Social support at age 33: the in¯uence of gender,employment status and social class

Sharon Matthewsa,*, Stephen Stansfeldb, Chris Powera

aInstitute of Child Health, Department of Epidemiology and Public Health, University College London, 30 Guilford Street,

London WC1N 1EH, UKbDepartment of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1 6BT, UK

Abstract

This paper investigates the conceptualisation and operationalisation of social support and it's relationship to

gender, employment status and social class. Clari®cation of these relationships is sought in order to betterunderstand associations between social support and health. We used data from the 33-year survey of the 1958British birth cohort study. Individual items and subscales of practical and emotional support were examined. In

general, men had lower support than women and social classes IV and V had lower support than classes I and II.Emotional support, either from personal (for example, from friends or family), or combined with organisationalsources of support (such as from a church or a ®nancial institution), showed consistent gender and social class

patterns. This suggests that emotional support is a robust concept across socio-demographic groups. Less consistenttrends were found for practical support, in that socio-demographic trends depended on how practical support wasmeasured. In particular, it depended on whether both personal and organisational sources of support wereexamined. Gender di�erences in social support were large and might therefore be expected to contribute to gender

di�erences in health, whereas social class di�erences in social support were modest, suggesting a minor explanatoryrole for this factor in accounting for inequalities in health. # 1999 Elsevier Science Ltd. All rights reserved.

Keywords: Social support; Gender; Employment status; British birth cohort

Introduction

Since the mid 1970s there has been increasing inter-

est in the relationship between social support and

health. Social support, as measured by social network

variables, has been shown to predict all cause mortality

among adults of all ages (Blazer, 1982; House et al.,

1982; Berkman and Breslow, 1983; Welin et al., 1985;

Schoenbach et al., 1986; Kawachi et al., 1996), and is

especially related to coronary heart disease mortality

(Orth-Gomer and Johnson, 1987; Kaplan et al., 1988;

Kawachi et al., 1996). As well as mortality, social sup-

port has been related to a wide range of health out-

comes including well-being and depression (Brown and

Harris, 1978; Aneshensel and Stone, 1982; Brown et

al., 1986; Brugha et al., 1990; Stansfeld et al., 1998b),

pregnancy outcome (Turner et al., 1990; Ho�man and

Hatch, 1996; Rogers et al., 1996), perinatal health of

mother's and children (Norbeck and Peterson Tilden,

1983; Oakley et al., 1994a,b; Kearns et al., 1997), post

traumatic distress disorder (Stephens and Long, 1997),

Social Science & Medicine 49 (1999) 133±142

0277-9536/99/$ - see front matter # 1999 Elsevier Science Ltd. All rights reserved.

PII: S0277-9536(99 )00122-7

* Corresponding author. Tel.: +44-171-813-8392; fax: +44-

171-242-2723

E-mail address: s.matthews@ich.ucl.ac.uk (S. Matthews)

improved immune status following drug therapy for

cancer (Lekander et al., 1996), anorexia and bulimianervosa (Tiller et al., 1997) and various chronic con-ditions such as rheumatoid arthritis (Fitzpatrick et al.,

1988, 1991) and diabetes (Kaplan and Hartwell, 1987).Although the literature is extensive, research on

social support has tended to focus on either men orwomen. For instance, cardiovascular risk has been pre-dominantly studied in men, whereas studies of mental

health have focused on women. However, the strengthof the relationship between social support and mor-tality may di�er between men and women (Fusilier et

al., 1986): for example low scores on an index of socialconnection were signi®cantly associated with mortality

risk for men but not women (Kaplan et al., 1988).Sources of social support may di�er both qualitativelyand quantitatively, for example men may bene®t from

work based sources of support, while women may relymore on family and non-work sources (Leavy, 1983).Such di�erences may play a role in explaining sex

di�erences in mortality and morbidity rates. Similarly,social support may contribute to socio-economic

inequalities in health and mortality. There is evidencethat social support varies by social class, perceivedsupport (Turner and Marino, 1994; Stansfeld et al.,

1998b) and network size (Fischer, 1982) are greater inhigher social groups. Moreover the contribution of

social support to class di�erences in health may varyfor men and women, but such gender comparisons aregenerally overlooked (Macintyre and Hunt, 1997).

Much of the research on social support is based onsecondary data or where original studies have beenconducted sample sizes are generally small or the

samples are very specialised. Therefore clari®cation isneeded of the nature of socio-economic and gender

di�erences in social support.Future investigations of social support should take

account of methodological issues such as the conceptu-

alisation and measurement of social support. Many ofthe inconsistencies in research ®ndings on social sup-

port and health may be due to methodological pro-blems (Miller and Ingham, 1976; Fuller and Larson,1980; Barrera, 1981; Billings and Moos, 1981;

Broadhead et al., 1983). Needless to say social supporthas been conceptualised and measured in many ways.It is unlikely that a universally recognised measure will

be established, rather key concepts and dimensions ofsocial support have emerged. For example, it has been

de®ned in terms of social networks, social integration,availability of support, received social support and per-ceived support (Sarason et al., 1990). For each of these

concepts, di�erent measures have been developed.Wellman (1981) identi®es `structural dimensions' ofsupport including the number of people in a network,

density and complexity of a network. Several investi-gators make a theoretical distinction between social

support and networks, whereby support denotes`emotional, instrumental and ®nancial aid' obtained

from a social network (Kaplan et al., 1977; House,1981; Thoits, 1982; Berkman, 1984). This introducesquality of interaction as well as number of contacts. A

further distinction is now often made betweenemotional (con®ding) and practical (or instrumental)social support, with investigators focusing on either or

both dimensions (Schaefer et al., 1981; Seeman et al.,1985; Stansfeld and Marmot, 1992; Rodgers, 1994).Given these methodological considerations, our

objectives were ®rst, to establish the appropriateness ofdi�erent de®nitions of social support for di�erentsocial strata focusing in particular on emotional andpractical support, and second, to examine the relation-

ship of social support to gender, employment statusand social position. Speci®cally, we addressed ®vequestions: do women report better or worse social sup-

port than men; how are these di�erences distributedacross separate support items; does social support dif-fer by employment status; are the socio-economic gra-

dients in social support similar for men and women,and ®nally, if social gradients exist, do they varyaccording to employment status? A ®nal objective is to

discuss the implications of the results for furtherresearch on social support and health. We used datafrom the 1958 British birth cohort study, which con-tains information on social relationships and support

at age 33.

Methods and measures

Sample

The 1958 British cohort includes all births in one

week in 1958 (3rd±9th March) in England, Scotlandand Wales. Information was collected on 98% ofbirths totalling 17,414. Subsequent follow-up of survi-

vors was undertaken at ages 7, 11, 16, 23 and mostrecently in 1991 at 33 years, when 11,405 subjects(69% of the target) were re-interviewed (Ferri, 1993).

Despite sample attrition, those remaining in the studywere found to be generally representative of the orig-inal sample (Ferri, 1993). Only data from the 33 yearsurvey were used in this analysis.

Measures

Social class: based on current (91% of men and72% of women) or most recent (the remainder) occu-pation according to the Registrar General's 1990

classi®cation. Women were classi®ed by their own oc-cupation and not by their partner's. Four categorieswere used: classes I and II (professional and manage-

S. Matthews et al. / Social Science & Medicine 49 (1999) 133±142134

rial), IIInm (skilled non-manual), IIIm (skilled man-

ual), and IV and V (semi and unskilled manual).Employment status: at age 33 respondents reported

their current main economic activity. Women were

categorised as employed (full-time, thirty hours ormore per week or part-time, less than thirty hours) or

home-workers (that is housewives). Men were cate-gorised as employed (employees or self-employed) orunemployed and seeking work. Men who were home-

workers (n=24), in full-time education (n=21), tem-porary or permanently sick or disabled (n=117), andunclassi®ed (n=38) were excluded from the analyses

due to small numbers. For women, those excludedwere unemployed (n=118), in full-time education

(n=48), temporary or permanently sick/disabled(n=64) and the unclassi®ed (n=35).Social support: six questions on social relationships,

adapted from the British Social Attitudes Survey(Finch, 1989) include:

1. ``Suppose you needed advice about an importantchange in your life, for example, about a job, or

moving to another part of the country, who wouldyou turn to for advice?'' (personal advice).

2. ``Suppose you were very upset about a problem

with your husband, wife or partner, and had notbeen able to sort it out with them. Even if you are

not married or have no partner, what would you doif you were, who would you turn to for help?'' (con-®ding support).

3. ``Suppose you felt just a bit down or depressed andyou wanted to talk about it, who would you turn tofor help?'' (distress support).

4. ``Suppose you had the `¯u' and you had to stay inbed for a few days, and needed help around the

home, with shopping and so on, who would youturn to for help?'' (domestic help).

5. ``Suppose you needed to borrow a large sum of

money, who would you turn to for help?'' (®nan-cial).

6. ``There are some household and garden jobs youreally can't do alone, for example, you may needsomeone to hold a ladder, who would you turn to

for help?'' (household DIY).

Respondents were required to nominate up to four

sources of support from personal (`spouse/partner',`parent/in-law', `other relative', `friend or neighbour',

`someone you work with') and organisational sources(`church, charity, social services etc.', `someone youpay to help'; and `other source of advice'). Initially a

scale was derived by summing the numbers of sourcesof support from across all possible eight sources (thatis, personal and organisational). Separate scales were

constructed for emotional support (items 1±3 above)and practical support (items 4±6 above). For `con®ding

support' (in the emotional scale) there was more miss-ing data than expected, especially for men, signifying

that the hypothetical situation (item 2) was particularlyproblematic for con®ding support. To overcome thisproblem, the emotional sub-scale comprised all three

items only for those who had married or cohabited,with a cut-o� of three or less indicating low support.For the never married the `con®ding support' item was

omitted, and a cut o� of two or less was used to indi-cate low support. In addition to the sub-scales foremotional and practical support, we examined the indi-

vidual questions separately, with a cut-o� of one orless indicating low support, that is, only one source ofsupport was identi®ed.

Data analysis

In the ®rst stage of analysis we examined social class

patterns for each support question separately, andcompared trends for ®ve (personal) with eight (per-sonal and organisational) sources of support; second,

we compared the social support sub-scales and individ-ual items to investigate relationships with gender,social position and employment status. Pearson's w 2

was used to test independence between social support,employment status and gender. Social class trends insocial support were examined for men and women,and for employment status groups, using the Mantel±

Haenszel w 2 test. Analysis was carried out using SPSSUnix version 6.1.

Results

Methodological ®ndings

Table 1 presents the percentages of men and women

with low support by social class, for individual ques-tions and for 5 (personal only) and 8 (personal and or-ganisational) support sources. Similar social trends

were observed for the 5 and 8 item support sourcesrepresenting emotional support: the percentage withlow support increased from classes I and II to classes

IV and V. Exclusion of organisational support had lit-tle impact on the social class trend. For practical sup-port, household DIY showed a consistent classgradient for scores based on both 5 and 8 support

sources. For `domestic help' there was no class trendfor men or women for either 5 or 8 support sources.However, for `®nancial' support the 5 and 8 support

sources showed inconsistent class distributions. A classgradient (to the detriment of lower classes) was evidentfor the 8 support sources measure but not for the 5

support sources measure. This suggests that whilst®nancial support from personal sources is similaracross social classes, support from organisational

S. Matthews et al. / Social Science & Medicine 49 (1999) 133±142 135

sources are less readily available to men and women in

lower social classes. Exclusion of organisational sup-port would therefore under-represent sources availableto higher social classes (I and II) relative to lower

classes (IV and V). Thus both organisational and per-sonal sources are included in the practical dimensionof social support used hereafter. In contrast, we have

based the emotional support sub-scale on personalsupport sources only, since these sources are most rel-evant conceptually to an emotional support dimension.

Gender, social class and work roles

Table 2 shows that men and women di�er signi®-

cantly ( p<0.05) in their perceived levels of social sup-port: 19.4% of men compared to 7.9% of womenreported low levels of emotional support, and 16.1%

of men and 9.6% of women reported low levels ofpractical support. At the other extreme, fewer men(27.2%) than women (38.6%) reported high emotional

support, whilst the di�erence narrowed for practicalsupport (23.7% men, 27.3% women). Signi®cant gen-der di�erences ( p<0.05) bene®ting women wereapparent for all support questions except for `house-

hold DIY' where men received more practical support

than women Table 2. There were particularly pro-

nounced gender di�erences for `distress support' and`domestic help' with over twice as many men reportinglow support. Overall, men and women were well sup-

ported for `personal advice' (21.3% and 11.2% menand women respectively reporting low support) and forwomen `domestic help' (with 13.4% reporting low sup-

port).Table 3 shows that of the 4869 men, 271 (6%) were

unemployed, 784 (16%) were self-employed, with themajority 3814 (78%) working as employees. For

women, 1455 (28%) were home-workers, 1748 (34%)were employed part-time, and 1961 (38%) were full-time employed. Most di�erences in social support

between employment states were small, though statisti-cally signi®cant. Overall, employed women were bettersupported than home-workers. Part- and full-time

women workers had similar levels of low emotionalsupport, whilst marginally more full-time employedwomen reported low levels of practical support. For

men, the employed as compared to the unemployed,and employees as compared to the self-employed, hadbetter emotional and practical support. While the gen-eral trends for the sub-scales were evident for some in-

dividual items (Table 3), for example emotional

Table 1

Social class at age 33 and social support items (percent with low support)

No. support sources Social class at age 33

mena womenb

I & II

(1942)

IIInm

(521)

IIIm

(1552)

IV & V

(734)

w 2 trend

(1df )

I & II

(1641)

IIInm

(1823)

IIIm

(363)

IV & V

(1150)

w 2 trend

(1df )

Emotional supportc

Personal advice 5 18.3 20.9 22.3 24.7 17.3�� 9.7 11.1 11.6 12.1 4.0�

8 17.1 20.0 22.6 23.6 21.3��� 9.1 10.6 11.6 11.6 4.7�

Con®ding support 5 31.0 31.2 36.8 37.2 14.4�� 19.9 24.4 23.6 25.8 11.7���

8 27.9 31.0 35.5 36.0 24.9��� 17.0 22.9 22.8 24.1 18.4���

Distress support 5 31.2 34.8 39.7 39.9 30.1��� 10.4 16.8 19.8 20.7 54.3���

8 30.0 33.9 39.1 39.0 33.5��� 9.7 15.8 19.3 19.6 54.0���

Practical supportc

Domestic help 5 31.8 29.4 34.2 33.9 2.6 13.2 13.2 16.1 14.3 1.4

8 31.0 29.4 33.9 33.4 3.4 12.3 12.8 15.5 14.1 2.6

Financial 5 62.9 62.9 59.8 58.6 1.7 53.4 55.3 54.8 54.1 0.1

8 36.1 36.1 36.1 44.1 23.6��� 28.9 34.0 37.5 37.5 23.3���

Household DIY 5 22.4 22.4 24.9 35.2 48.1��� 28.2 33.6 31.6 37.8 24.2���

8 20.9 20.9 23.6 34.8 57.9��� 25.7 31.9 30.2 37.1 36.8���

a Sample for men varies for each variable ranging from 4198 to 4754, with those reporting low support ranging from 961 to 1640

(emotional), and 1214 to 2909 (practical).b Sample for women varies for each variable ranging from 4827 to 4991, with those reporting low support ranging from 542 to

1118 (emotional), and 655 to 2663 (practical).c Low support=1 or less sources of social support.� p<0.05, ��p<0.01, ���p<0.001.

S. Matthews et al. / Social Science & Medicine 49 (1999) 133±142136

support especially in women, some sub-scales wereexplained entirely by a particular item, such as house-hold DIY for practical support in men.

Social class di�erences in emotional and practicalsupport sub-scales are shown in Table 4. Social gradi-ents are evident for both men and women with lowsupport increasing from classes I and II through to

classes IV and V. Similar gradients were also evidentfor the individual items, except for `domestic help'(Table 1). Gradients are especially strong for women

for `distress support' with about twice as many womenin classes IV and V having low support compared to Iand II. For both men and women, the gradient in the

practical support sub-scale (Table 4) is due, in particu-lar, to class di�erences in the `household DIY' itemand to a lesser extent to the `®nancial' item (Table 1);

whilst for the emotional support subscale no singleitem was especially strong for men, whereas forwomen `distress support' contributed most to the classgradient.

Finally, Table 5 shows the practical and emotionalsupport sub-scales according to employment status andsocial class. For women, signi®cant social gradients

were evident for all employment states; whilst for mena social gradient was evident in low emotional support

only among employees. Among all employed men andwomen the social gradient in low social support wassimilar.

Discussion

Given the numerous di�erences in the conceptualis-ation of social support and inconsistent relationshipswith health, it is necessary to understand gender and

socio-economic relationships with social support beforeexamining the association with health. We con®rmedthat the largest di�erences in social support are

between women and men, with women better sup-ported (Vaux, 1985; Shye et al., 1995; Stansfeld et al.,1998b). There was also a consistent trend for greater

support among the higher social classes compared tolower social classes, and among employees comparedto other groups. However, this depended on how socialsupport was conceptualised. These ®ndings have impli-

cations for both methodological and substantiveresearch on social support and health.Methodological implications of the study relate to

both emotional and practical support. Emotional sup-port had a consistent social pattern irrespective of

Table 2

Gender comparisons of social support, indicated by individual items and emotional and practical subscales

Men (%) Women (%) w 2 (df )

Emotional supporta (men: N=5023, women: N=5409)

Individual items (% low)

Personal advice 21.3 11.2 194.5 (1)���

Con®ding support 33.9 23.9 118.7 (1)���

Distress support 35.7 16.4 502.2 (1)���

Sub-scaleb

Low (R3 support sources) 19.4 7.9 451.9 (3)�

Low±medium (4±6 sources) 27.6 21.8

Medium±high (7±9 sources) 25.8 32.7

High (10±12 sources) 27.2 38.6

Practical supporta (men: N=5147, women: N=5499)

Individual items (% low)

Domestic help 32.2 13.4 531.0 (1)���

Financial 39.5 33.9 35.1 (1)���

Household DIY 25.7 31.5 42.2 (1)���

Sub-scale

Low (R3 support sources) 16.1 9.6 115.8 (3)�

Low±medium (4±6 sources) 32.2 31.4

Medium±high (7±9 sources) 28.0 31.8

High (10±12 sources) 23.7 27.3

a Sources of support include: spouse/partner; parent/in law; other relative; friend or neighbour; someone you work with; with the

addition of church, charity, social services etc.; someone you pay to help; other sources of advice for practical support.b Categories adapted for those who had always been single: low (R2 sources); low±medium (3±4 sources); medium±high (5±6

sources); high (7±8 sources).� p<0.05, ��p<0.01, ��� p<0.001.

S. Matthews et al. / Social Science & Medicine 49 (1999) 133±142 137

Table

3

Employmentstatusandlow

socialsupport

(%)

Low

emotionalsupport

Low

practicalsupport

support

subscale

personaladvice

con®ding

distresssupport

support

subscale

domestichelp

®nancial

household

DIY

Men,N=

4869a

Employed

(4598)

18.9

21.2

33.5

35.7

15.6

32.1

39.6

24.8

Employee

(3814)

18.0

20.3

33.1

34.9

14.8

31.6

39.3

23.9

Self-em

ployed

(784)

23.3

25.6

35.5

39.8

19.4

34.4

41.4

29.1

Unem

ployed

(271)

25.2

22.9

37.5

36.6

20.1

33.8

35.5

33.6

w2(1df)

(employed

vs.unem

ployed)

6.7��

ns

ns

ns

4.1�

ns

ns

10.4��

w2(1df)

(employee

vs.self-employed)

12.1���

11.2���

ns

6.7��

10.8���

ns

ns

9.4��

Women,N=

5164a

Employed

(3709)

6.4

9.9

21.6

15.2

8.5

12.9

32.6

30.6

Full-tim

e(1961)

6.3

9.6

21.3

15.2

9.4

15.8

33.0

29.2

Part-tim

e(1748)

6.5

10.2

21.9

15.2

7.4

9.8

32.1

32.2

Home-work

(1455)

10.5

14.0

29.2

19.0

11.5

13.4

36.7

33.8

w2(1df)

(employed

vs.homew

ork)

11.5���

17.8���

32.5���

11.1���

25.4���

ns

7.6��

4.9�

w2(1df)

(full-vs.part-tim

eem

ployed)

4.8�

ns

ns

ns

ns

29.9���

ns

4.0�

aNumbersvary

slightlyforthesupport

item

s.�p<

0.05,��p<

0.01,���p<

0.001,nsnotsigni®cantp<

0.05.

S. Matthews et al. / Social Science & Medicine 49 (1999) 133±142138

whether an aggregate measure or separate items were

used. This suggests that emotional support is a robust

universal construct that transcends gender and social

and employment position. In contrast, practical sup-

port appeared to depend on whether personal or or-

ganisational sources of support were examined, as

indicated by the variable patterns with social position.

This was striking for ®nancial support, which was

more readily available from organisational sources to

those in non-manual occupations. If measures of ma-

terial resources are used to indicate practical support,

it will be necessary to take account of di�erential

access to such resources by socio-economic status.

Demonstration of social class di�erences in practical

support will depend on the measures used.

With regard to the substantive results, the lower sup-

port of men compared to women in this cohort is con-

sistent with ®ndings from other population studies

(Vaux, 1985; Shye et al., 1995). This gender di�erence

was particularly marked for emotional support speci®-

cally for `distress support'. Women have been shown to

have larger and more multifaceted networks than men,

whereby women report having more friends and provide

and receive more support from members of their net-

work (Antonucci and Akiyama, 1987). Better social re-

lationships in women may have implications for their

health either through bu�ering the e�ects of stress on

mental and physical health or through direct positive

e�ects on health status. It is possible therefore that pro-

tective e�ects of support will be stronger in women. On

the other hand a larger social network may imply reci-

procal commitments to provide support and if this is

demanding it may be accompanied by a health cost.

This may explain why social support appears to have a

greater protective e�ect for men than women in coron-

ary heart disease (House et al., 1982; Schoenbach et al.,

1986; Kaplan et al., 1988). Also, it may be that men

achieve good social supports later in life, largely from

close relationships with spouses or partners, which is

Table 4

Social class at age 33 and low social support (%)

Social class at age 33 All w 2 trend (1df )

I & II IIInm IIIm IV & V

Men

(N ) (1935) (520) (1554) (742)

Low emotional support 15.7 16.7 22.7 22.9 19.2 32.2���

Low practical support 11.7 12.7 18.9 23.2 16.0 68.7���

Women

(N ) (1635) (1825) (363) (1152)

Low emotional support 4.7 7.3 9.9 9.9 7.2 29.4���

Low practical support 6.6 8.4 12.2 12.9 9.1 37.6���

� p<0.05, ��p<0.01, ��� p<0.001.

Table 5

Men and women with low social support by social class at

age 33 and employment status (%)

Social class at age 33 w 2 trend (1df )

I & II IIInm IIIm IV & V

Men

Emotional support

Employed 15.2 16.8 22.3 22.2 29.9���

Employee 14.4 16.7 21.1 22.3 27.2���

Self-employed 19.9 17.9 26.2 21.6 ns

Unemployed 30.2 14.3 26.0 25.6 ns

Practical support

Employed 11.5 12.6 18.6 22.9 60.3���

Employee 11.2 12.4 17.3 22.7 48.5���

Self-employed 13.6 14.3 22.6 23.9 9.7��

Unemployed 12.7 7.1 18.8 27.6 6.5�

Women

Emotional support

Employed 4.7 6.9 6.9 8.3 10.3��

Full-time 4.8 7.4 8.9 9.1 8.1��

Part-time 4.4 6.4 4.5 8.0 4.0�

Home-work 5.0 7.3 14.9 11.9 11.4���

Practical support

Employed 6.5 8.3 9.9 11.7 18.2���

Full-time 7.0 10.2 14.0 15.9 20.7���

Part-time 5.1 6.6 5.1 10.0 8.6��

Home-work 7.2 7.2 13.0 15.5 16.1���

� p<0.05, ��p<0.01, ���p<0.001, ns: not signi®cant

p>0.05.

S. Matthews et al. / Social Science & Medicine 49 (1999) 133±142 139

not necessarily the case for women, who are socialised

to develop a wider circle of support from an earlier age.This is illustrated in a middle aged cohort study, thatbetter mental health was predicted by support from the

closest person for men (Stansfeld et al., 1998b) butwomen bene®ted more from a combination of supportsources (Fuhrer et al., 1999).

Whilst there is a fairly extensive literature on genderand social support, the evidence on social support and

social position is less well documented. The data fromthe 1958 birth cohort show lower support in lowersocial classes, based on the emotional and practical

support subscales and the separate items, except for`domestic help'. As the social class trends were modest,

perceived availability of social support is unlikely toprovide a major explanation for socio-economicinequalities in health. This was demonstrated in further

analysis of the cohort, in which social support hadonly a minor impact on social class di�erences in self-rated health at age 33 for both sexes (Power et al.,

1998), although it's contribution to social class di�er-ences in other health measures has not yet been estab-

lished. Elsewhere, social support provided only amodest explanation of employment grade di�erences inpsychiatric sickness absence (Rael et al., 1995),

although it explains somewhat more of the gradient indepression among male middle aged civil servants(Stansfeld et al., 1998b). Likewise, social network

measures showed only a small e�ect in explainingsocial class gradients in mental illness in a Swedish

general population (Lundberg, 1991).Di�erences in social support by employment status

were modest. As expected, unemployed and self-

employed men and home-working women had lowerlevels of both emotional and practical support (Brownand Harris, 1978; Burke et al., 1979; Billings and

Moos, 1981; Vanfossen, 1981; Bartley, 1994;Bromberger and Matthews, 1994; Roberts et al., 1997).

This is likely to re¯ect limited social networks outsidethe household. Interestingly, di�erences in support forwomen working full- or part-time were minor. This

suggests that participation in the paid labour marketfor women is su�cient to provide opportunities forsupport regardless of the number of hours worked.

Whereas, in another investigation based on this cohort,social gradients in negative psychosocial work charac-

teristics were stronger for part-time than for full-timeworkers (Matthews et al., 1998). Women involved inpart-time employment had less opportunity for learn-

ing and greater monotony than full-time workers.Interestingly, there was no social class trend in lowemotional support among unemployed men, suggesting

that unemployment reduces the availability of socialsupport irrespective of social class background.

It is important to bear in mind that the six supportitems included in our analyses are hypothetical, aiming

to measure availability of perceived social support. Oneconsequence of the hypothetical constructs is that we

are unable to identify individuals with no support andindividual assessments of support may be in¯uenced bymood and personality. Whilst hypothetical constructs

may be important, they represent only one dimension ofsocial support. Other dimensions may prove to be morein¯uential for health, especially for men. For instance,

marital status and satisfaction, organisational member-ship including church involvement and leisure activitieshave not been considered so far in our analysis.

Furthermore, a limitation of social network measures isthat they fail to consider quality of social support. Inparticular, one person may provide much moreemotional and practical support than several more dis-

tant contacts. An issue to consider in future would bethe importance attached to each dimension of support.For instance, should each dimension of emotional sup-

port be weighted equally in deriving an aggregate vari-able? Another area to consider is that of negativeaspects of close relationships which have more of an

impact on health than positive social relations and maybe more important in contributing to social inequalitiesin health (Stansfeld et al., 1998a).

In order to advance the study of social support andhealth it will be necessary to identify more preciselywhat it is about support that is bene®cial for health.Part of this endeavour requires a better understanding

of the distribution of di�erent aspects of supportacross social groups to identify those most and least atrisk. This paper contributes to the understanding of

social support in early adulthood.

Acknowledgements

This research was supported by a grant from the(UK) Economic and Social Research Council underthe Health Variations Programme (L128251021) to

Chris Power, Sharon Matthews, Stephen Stansfeld andOrly Manor. CP (Weston Fellow) is a fellow with theCanadian Institute for Advanced Research. Data

acknowledgement: Centre for Longitudinal Studies,Institute of Education, National Child DevelopmentStudy Composite File including selected Perinatal Dataand sweeps one to ®ve (computer ®le). National

Birthday Trust Fund, National Children's Bureau,Centre for Longitudinal Studies, Institute of Education(original data producers). Colchester Essex: The Data

Archive (distributor), 21 June 1994. SN: 3148.

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