Social Support, Volunteering and Health Around the World: Cross-National Evidence From 139 Countries

Kumar, S., Calvo, R., Avendano, M., Sivaramakrishnan, K., & Berkman, L. F. (2012). Social support, volunteering and health around the world: cross-national evidence from 139 countries. Social Science & Medicine, 74(5), 696-706.

Personal health was associated with social support, which included relationships with family and friends as well as volunteer opportunities.

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Sample

  • N: 438,381 from the Gallup World Poll, which began in 2005 and collected data annually from representative samples in 154 countries, representing 95% of the world’s adult population. From 2005 to 2009, the survey sampled around 1,000 individuals from each country, though samples differed depending on population size in each country. Not all countries were sampled each year, and until 2008, only 78 countries were sampled in all three waves. In contrast to previous international surveys, the Gallup World Poll covered more poor countries in Sub-Saharan Africa and was nationally representative for a larger number of countries. For this study, the authors looked at data collected during 2005 to 2009.
  • Subject Ages: 15 to 75 years
  • Location: 154 countries
  • SES: All
  • Eligibility: Civilian, non-institutionalized population

Hypothesis

  1. Low- and middle-income countries’ social connectedness and volunteering are more important to the health of individuals than in high-income countries.

Variables Measured, Instruments Used

  • Statistical computations were applied to the data set compiled from telephone surveys and face-to-face interviewing. Further details of the sampling frame are provided in the Gallup Annual Report (2008).

Design—Correlational

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Findings

  1. Associations of social support and volunteering with self-rated health are consistently positive across different cultural, economic and geographic settings. However, the magnitude of this association varies significantly.
  2. The hypothesis that associations between health and social support will be stronger in non-Western countries as a result of their weaker social protection policies.
  3. Results suggest no marked gender difference in the relationship between social capital and self-rated health.
  4. Self-rated health was significantly associated with having social support from friends and relatives and volunteering. These associations are strikingly consistent across countries.
  5. Results indicate that the link between social capital and health is not restricted to high-income countries but extends across many geographical regions regardless of their national income level.

Limitations

  • Data do not allow cross-national or cross-regional comparisons of absolute levels of self-rated health and social contacts.
  • Measures in the Gallup survey are dichotomous. There was no examination of whether there was a “dose response” association between social capital measures and health.
  • The use of single items instead of a multidimensional measure of both health and social support
  • While it is tempting to interpret these findings as evidence of causality from social networks and volunteering to health, it is likely that at least part of the association observed reflects the impact of health on these two forms of social capital (reverse causation).
  • The extent of comparability of measures of social capital across different cultures and regions would also limit the interpretation of our results.