Social Inclusion as a Determinant of Mental Health and Wellbeing

The link between social inclusion and mental health & wellbeing

A study of 2000 people in Finland found that social support strengthened mental health in all respondents (Sohlman 2004).

Young people reporting poor social connectedness (that is, having no-one to talk to, no-one to trust, no-one to depend on, and no-one who knows them well) are between two and three times more likely to experience depressive symptoms compared with peers who reported the availability of more confiding relationships (Glover et al, 1998).

A large meta-analysis of routinely collected data from 1952-1993 found a significant increase in mean levels of anxiety among US college students and school children which was correlated with reduced social connectedness (Twenge, 2000).

Evidence of significant and persistent correlations has been found between poor social networks (weak social ties, social connectedness, social integration, social activity, and social embeddedness) and mortality from almost every cause of death (Seeman 2000; Berkman & Glass 2000; Eng et. al 2002).

Studies have consistently demonstrated people who are socially isolated or disconnected from others have between two and five times the risk of dying from all causes compared to those who maintain strong ties with family, friends & community (Berkman & Glass 2000).

Belonging to a social network of communication and mutual obligation makes people feel cared for, loved, esteemed and valued. This has a powerful protective effect on health. Supportive relationships may also encourage healthier behaviour patterns (Wilkinson & Marmot 2003).

Two different but potentially complimentary mechanisms have been proposed to explain how social networks influence mental health. Social networks may have a beneficial effect on mental health regardless of whether or not the individuals are under stress, social networks may also improve the wellbeing of those under stress by acting as a buffer or moderator of that stress (Kawachi & Berkman, 2001).

By providing emotional support, companionship and opportunities for meaningful social engagement, social networks have an influence on self-esteem, coping effectiveness, depression, distress and sense of wellbeing (Berkman & Glass, 2000).

Social networks and social ties have a beneficial effect on mental health outcomes, including stress reactions, psychological wellbeing, and symptoms of psychological distress including depression and anxiety (Kawachi & Berkman 2001).

Whiteford, Cullen and Baingana (in press) indicate that :

• The benchmark Whitehall study demonstrated the link between social exclusion and ill health, and social isolation has been linked to unhappiness, illness, and shortened life.
• Socialising with colleagues from work, attending religious services and participation in clubs is related to positive health status.
• Vulnerability for depression includes the lack of confiding relationships, unemployment and low social status all of which can derive from a breakdown in social cohesion. Even in conditions where psychosocial factors are generally not considered to be pathological, this relationship has been reported. For example, socially isolated elderly people have a relatively greater risk of developing Alzheimer’s disease.

Social relationships have potentially health promoting and health damaging effects. Positive mental and physical health effects are associated with social interactions among older adults, including better recovery after disease onset. Critical and/or overly demanding social ties have however been correlated with increased stress and risk of depression among the elderly (Seeman, 2000).

The amount of emotional and practical social support people get varies by social and economic status. Poverty can contribute to social exclusion and isolation. People who get less social and emotional support are more likely to experience more depression (Wilkinson & Marmot 2003).

The Victorian Population Health Survey (VPHS) 2002 found that people with few social networks were more likely to report fair to poor health and to be experiencing some level of psychological distress. The study identifies higher network scores were associated with those who lived in rural areas, older age groups, those who were Australian born and those who were employed. Higher network scores were also associated with a range of benefits including an increased ability to get help in an emergency, feeling valued by society, accepting diversity and better health outcomes (DHS 2003).

An analysis of VPHS community strength indicator data undertaken by the Department of Victorian Communities shows that people who participate and those who can get help when needed are healthier and feel more positive about the communities in which they live. It also shows inequalities between population groups, most notably between socio-economic and ethnic groups (DVC 2004).

Baum et al. (2000) found mental health status was more strongly correlated with levels of participation in social and community life than physical health.

A national survey conducted by the Australian Bureau of Statistics in 2001 found rates of mental and behavioural problems and 'a very high level of psychological distress' were higher amongst adults who lived alone compared with adults living in a household with at least one other person (ABS 2003).

People are increasingly more likely to live alone and spend much more time by themselves according to an Australian Bureau of Statistics study which found that between 1992 and 1997, the percentage of our waking time spent alone increased by 14% to 3 hours a day (ABS 2000). The link between social capital and mental health & wellbeing.

There is growing evidence of correlations between various dimensions of social capital and aspects of mental health such as: common mental illnesses (Pevalin, 2002; Pevalin & Rose, 2002); happiness and wellbeing (Saguaro Seminar, 2001; Putnam, 2001); self-assessed mental health status (Baum et al, 2000); depressive symptoms (Ostir et al, 2003); feelings of insecurity related to crime (Lindstrom et al, 2003); general psychological distress (Berry & Rickwood, 2000; Berry & Rogers, 2003); emotional health (Rose, 2000); and binge drinking (Weitzman & Kawachi, 2000).

Although low levels of social capital have been correlated with poorer health, including mental health, a large UK study has found that social capital does not moderate or buffer the negative impact of structural socio-economic factors on health or common mental illness (Pevalin and Rose, 2002).

Greater levels of community participation, social support and trust in others in the community have been associated with reduced experience of psychological distress (Berry & Rickwood, 2000). 

Lower levels of social trust have been associated with higher rates of most causes of death, including heart attacks, cancer, stroke, unintentional injury and infant mortality (Kawachi & Berkman 2000).

Variations in anti-social behaviour and suicidal behaviour have been traced to strengths or absences of social cohesion (OECD 2001). Whiteford, Cullen and Bangana (in press) indicate that :
• There is a correlation between poor health and lower levels of social capital as evidenced by levels of interpersonal trust and norms of reciprocity (both of which can serve as indicators for social capital).
• There is evidence for an inverse relationship between social capital and the presence of mental disorders in populations.
• Social scientists have demonstrated higher social capital may protect individuals from social isolation, create social safety, lower crime levels, improve schooling and education, enhance community life and improve work outcomes.
• The same strong ties that are needed for people to act together can also exclude non-members, such as the poor or minority groups. Strong ties within the group may lead to less trust and reciprocity to those outside the group.
• Analysis of ecological factors indicates societies with low trust levels exhibit higher rates of violent and property crime, such as homicide, assault, robbery and burglary.

This article originally appeared on www.vichealth.vic.gov.au

How Acupuncture Helps You To Control Blood Pressure

People have known for centuries that acupuncture helps with a number of conditions, including high blood pressure and pain, and now advances in modern science can help explain exactly why this ancient Chinese treatment is so effective.

According to research carried out by the University of California Irvine's Susan Samueli Center for Integrative Medicine, regular electroacupuncture treatment boosts the release of an opioid in the brain stem. This particular opioid controls blood pressure, which explains why the treatment is so helpful in reducing hypertension.

Electroacupuncture entails sending pulsating electrical currents through acupuncture needles to stimulate acupoints. It does not require the super-precise needle placement that is so crucial to traditional acupuncture, because the electrical current can reach a wider area. While it offers a lot of the same benefits as traditional acupuncture, it seems to work particularly well on pain.

Rats that underwent electroacupuncture noted a drop in blood pressure that persisted for three days after the treatment. This came about as the result of a boost in the gene expression of one of the body's major opioid peptides known as enkephalins.

This is the first time that research has proven the molecular activity responsible for the hypertension-reducing effects of electroacupuncture. The landmark study was published in Scientific Reports.
 

Hypertension affects a third of the world's adults

In the U.S., more than $30 billion is spent each year unnecessarily to treat hypertension, which equates to more than 1 percent of the nation's annual healthcare costs. Many patients are being prescribed strong blood pressure medications despite only having mild hypertension, putting them at risk for a number of side effects, including digestive disorders, anxiety, kidney damage and cholesterol problems.

Untreated hypertension can cause serious problems, including heart and kidney damage, stroke, the buildup of fluid in the lungs, and vision loss, so alternative treatments could help make significant inroads in this major health problem. Lifestyle changes such as improving one's diet and getting more exercise should always be the first line of defense, and for many people, acupuncture could also make a big difference.

With hypertension affecting around a third of the world's adult population, this could lead to much better treatment than the current medication, which has a host of unpleasant side effects. The UCI team found that acupuncture at particular places on the wrist brings about the drop in blood pressure, illustrating its promise as a simple treatment for clinical hypertension.
 

Electroacupuncture also helps relieve stress, pain

The benefits of electroacupuncture don't stop at hypertension. Georgetown University Medical Center researchers have found that the treatment can block the release of the body's stress hormones, helping to protect people from the impact of stress.

It has also been shown to reduce pain and the need for painkillers following operations like Cesarean sections. In a study published in the Chinese Medical Journal, researchers found that women who had been administered acupuncture or electroacupuncture for pain relief had significantly lower levels of pain than the placebo group in the two hours after surgery. They also asked for morphine 10 minutes later on average, and used about a third less of it in the first 24 hours following the surgery. As such, they also noted fewer opioid-related side effects.

Another study out of Duke University, meanwhile, found that acupuncture resulted in significantly lower levels of pain and painkiller use in patients post-surgery, regardless of whether it had been administered before the operation or afterward.

While some people claim that acupuncture's benefits come from a placebo effect, the research shows that changes do occur in the brain during electroacupuncture. This treatment, along with other ancient Chinese remedies like cupping therapy, is growing in popularity as people increasingly seek alternative treatments that do not have harmful side effects.

This article originally appeared on naturalnews.com