Cardiovascular Diseases Clinical Trial
To examine the mechanism through which social support affects morbidity and mortality from coronary heart disease.
BACKGROUND:
Two hypotheses have been proposed to account for the effects of social support on
cardiovascular morbidity and mortality. Both hypotheses operate through effects on risk
factors for coronary heart disease, specifically arterial blood pressure and serum lipids.
The stress- buffering hypothesis states that social support functions as a social resource
for individuals exposed to social stressors; those persons with more support are less
vulnerable to the risk-enhancing effects of stressors. The health behavior hypothesis states
that persons with more support engage in more positive health behaviors, such as avoiding
tobacco; moderate alcohol use; exercise; and, a prudent diet. A major limitation in research
to evaluate these alternative hypotheses has been the failure to conceptualize and measure
social support in a way appropriate to detect its effects in varying social and cultural
contexts. This is a major issue in research in sub-cultural communities that are also high
risk communities, such as African-Americans.
DESIGN NARRATIVE:
A cross-sectional survey of social stressors, social supports, health behaviors, and
arterial blood pressure and serum lipids was conducted in a Black community in the rural
South to evaluate the relative strengths of the stress-buffering versus the health behavior
hypothesis. Social support was measured using a culturally appropriate technique which was
sensitive both to the distinction between kin and nonkin social support, and the
modification of the effects of that support by generational status. Multiple regression
analysis and path analysis were used to evaluate the alternative hypotheses.
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