Journal of Behavioral Medicine

, Volume 36, Issue 2, pp 199–211

Adults with cardiovascular disease who help others: a prospective study of health outcomes

  • Michele Heisler
  • HwaJung Choi
  • John D. Piette
  • AnnMarie Rosland
  • Kenneth M. Langa
  • Stephanie Brown
Article

Abstract

Little is known about the health impact of helping behaviors among individuals with high-risk chronic diseases such as cardiovascular disease (CVD). Using a nationally representative, longitudinal survey, we examined the subsequent health of adults with CVD (n = 4,491) who spent time providing non-paid assistance to family and friends outside of their households compared with those who had provided no assistance. After both adjusting for baseline characteristics and using propensity score matching methods, spending up to 200 h over the prior 12 months helping others was associated with lower odds of experiencing a new CVD event or dying in the subsequent 2 years. Providing up to 100 h of assistance was associated with reporting fewer depressive symptoms. This threshold effect raises the question of whether assistance beyond a certain number of hours may impose a burden that mitigates health benefits from helping others. Health care providers could play an important role exploring ways that patients with CVD can provide beneficial levels of assistance to others in their own social networks or communities, thereby possibly also improving their own health.

Keywords

Social support Epidemiology Cardiovascular disease Cohort 

References

  1. Baumeister, R. (1991). Meanings of life. New York, New York: Gilford Press.Google Scholar
  2. Berkman, L. F., & Glass, T. (2000). Social integration, social networks, social support, and health. In L. F. Berkman & I. Kawachi (Eds.), Social epidemiology. New York: Oxford.Google Scholar
  3. Berkman, L. F., et al. (2003). Effects of treating depression and low perceived social support on clinical events after myocardial infarction: The enhancing recovery in coronary heart disease patients (ENRICHD) randomized trial. JAMA, 289, 3106–3116.PubMedCrossRefGoogle Scholar
  4. Brown, S. L., et al. (2012). Caregiving and decreased mortality risk. Psychological Science, In PressGoogle Scholar
  5. Brown, S. L., & Brown, R. M. (2006). Selective investment theory: Recasting the functional significance of close relationships. Psychological Inquiry, 17, 1–29.CrossRefGoogle Scholar
  6. Brown, S. L., et al. (2003). Providing social support may be more beneficial than receiving it: Results from a prospective study of mortality. Psychological Science, 14, 320–327.PubMedCrossRefGoogle Scholar
  7. Brown, W. M., et al. (2005). Altruism relates to health in an ethnically diverse sample of older adults. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 60B, 143–152.CrossRefGoogle Scholar
  8. Brown, S. L., et al. (2008). Self-reported helping behavior predicts coping with spousal loss. Personality and Social Psychology Bulletin, 34, 849–861.PubMedCrossRefGoogle Scholar
  9. Brunstein, J. C. (1993). Personal goals and subjective well-being: A longitudinal study. Journal of Personality and Social Psychology, 65, 1061–1070.CrossRefGoogle Scholar
  10. Carlin, J. B., et al. (2008). A new framework for managing and analyzing multiply imputed data in Stata. The Stata Journal, 8, 49–67.Google Scholar
  11. Carter, C. S. (1998). Neuroendocrine perspectives on social attachment and love. Psychoneuroendocrinology, 23, 779–818.PubMedCrossRefGoogle Scholar
  12. Cialdini, R. B., et al. (1997). Reinterpreting the empathy-altruism relationship: When one into one equals oneness. Journal of Personality and Social Psychology, 73, 481–494.PubMedCrossRefGoogle Scholar
  13. DiMatteo, M. R. (2004). Social support and patient adherence to medical treatment: A meta-analysis. Health Psychology, 23, 207–218.PubMedCrossRefGoogle Scholar
  14. Estabrooks, P. A., et al. (2003). Physical activity promotion through primary care. JAMA, 289, 2913–2916.PubMedCrossRefGoogle Scholar
  15. Friedmann, E. et al. (2006). Relationship of depression, anxiety, and social isolation to chronic heart failure outpatient mortality. American Heart Journal, 152(5), 940 e941–940 e948Google Scholar
  16. Gallant, M. P. (2003). The influence of social support on chronic illness self-management: a review and directions for research. Health Education & Behavior, 30, 170–195.CrossRefGoogle Scholar
  17. Heaphy, E. D., & Dutton, J. E. (2008). Positive social interactions and the human body at work: Linking organizations and physiology. Academy of Management Review, 33, 137–162.CrossRefGoogle Scholar
  18. Hirschfelder, A. S., & Reilly, S. L. (2007). Rx: Volunteer: A prescription for healthy aging. In S. Post (Ed.), Altruism and health (pp. 115–140). New York: Oxford University Press.Google Scholar
  19. House, J. S. (2001). Social isolation kills, but how and why? Psychosomatic Medicine, 63, 273–274.PubMedGoogle Scholar
  20. House, J. S., et al. (1988). Social relationships and health. Science, 241, 540–545.PubMedCrossRefGoogle Scholar
  21. Idler, E. L., & Benyamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38, 21–37.PubMedCrossRefGoogle Scholar
  22. Ironson, G., & Hayward, H. (2008). Do positive psychosocial factors predict disease progression in HIV-1? A review of the evidence. Psychosomatic Medicine, 70, 546–554.PubMedCrossRefGoogle Scholar
  23. Juster, F. T., & Suzman, R. (1995). An overview of the health retirement study. J Human Research, 30, S7–S56.CrossRefGoogle Scholar
  24. Krause, N., et al. (1992). Providing support to others and well-being in later life. Journal of Gerontology, 47, 300–311.CrossRefGoogle Scholar
  25. Krumholz, H. M., et al. (1998). Prognostic importance of emotional support for elderly patients hospitalized with heart failure. Circulation, 97, 958–964.PubMedCrossRefGoogle Scholar
  26. Liang, J., et al. (2001). Social exchange and well-being: Is giving better than receiving? Psychology and Aging, 16, 511–523.PubMedCrossRefGoogle Scholar
  27. Lloyd, C., et al. (2005). Stress and diabetes: A review of the links. Diabetes Spectrum, 18, 121–127.CrossRefGoogle Scholar
  28. Luoh, M. C., & Herzog, A. R. (2002). Individual consequences of volunteer and paid work in old age: Health and mortality. Journal of Health and Social Behavior, 43, 490–509.PubMedCrossRefGoogle Scholar
  29. Luttik, M. L., et al. (2005). The importance and impact of social support on outcomes in patients with heart failure: An overview of the literature. Journal of Cardiovascular Nursing, 20, 162–169.PubMedGoogle Scholar
  30. McEwen, B. S. (1998). Protective and damaging effects of stress mediators. New England Journal of Medicine, 338, 171–179.PubMedCrossRefGoogle Scholar
  31. Moran, A., et al. (2008). Social support and conscientiousness in hemodialysis adherence. Annals of Behavioral Medicine, 19, 333–338.CrossRefGoogle Scholar
  32. Murberg, T. A. (2004). Long-term effect of social relationships on mortality in patients with congestive heart failure. International Journal of Psychiatry in Medicine, 34, 207–217.PubMedCrossRefGoogle Scholar
  33. Musick, M. A., & Wilson, J. (2003). Volunteering and depression: The role of psychological and social resources in different age groups. Social Science and Medicine, 56, 259–269.PubMedCrossRefGoogle Scholar
  34. Oman, D. (2007). Does volunteering foster physical health and longevity? In S. Post (Ed.), Altruism and health (pp. 15–32). New York: Oxford University Press.CrossRefGoogle Scholar
  35. Post, S. G. (2005). Altuism, happiness, and health: It’s good to be good. International Journal of Behavioural Medicine, 12, 66–77.CrossRefGoogle Scholar
  36. Post, S. (2007). Altruism and health. New York: Oxford University Press.CrossRefGoogle Scholar
  37. Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in well older adults. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
  38. Sayers, S. L., et al. (2008). Social support and self-care of patients with heart failure. Annals of Behavioral Medicine, 35, 70–79.PubMedGoogle Scholar
  39. Schwartz, C. E., & Sendor, M. (1999). Helping others helps oneself: Response shift effects in peer support. Social Science and Medicine, 48, 1563–1575.PubMedCrossRefGoogle Scholar
  40. Schwartz, C., & Sendor, M. (2000). Helping others helps oneself: Response shift effects in peer support. In K. Schmaling (Ed.), Adaptation to changing health: Response shift in quality-of-life research. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  41. Schwartz, C. E., et al. (2003). Altruistic social interest behaviors are associated with better mental health. Psychosomatic Medicine, 65, 778–785.PubMedCrossRefGoogle Scholar
  42. Schwartz, C. E., et al. (2004). Exploring response shift in longitudinal data. Psychology & Health, 19, 51–69.CrossRefGoogle Scholar
  43. Smith, C., et al. (1994). Meta-analysis of the associations between social support and health outcomes. Annals of Behavioral Medicine, 16, 352–362.Google Scholar
  44. Soldo, B. J. et al. (1997). Asset and health dynamics among the oldest old: An overview of the AHEAD study. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 52 Spec No, 1–20Google Scholar
  45. Steffick, D., & Group, H. R. S. H. W. (2000). Documentation of affective functioning measures in the health and retirement study. Ann Arbor: Survey Research Center, University of Michigan.Google Scholar
  46. Surwit, R. S., et al. (2002). Stress management improves long-term glycemic control in type 2 diabetes. Diabetes Care, 25, 30–34.PubMedCrossRefGoogle Scholar
  47. Van Willigen, M. (2000). Differential benefits of volunteering across the life course. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 55, S308–S318.CrossRefGoogle Scholar
  48. Wheeler, J. A., et al. (1998). The beneficial effects of volunteering for older volunteers and the people they serve: A meta-analysis. International Journal of Aging and Human Development, 47, 69–79.PubMedCrossRefGoogle Scholar
  49. Wiesli, P., et al. (2005). Acute psychological stress affects glucose concentrations in patients with type 1 diabetes following food intake but not in the fasting state. Diabetes Care, 28, 1910–1915.PubMedCrossRefGoogle Scholar
  50. Yinon, Y., & Landau, M. O. (1987). On the reinforcing value of helping behavior in a positive mood. Motivation and Emotion, 11, 83–93.CrossRefGoogle Scholar
  51. Zhang, X., et al. (2007). Social support and mortality among older persons with diabetes. Diabetes Education, 33, 273–281.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC (outside the USA) 2012

Authors and Affiliations

  • Michele Heisler
    • 1
    • 2
    • 3
    • 4
  • HwaJung Choi
    • 2
    • 3
  • John D. Piette
    • 1
    • 3
  • AnnMarie Rosland
    • 1
    • 3
  • Kenneth M. Langa
    • 1
    • 3
  • Stephanie Brown
    • 5
  1. 1.VA Center for Clinical Management ResearchVA Ann Arbor Healthcare SystemAnn ArborUSA
  2. 2.Robert Wood Johnson Foundation Clinical Scholars ProgramUniversity of Michigan School of MedicineAnn ArborUSA
  3. 3.Department of Internal MedicineUniversity of Michigan School of MedicineAnn ArborUSA
  4. 4.Department of Health Behavior and Health EducationSchool of Public HealthAnn ArborUSA
  5. 5.Stonybrook University School of MedicineStonybrookUSA

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