By Noah J. Webster, Ph.D.

The link between social relationships and health has long been established in the United States and other high-income countries. Much less is known, however, about this association in other parts of the world. In a recent study published in the Journals of Gerontology: Social Sciences, my colleagues and I investigated this link. Specifically, we identified the degree to which various types of people exist within the social networks of older adults in Lebanon and examined how the proportion of each type is related to health. Further, we explored the mediating role of positive support and trust in this process. Our study builds on social network research, which has highlighted how grouping people together with similar types of networks can yield important insights. We advance this work by identifying types of people within social networks.

Social network research highlights how grouping people together with similar types of networks yields important insights

Social and Cultural Context: Family demography has shifted dramatically in Lebanon over the last few decades with decreasing fertility rates and increasing life expectancies. Today’s Lebanese older adults have also experienced a protracted civil war (1975–1990), and ongoing political strife. Such events have diminished the government’s ability to provide for Lebanese elders, resulting in family as the major resource available to meet their needs. This resource faces challenges though as youth out-migration increases due to limited economic opportunities and continuing political instabilities.

Theoretical Perspective: This study is grounded in the Convoy Model of Social Relations, which provides a framework for understanding the multiple dimensions of social relationships and their effects on health. Social convoys or networks can be described in terms of their structural characteristics (e.g., size and composition), which are hypothesized to influence health directly and indirectly through the mobilization of support. In this study we focused in particular on the role of positive support. We also explored trust in others as another potential mediator given the recent civil war and ongoing political divisions in Lebanon.

We explored trust in others as potential mediator given the recent Civil War and ongoing political divisions in Lebanon

Key Findings

• Network Member Typologies: Utilizing data from the Family Ties and Aging Study (2009), three types of people within the networks of the sample (N=195) of adults aged 60+ were identified:

• Geographically Distant Male Youth were emotionally very close, but geographically distant, younger, infrequently in contact with the elders, and predominantly male.

• Geographically Close/Emotionally Distant Family were emotionally the least close, but geographically proximate, oldest, had weekly to monthly contact with the elders, and were approximately equally male and female.

• Close Family were emotionally and geographically the closest, were older, in daily contact with the elders, and approximately equally male and female.

• Links Between Network Member Type Proportions and Health: More Geographically Distant Male Youth in networks was associated with having health limitations, whereas more Close Family was associated with having no health limitations.

 Links Between Network Member Type Proportions, Support and Trust:

• Positive Support: More Geographically Distant Male Youth and Geographically Close/Emotionally Distant Family in networks were associated with less positive support, whereas more Close Family was associated with more positive support.

• Trust: More Geographically Distant Male Youth and Geographically Close/Emotionally Distant Family in networks were associated with more trust in others, whereas more Close Family was associated with less trust.

 Mediating Role of Positive Support and Trust:

• More positive support was associated with having health limitations, whereas more trust was related to fewer depressive symptoms.

• Positive support mediated the link between type proportions and health limitations, whereas trust mediated the link between type proportions and depressive symptoms.

In light of the aging Lebanese population, findings highlight the needs of older adults in Lebanon

Theoretical Implications: Findings support application of the Convoy Model in a Lebanese context. Use of the model’s constructs of network structure suggest considerable diversity in social network composition in Lebanon. Findings also provide support for the Convoy Model’s proposition regarding the mediating role of positive support in the link between network structure and health, and also support our expansion of this proposition to include trust.

Health Policy Implications: In light of the aging Lebanese population, findings highlight the needs of older adults in Lebanon. If the trend of youth emigration holds steady or increases, reliance on older close family for support may actually increase. Currently, Geographically Distant Male Youth comprise the smallest portion of older adults’ social networks in Lebanon, but their association with less support and functional health limitations is reason for concern. These trends may signify potential vulnerabilities given the weak welfare state and continued out-migration of youth.

Funding Acknowledgement: This work was supported by the Doha International Institute of Family Studies and Development and the Lebanese National Council on Scientific Research.

Read the Article

Webster, N. J., Antonucci, T. C., Ajrouch, K. J., & Abdulrahim, S. (2015). Social networks and health among older adults in Lebanon: the mediating role of support and trust. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 70(1), 155-166.

About the Author

Noah J. Webster, Ph.D., is an assistant research scientist in the Life Course Development Program at the University of Michigan’s Institute for Social Research. Dr. Webster’s research focuses on the interrelated themes of: (1) the bidirectional influences of health, health-related behaviors and social relationships; and (2) the role of environmental and social contexts in shaping health disparities across the life course. He has a Ph.D. in sociology from Case Western Reserve University with specializations in medical sociology and research methods. Dr. Webster is co-investigator on a number of ongoing sponsored research projects, including the longitudinal study of Social Relations, Aging and Health funded by the National Institute on Aging. He was also co-investigator, collaborating with Drs. Antonucci and Kahn, on a recently completed MacArthur Foundation–funded experimental field study to examine the impact of a multifaceted intervention in affordable senior housing communities. More information can be found here: https://www.src.isr.umich.edu/people/noah-webster/.