the role as a caregiver within the social network can be so extensive and full of strain that the health of the caregiver is affected (Parker, 1990; Twigg et al., 1990; Due, 1993).

We argue that relational strain is different from lack of social support. We define relational strain as the extent to which functions of social relationships cause emotional or instrumental strain. Relational strain is the negative dimension of the functional aspect of social relations. We have pointed out two important aspects of relational strain: conflicts and excessive demands. The concept of relational strain may well have the same essential aspects as job strain i.e. demand and control (Karasek and Theorell, 1990). This will be an empirical question for future studies.

Antonucci and Akiyama (1987)suggest that both receiving and giving social support might enhance health and wellbeing.

The term `social anchorage' is interesting, but the importance of this concept in relation to health has not yet been widely tested. According to Hanson: ``social anchorage describes to what degree the individual belongs to and is anchored within formal and informal groups, and in a more qualitative sense his feeling of membership in these groups'' (Hanson, 1988). We believe his qualitative dimension to be an important element of the function of social relations.

The operationalisation of social network and social support in this article considers everyday network and everyday support and does not include an effort to measure social network and support during episodes of crisis. However, since we study a randomly selected population, people who have currently experienced a crisis will be represented in the study to the extent of the prevalence of crises in the population.

Several studies have shown major age and gender differences in limited areas of social relations. However, it has not been possible to find a more thorough description of the structure and the function of social relations among individuals in different age groups and among men and women. Such information is important for future studies of associations between, for example, social relations and health.

The aim of this article is to present a conceptual framework for social relations and social support and to provide descriptive population-based survey data for the structure and function of social relations for men and women in key life transition periods.