AJPH First Look, published online ahead of print Jun 29, 2006
August 2006, Vol 96, No. 8 | American Journal of Public Health 1341
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2006.093633
Social Ties and Health
Jennifer A. Ellis, PhD, Technical Deputy Editor
This issue of the Journal focuses on the myriad ways in which social ties affect public health. As Durkheim first posited in the late 19th century, attention to the role of social ties and other social factors can illuminate key issues in understanding health disparities at both the individual and population levels (Durkheim E. Suicide. New York, NY: Free Press; 1951 [originally published 1897]). More than a century later, Durkheim’s connection of social facts to suicide-related mortality rates has provided researchers across disciplines with a foundation for a better understanding of the connections between social factors and health.
Apt examples are provided here of the sophisticated theoretical and analytic approaches now used by public health researchers. The articles in this issue present important evidence about the implications of social ties—and the lack thereof—in a variety of contexts. Beyond increasing our understanding of how social ties operate, these findings give us pause to consider whether or not interventions to strengthen them ought to be designed and carried out.
Traditionally, stronger social ties have been equated with better health. For instance, Pattussi et al. (p1462) conducted a multilevel study to assess the effects of individual and neighborhood characteristics on dental injuries among adolescents in Distrito Federal, Brazil. They found that the prevalence of dental injuries was significantly lower in neighborhoods with higher social capital, especially for boys. Viswanath et al. (p1456) focused on the roles of community integration (social capital) and community pluralism (size) on the recall of health information messages. They found that community ties made an independent contribution to message recall, while the moderating role of pluralism was not significant, although the direction of the effect was intriguing.
Social ties are also at play in disasters. Brodie et al. (p1402) conducted a random survey of evacuees living in Houston-area shelters as a result of Hurricane Katrina in September 2005. Of those who stayed in New Orleans after the order to evacuate the city, more than a third (34%) said the lack of a car or other way to leave was their main reason for not evacuating. More than 1 in 10 (12%), however, said the main reason they stayed behind was that they were physically unable to leave or that they had to care for someone who was physically unable to leave. Thus, social ties may place some people in harm’s way during disasters owing to their concern for others.
Yet social ties may also assist in recovery from disasters. Becker (p1397) used a train-the-trainer model to equip 1050 community-level workers with psychosocial care skills at the disaster sites of Nagappattinem and Cuddalore, India, after the December 2004 tsunami. Emotional support was embedded into relief and rehabilitation efforts by trainees who were able to relate to the survivors in the context of their own language and cultural traditions.
As the articles in this issue make clear, public health researchers are continuing to extend Durkheim’s exploration of the effect of social factors on individual and population health. Logistical and ethical dilemmas have complicated the testing of psychosocial interventions in large-scale disasters; thus their effectiveness above and beyond material support is still unclear. Yet the importance of social ties to the health and welfare of populations worldwide is no longer in doubt.
Footnotes
Peer Reviewed
Copyright © 2006 by the American Public Health Association
