Abstract
The association of social support and healthoutcomes has received considerable attention inrecent years, but the cultural dimension of socialsupport has not been extensively investigated. Inthis paper, using data collected in a Braziliancity, we present results indicating that thoseindividuals whose reported access to social supportmore closely approximates an ideal cultural model ofaccess to social support have lower blood pressureand report fewer depressive symptoms and lowerlevels of perceived stress. The cultural model ofsocial support is derived using a combination ofparticipant observation, semi-structured interviews,and the systematic ethnographic technique ofcultural consensus modelling. These results arethen used to develop a measure of an individual‘sapproximation to that model of social support in asurvey of four diverse neighborhoods in the city(n = 250). We call this approximation to the idealcultural model of social support ‘culturalconsonance’ in social support. The association ofhealth outcomes with cultural consonance in socialsupport is independent of individual differences inthe reporting of social support, and of standardcovariates. In the case of blood pressure andperceived stress, it is independent of diet, andother socioeconomic and psychosocial variables. Theassociation with depressive symptoms is notindependent of other psychosocial variables. Theimplications of these results are discussed withrespect to research on cultural dimensions of thedistribution of disease.
Similar content being viewed by others
REFERENCES
Almeida-Filho, Naomar de 1987 Migration and Mental Health in Bahia, Brazil. Salvador, Brazil: Caja de Ahorros de la Inmaculada de Aragon.
Azevedo, Thales de 1963 Social Change in Brazil. Gainesville, FL: University of Florida Press.
Berkman, Lisa F., and S. Leonard Syme 1979 Social Networks, Host Resistance, and Mortality. American Journal of Epidemiology 109: 186–204.
Blumethal, J.A., M.M. Burg, J. Barefoot, R.B. Williams, T. Harvey, and G. Zinet 1987 Social Support, Type A Behavior, and Coronary Artery Disease. Psychosomatic Medicine 49: 331–340.
Borgatti, Stephen P. 1992 ANTHROPAC 4.05. Columbia, SC: Analytic Technologies.
Borofsky, Robert 1994 On the Knowledge and Knowing of Cultural Activities. InRobert Borofsky, ed., Assessing Cultural Anthropology, pp. 331–347. New York: McGraw Hill.
Cassel, John, Ralph Patrick, and C. David Jenkins 1960 Epidemiological Analysis of the Health Implications of Culture Change. Annals of the New York Academy of Sciences 84: 938–949.
Cassel, John 1976 The Contribution of the Social Environment to Host Resistance. American Journal of Epidemiology 104: 107–123.
Cobb, Sidney 1976 Social Support as a Moderator of Life Stress. Psychosomatic Medicine 38: 300–314.
Cohen, Sheldon 1988 Psychosocial Models of the Role of Social Support in the Etiology of Physical Disease. Health Psychology 7: 269–297.
Cohen, Sheldon, Tom Kamarck, and Robin Mermelstein 1983 A Global Measure of Perceived Stress. Journal of Health and Social Behavior 24: 385–396.
Cohen, Sheldon, and Thomas Ashby Wills 1985 Stress, Social Support, and the Buffering Hypothesis. Psychological Bulletin 98: 310–357.
Cohen, Sheldon, and S. Leonard Syme, eds. 1985 Social Support and Health. Orlando, FL: Academic Press.
Cohen, Sheldon, Jay R. Kaplan, and Stephen B. Manuck 1994 Social Support and Coronary Heart Disease. InSally A. Shumaker and Susan M. Czajkowski, eds., Social Support and Cardiovascular Disease, pp. 195–222. New York: Plenum Press.
D'Andrade, Roy G. 1984 Cultural Meaning Systems. InRichard A. Schweder and Robert A. LeVine, eds., Culture Theory: Essays on Mind, Self, and Emotion, pp. 88–119. Cambridge: Cambridge University Press.
1987 Modal Responses and Cultural Expertise. American Behavioral Scientist 31: 194–202.
Dimsdale, Joel E. 1995 Social Support: A Lifeline in Stormy Times. Psychosomatic Medicine 57: 1–2.
Dressler, William W. 1991a Stress and Adaptation in the Context of Culture: Depression in a Southern Black Community. Albany, NY: State University of New York Press.
1991b Social Support, Lifestyle Incongruity, and Arterial Blood Pressure in a Southern Black Community. Psychosomatic Medicine 53: 608–620.
1994 Cross-Cultural Differences and Social Influences in Social Support and Cardiovascular Disease. InSally A. Shumaker and Susan M. Czajkowski, eds., Social Support and Cardiovascular Disease, pp. 167–192. New York: Plenum Press.
1996 Using Cultural Consensus Analysis to Develop a Measurement: A Brazilian Example. Cultural Anthropology Methods 8: in press.
Dressler, W.W., A. Mata, A. Chavez, F.E. Viteri, and P.N. Gallagher 1986 Social Support and Arterial Blood Pressure in a Central Mexican Community. Psychosomatic Medicine 48: 338–350.
Dressler, W.W., J.E. Dos Santos, F.E. Viteri, and P.N. Gallagher 1991 Social and Dietary Predictors of Serum Lipids: A Brazilian Example. Social Science and Medicine 32: 1229–1235.
Gaines, Atwood D. 1992 Ethnophychiatry: The Cultural Construction of Psychiatries. InEthnopsychiatry: The Cultural Construction of Professional and Folk Psychiatries, pp. 3–49. Albany, NY: State University of New York Press.
Gerin, William, D'vorah Milner, Shalinee Chawla, and Thomas G. Pickering 1995 Social Support as a Moderator of Cardiovascular Reactivity in Women. Psychosomatic Medicine 57: 16–22.
Griffith, Linda S., Beverly J. Field, and Patrick J. Lustman 1990 Life Stress and Social Support in Diabetes: Association with Glycemic Control. International Journal of Psychiatry in Medicine 20: 365–372.
Henry, James P., and John Cassel 1969 Psychosocial Factors in Essential Hypertension. American Journal of Epidemiology 90: 171–200.
Hess, David J. 1995 Introduction. InDavid J. Hess and Roberto A. DaMatta, eds., The Brazilian Puzzle: Culture on the Borderlands of the Western World, pp. 1–27. New York: Columbia University Press.
Hirdes, John P., and William F. Forbes 1992 The Importance of Social Relationships, Socioeconomic Status, and Health Practices with Respect to Mortality Among Healthy Ontario Males. Journal of Clinical Epidemiology 45: 175–182.
Janes, Craig R. 1990 Migration, Social Change, and Health: A Samoan Community in Urban California. Stanford, CA: Stanford University Press.
Kessler, Ronald C., and Jane D. McLeod 1985 Social Support and Mental Health in Community Samples. InSheldon Cohen and S. Leonard Syme eds., Social Support and Health, pp. 219–240. Orlando, FL: Academic Press.
Kottak, Conrad 1967 Kinship and Class in Brazil. Ethnology 6: 427–443.
Matta, Roberto da 1987 A Casa e a Rua, 2nd ed. Rio de Janeiro: Guanbara.
1991 Carnivals, Rogues, and Heroes. Translated by John Drury. Notre Dame, IN: University of Notre Dame Press.
McEwen, Bruce S., and Eliot Stellar 1993 Stress and the Individual: Mechanisms Leading to Disease. Archives of Internal Medicine 153: 2093–2101.
Miller, Charlotte I. 1979 The Function of Middle-Class Extended Family Networks in Brazilian Urban Society. InMaxine L. Margolis and William E. Carter, eds., Brazil: Anthropological Perspectives, pp. 305–316. New York: Columbia University Press.
Orth-Gomer, Kristina, and Jeffrey V. Johnson 1987 Social Network Interaction and Mortality. Journal of Chronic Diseases 40: 949–957.
K. Romney, A. Kimball, Susan C. Weller, and William H. Batchelder 1986 Culture as Consensus: A Theory of Culture and Informant Accuracy. American Anthropologist 88: 313–338.
Romney, A. Kimball, William H. Batchelder, and Susan C. Weller 1987 Recent Applications of Cultural Consensus Theory. American Behavioral Scientist 31: 163–177.
Sabini, John, and Jay Schulkin 1994 Biological Realism and Social Constructivism. Journal for the Theory of Social Behavior. 24: 207–217.
Santos, Jose Ernesto Dos, William W. Dressler, and Fernando Viteri 1994 Fatores de Risco de Doença Arterial Coronariana e Suas Correlações Com Variáveis Dietéticas e Sociais. Arquivos Brasilerios de Cardiologia 63: 371–375.
Sarti, Cynthia A. 1995 Morality and Transgression Among Brazilian Poor Families: Exploring the Ambiguities. InDavid J. Hess and Roberto A. DaMatta, eds., The Brazilian Puzzle: Culture on the Borderlands of the Western World, pp. 116–133. New York: Columbia University Press.
Shumaker, Sally A., and Susan M. Czajkowski, eds. 1994 Social Support and Cardiovascular Disease. New York: Plenum Press.
Somers, Anne R. 1979 Marital Status, Health, and Use of Health Services. JAMA 241: 1818–1822.
Ware, Norma C., and Arthur Kleinman 1992 Culture and Somatic Experience. Psychosomatic Medicine 54: 546–560.
Weller, Susan C. 1987 Shared Knowledge, Intracultural Variation, and Knowledge Aggregation. American Behavioral Scientist 31: 178–193.
Wethington, Ethel, and Ronald C Kessler 1986 Perceived Support, Received Support, and Adjustment to Stressful Life Events. Journal of Health and Social Behavior 27: 78–89.
Young, Alan 1980 The Discourse on Stress and the Reproduction of Conventional Knowledge. Social Science and Medicine 14: 133–146.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dressler, W.W., Balieiro, M.C. & Dos Santos, J.E. The Cultural Construction of Social Support in Brazil: Associations with Health Outcomes. Cult Med Psychiatry 21, 303–335 (1997). https://doi.org/10.1023/A:1005394416255
Issue Date:
DOI: https://doi.org/10.1023/A:1005394416255