Marital status and gender differences in managing a chronic illness: The function of health-related social control

• Published in: Social science & medicine (1982) Vol. 71; no. 10; pp. 1831 - 1838
• Main Authors: August, Kristin J., Sorkin, Dara H.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2010; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Adult; Aged; Aged, 80 and over; California; Chronic Disease - therapy; Chronic Illness; Chronic illnesses; Cultural Pluralism; Diabetes; Diabetes Mellitus, Type 2; Emotions; Female; Gender differences; Gender differentiation; Health; Health Behavior; Health behaviors; Hostility; Humans; Illness; Illness management; Long-term care; Male; Marital Status; Middle Aged; Patients; Regression analysis; Sex Differences; Sex Factors; Social Control; Social control Health behaviors Marital status Gender differences Illness management Type 2 diabetes USA Social networks; Social Control, Formal; Social Networks; Social Response; Social sciences; Social Support; Stress, Psychological; Type 2 diabetes; U.S.A; USA; California; Southern California; United States > US; Type 2 diabetes; Social control; USA; Marital status; Health behaviors; Illness management; Social networks; Gender differences
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2010.08.022

The attempts of social network members to regulate individuals’ health behaviors, or health-related social control, is one mechanism by which social relationships influence health. Little is known, however, about whether this process varies in married versus unmarried individuals managing a chronic illness in which health behaviors are a key component. Researchers have proposed that social control attempts may have dual effects on recipients’ well-being, such that improved health behaviors may occur at the cost of increased emotional distress. The current study accordingly sought to examine marital status differences in the sources, frequency, and responses to health-related social control in an ethnically diverse sample of 1477 patients with type 2 diabetes from southern California, USA. Results from two-way ANCOVAs revealed that married individuals reported their spouses most frequently as sources of social control, with unmarried women naming children and unmarried men naming friends/neighbors most frequently as sources of social control. Married men reported receiving social control most often, whereas unmarried men reported receiving social control least often. Regression analyses that examined behavioral and emotional responses to social control revealed that social control using persuasion was associated with better dietary behavior among married patients. Results also revealed a complex pattern of emotional responses, such that social control was associated with both appreciation and hostility, with the effect for appreciation most pronounced among women. Findings from this study highlight the importance of marital status and gender differences in social network members’ involvement in the management of a chronic illness.