The Relationship Between Disproportionate Social Support and Metabolic and Inflammatory Markers: Moderating Role of Socioeconomic Context

Abstract

Objective: The present study examines the association of disproportionate social support (the relative balance of support given versus received) on metabolic and inflammatory outcomes and whether effects vary by socioeconomic context.

Methods: We enrolled a sample of 307 parental caregivers living with a child with a chronic illness. Parents were assessed on four dimensions of social support: emotional support received, instrumental support received, emotional support given, and instrumental support given. Disproportionate social support was calculated as the difference between support received and support given. Participants provided sociodemographic information, were interviewed about financial stress, and were assessed on metabolic (systolic blood pressure, diastolic blood pressure, total cholesterol, body fat percent, and body mass index) and inflammatory (interleukin 6 and C-reactive protein) outcomes.

Results: More disproportionate instrumental and emotional support was associated with higher inflammation (b = 0.10, SE = 0.04, p = .014; b = 0.0.09, SE = 0.05, p = .042, respectively). We observed significant interactions between disproportionate social support and income (b = -0.04, SE = 0.02, p = .021). Parents from lower-income households who gave more emotional support than they received had higher inflammation compared with those from higher-income households. We also observed a significant interaction between disproportionate instrumental support and income (b = 0.04, SE = 0.02, p = .006). Parents from lower-income households who received more instrumental support than they gave had worse metabolic outcomes compared with parents from higher-income households. Parallel interaction patterns were observed using an interview-based measure of financial stress.

Conclusions: These findings show that disproportionate social support has implications for physical health, particularly for caregivers from socioeconomically disadvantaged households.

Figure 1.

The effects of family socioeconomic variables and disproportionate instrumental social support on the metabolic composite. Multiple linear regression analyses were used which controlled for age, race, and sex. The lines represent estimated regression lines for +1 SD instrumental support (representing those who disproportionately give more instrumental support than they receive) and −1SD instrumental support (representing those who disproportionately receive more instrumental support than they give). The metabolic composite was calculated by averaging standardized SBP, DBP, total cholesterol, body fat percentage, and BMI. The two figures depict significant interaction effects for each family socioeconomic variable: income (Panel A) and an interview-based measure of financial stress (Panel B).

Figure 2.

The effects of family socioeconomic variables and disproportionate emotional social support on low-grade inflammation. Multiple linear regression analyses were used which controlled for age, race, and sex. The lines represent estimated regression lines for +1SD emotional support (representing those who disproportionately give more emotional support than they receive) and −1SD emotional support (representing those who disproportionately receive more emotional support than they give). The inflammation composite was calculated by averaging standardized IL-6 and hs-CRP scores. The two figures depict significant interaction effects for each family socioeconomic variable: income (Panel A) and an interview-based measure of financial stress (Panel B).