Reciprocal Effects of Health and Social Support in Older Adults' Relationships With Children and Friends

Objectives. Although numerous studies have found a positive relationship between social support and health, little research has examined simultaneously multiple reciprocal causal pathways between health and social support using longitudinal data. This study examined: (1) the longitudinal reciprocal effects between health and older adults’ perceived support from children and friends and (2) the extent to which the effects of health on social relationships differ by the types (frequency of contact, positive interactions, and negative interaction) and the sources of support (children vs. friends).

Methods. Analyses were based on data from the 2006 and 2010 waves of the Health and Retirement Study. In order to examine how health (or social support) at an earlier time point (2006, T1) affect support from children and friends (or health) at a later time point (2010, T2), controlling for the outcomes at T1, we used an analytic sample of 3,760 older adults who are aged 60 and older and participated in the 2006 and 2010 core and the Leave-Behind Questionnaire on psycho-social indicators. we performed six sets of simultaneous Structural Equation Models depending on the types (i.e., frequencies of contact, positive social interactions, and negative social interactions) and the sources (i.e., from children and friends) of social support.

Results. When the bidirectional effects between health and social support were examined simultaneously, the effect of social support at T1 on health at T2 was not significant. In contrast, poor health at T1 was associated with decreased contact and positive interactions with friends as well as increased negative interactions with children and friends at T2. Poor health at T1 did not significantly influence the level of contact and positive interactions with children at T2.

Discussion. The findings call for a modification of our long-time assumption that social support is a stable resource that we can resort to in times of need. Instead, social relationships may be a resource in flux. It is impacted by outside stressors such as health problems, and the negative effects of poor health are greater for friendships than for parent-child relations. Thus, policies or social service programs for older adults should not only focus on mobilizing support from available social ties but also identify ways to maintain the support in times of health deterioration. Further, in order to benefit from social support during the phase of health decline, one may need to invest in social relationships when one is healthy.