Andrew G. Shuman, MD is an Assistant Professor in the Department of Otolaryngology - Head and Neck Surgery at the University of Michigan Medical School. He is also the Chief of the ENT Section of the Surgery Service at the VA Ann Arbor Health System. He is a service chief of the Clinical Ethics Service in the Center for Bioethics and Social Sciences in Medicine (CBSSM). His current research interests explore ethical issues involved in caring for patients with head and neck cancer, and in managing clinical ethics consultations among patients with cancer.
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Joel D. Howell is a Professor at the University of Michigan in the departments of Internal Medicine (Medical School), Health Management and Policy (School of Public Health), and History (College of Literature, Science, and the Arts), as well as the Victor C. Vaughan Professor of the History of Medicine. He received his M.D. at the University of Chicago, and stayed at that institution for his internship and residency in internal medicine. At the University of Pennsylvania, he was a Robert Wood Johnson Clinical Scholar, and received his Ph.D. in the History and Sociology of Science.
I serve as Professor of Family Medicine, Director of Japanese Family Health Program, and Co-Director of the Michigan Mixed Methods Research and Scholarship Program at the University of Michigan. In addition to being a family/general doctor fluent in Japanese, I have long been interested in the influence of culture on medical decision making and ethics, and have conducted numerous health research projects, and published numerous papers in English and Japanese.
A longer life may result from the amount of social support present in your life, but is the longevity due to giving or receiving that support?
Imagine that in your busy schedule each week, you typically at least have Wednesday and Saturday nights free as time to spend however you want. Recently, however, one of your close friends had her car break down and now she is wondering whether you would be willing to drive her to and from a yoga class on Wednesday nights for the next three weeks while the car is in the shop. She told you that the class is only about a 15 minute drive each way. She said that you shouldn't feel pressured, and she just thought she'd ask if you had the time to help her out.
- Yes, I'd take the time to help her out.
- No, I'd keep my Wednesday nights free.
Giving vs. receiving: effects on mortality
A research team of investigators at the U of M Institute for Social Research teamed up with CBDSM investigator, Dylan Smith, to conduct a study investigating whether giving or receiving help affects longevity. The researchers noted that receiving social support is likely to be correlated with other aspects of close relationships, including the extent to which individuals give to one another. Based on this, they hypothesized that some of the benefits of social contact, sometimes attributed to receiving support from others, may instead be due to the act of giving support to others.
Using a sample of 423 married couples from the Detroit area, the investigators conducted face-to-face interviews over an 11-month period. The interviews assessed the amount of instrumental support respondents had given to and received from neighbors, friends, and relatives, as well as the amount of emotional support they had given to and received from their spouse. Instrumental support included things like helping with transportation, errands, and child care, whereas emotional support involved having open discussions with a spouse and feeling emotionally supported. Mortality was monitored over a 5-year period by checking daily obituaries and monthly death record tapes provided by the State of Michigan. To control for the possibility that any beneficial effects of giving support are due to a type of mental or physical robustness that underlies both giving and mortality risk, the investigators also measured a variety of demographic, health, and individual difference variables, including social contact and dependence on the spouse.
The investigators found that those who reported giving support to others had a reduced risk of mortality. This was true for both instrumental supoprt given to neighbors, friends, and relatives, and for emotional support given to a spouse. They also found that the relationship between receiving social support and mortality depended on other factors. Specifically, receiving emotional support appeared to reduce the risk of mortality when dependence on spouse, but not giving emotional support, was controlled. Receiving instrumental support from others actually increased the risk of mortality when giving support, but not dependence on spouse, was controlled.
What can we make of these findings?
It appears from these results that the benefits of social contact are mostly associated with giving rather than receiving. Measures that assess receiving alone may be imprecise, producing different results as a function of dependence and giving support.
Given the correlational nature of this study, it is not possible to determine conclusively that giving support accounts for the social benefit traditionally associated with receiving support. Nevertheless, the results of the present study should be considered a strong argument for the inclusion of measures of giving support in future studies of social support, and perhaps more importantly, researchers should be cautious of assuming that the benefits of social contact reside in receiving support.
It's true that when helping others out, you might have to give up some of your own time, but based on the above findings, it looks like in the long run you may end up ultimately gaining more time.
Read the article:
Providing social support may be more beneficial than receiving it: results from a prospective study of mortality.
Brown S, Nesse RM, Vinokur AD, Smith DM. Psychological Science 2003;14:320-327.
The CBSSM Research Colloquium featured the Bishop Lecture in Bioethics as the keynote address. Myra Christopher presented the Bishop Lecture with a talk entitled: "The Moral Imperative to Transform the Way Pain is Perceived, Judged and Treated".
Myra Christopher holds the Kathleen M. Foley Chair in Pain and Palliative Care at the Center for Practical Bioethics. Prior to December 2011, Ms.
Christopher was President and CEO of the Center for Practical Bioethics since its inception in 1984 through December 2011. From 1998-2003, Christopher also served as the national program officer of the Robert Wood Johnson Foundation’s National Program Office for State-based Initiatives to Improve End-of Life Care which was housed at the Center. These roles have allowed Christopher to continue her lifelong mission to improve care for those who are seriously ill and their families.
Since the late 1990s, Christopher has expanded the scope of her work to include the under treatment of chronic pain. She is currently the Director of the Pain Action Initiative: A National Strategy (PAINS) and serves as Chair of the PAINS Steering Committee. From 2010-2011 she served as a member of Pain Study Committee at the Institute of Medicine focused on the under-treatment of pain. In 2012 she was appointed by the Secretary of Health and Human Services, Kathleen Sibelius, to the Interagency Pain Research Coordinating Committee (IPRCC) at the National Institutes of Health. In that capacity, she also serves on the Oversight Committee for the National Pain Strategy Task Force.
The Center for Bioethics and Social Sciences in Medicine (CBSSM) Research Colloquium was held Thursday, May 15, 2014 at the Vandenberg Meeting Hall (2nd floor), The Michigan League, 911 N. University Ave, Ann Arbor, MI 48109.
- Click here for an audio recording of the 2014 Bishop Lecture
Scott Roberts, PhD, is Professor of Health Behavior & Health Education at the University of Michigan’s School of Public Health (U-M SPH), where he directs the School’s Public Health Genetics program and teaches a course on public health ethics. A clinical psychologist by training, Dr. Roberts conducts research on the psychosocial implications of genetic testing for adult-onset diseases.
Michele Heisler, M.D., M.P.A., professor of internal medicine, was selected to receive the 2017 Clinical and Health Services Research Award from the Dean's awards program.
The award recognizes outstanding contributions made to the Medical School in clinical or health services research. Heisler will be honored at the annual Dean's Awards Dinner on November 14.