Journal of Urban Health

, Volume 90, Issue 1, pp 175–184 | Cite as

Reconsidering the Effects of Poverty and Social Support on Health: A 5-Year Longitudinal Test of the Stress-Buffering Hypothesis

  • David MoskowitzEmail author
  • Eric Vittinghoff
  • Laura Schmidt


Prior research in the general population has found that social support can buffer the adverse effects of stressors on health. However, both stressors and social support may be qualitatively different for those living in urban poverty. We examined the effects of social support and poverty-specific stressors on self-rated health. We used data from the Welfare Client Longitudinal Survey (WCLS), a 5-year longitudinal study of 718 public aid recipients. We measured received social support and “net social support,” defined as the difference between support received and that given to others. We used restricted cubic splines to model the stress-buffering effects of social support on self-rated health as a function of stressful life events and neighborhood disorder. Increased exposure to stressors was associated with poorer self-rated health. Evidence of stress buffering was confined to those with the heaviest exposure to stressors, and its effects decreased across increasing levels of social support. Analyses using net social support had generally more modest effects than those using received social support. Social support does not buffer the effects of stressors on health uniformly for individuals living in conditions of urban poverty. Researchers and policymakers should be cautious in overestimating the beneficial effects that social support may have on health for marginalized populations.


Social support Stressors Self-rated health Social environment Urban poverty 



This study was supported by grants from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) P50 AA05595, R01 AA13136, R01 AA0149918, and R21AA015397. Dr. Moskowitz was supported by the Primary Care Research Fellowship at UCSF, funded by the Department of Health and Human Services, Health Resources and Services Administration D55HP05165. Dr. Schmidt’s effort was supported by the Philip R. Lee Institute for Health Policy Studies Fellowship Program and NIAAA grant R01AA017197.


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Copyright information

© The New York Academy of Medicine 2012

Authors and Affiliations

  • David Moskowitz
    • 1
    Email author
  • Eric Vittinghoff
    • 2
  • Laura Schmidt
    • 3
    • 4
  1. 1.Department of Ambulatory and Preventive MedicineAlameda County Medical CenterOaklandUSA
  2. 2.Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoUSA
  3. 3.Department of Anthropology, History and Social MedicineUniversity of California at San FranciscoSan FranciscoUSA
  4. 4.Philip R. Lee Institute for Health Policy StudiesUniversity of California San FranciscoSan FranciscoUSA

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