Health Psychology Review

Vol. 1, No. 2, September 2007, 186
207

Social status, social support, and stress: a comparative review of the health
consequences of social control factors
Lisa Beck*

Department of Psychology, Bryn Mawr College, Bryn Mawr, PA, USA

(Received 20 October 2007; final version received 25 April 2008)

The purpose of this review is to present evidence that two fundamental relationship
dimensions, social status and social support, play significant roles in protecting
individuals from stressors, stress responding, and related health problems. While there
is a substantial literature on the link between social support and health, the role of social
status has been largely overlooked in health psychology research. Research with humans
and animals, in a variety of disciplines, demonstrates the effects of both status and
support on acute stress responding and long-term health outcomes. Taken together, this
research suggests that status and support serve to increase the individual’s control over
the social and physical environment, thus reducing the experience and effects of stress.
The proposed social control model has implications for future research, including
development of new measures, identification of health-relevant relationships, and
generation of research questions to further illuminate our understanding of how social
interactions affect health.
Keywords: status; support; control; stress; social self-preservation

For humans and for all social animals, social relationships are not luxuries but are essential
for survival. Shelter, security, and access to resources often depend on proximity to others.
Getting along with other individuals is essential, as outsiders may not be tolerated at a
food source or safe sleeping area. Within a group, individuals have different roles and
skills. Age, ability, or other individual variations give rise to differences in status, which
affect how each member behaves and experiences group life. High-ranking members of a
group
whether crayfish or real estate moguls
get better food, more attention from the
opposite sex, and larger territories than their subordinates. Social status and social support
are fundamental motivations in social interactions, and are central to the study of both
human and animal behaviour.
This paper proposes a model describing how the fundamental social dimensions of
status and support affect health, through their effects on the individual’s experience of and
response to stress. First, I review evidence for the pervasive importance of status and
support in a wide range of human and animal research. Next, I discuss the social and
environmental triggers of physiological stress responding, and how chronic stress
responding leads to a variety of health problems. Then, I review animal and human
research to show that status and support reduce stress responding and are associated with
better health. Conversely, low status and social isolation are associated with more stress
responding and negative health outcomes. Environmental controllability and predictability

*Email: lbeck@brynmawr.edu

ISSN 1743-7199 print/ISSN 1743-7202 online

# 2008 Taylor & Francis
DOI: 10.1080/17437190802217246
http://www.informaworld.com
 Health Psychology Review 187

are also important predictors of stress and health, and may underlie the effects of status
and support. Thus, status and support can be viewed as social sources of control that
protect against the occurrence of stressors, reduce physiological responding to stressors,
and reduce the impact that stress-related health problems have on daily life. Finally, I
discuss the implications of the proposed model for better understanding of earlier findings
and for generating questions for further research.
One of the problems with searching for correlations between social support and health
is that the constructs have multiple dimensions. ‘Health’ can be measured by symptom self-
report, blood pressure, accidental injury, chronic illness, or death. Similarly, social support
is not a monolithic construct, but is commonly subdivided into more meaningful elements.
Cohen and Wills (1985) provide four useful categories of social support. Informational
support is advice or guidance that can help to define and solve problems. Instrumental
support is material assistance such as transportation to a medical appointment, or money
for lunch. Social companionship offers a sense of affiliation, distraction from problems,
and positive mood. Finally, emotional support provides a sense of self-worth, that one is
appreciated despite one’s failings.
Operationalising one or more of these dimensions presents another complication
(Stroebe, Stroebe, Abakoumkin, & Schut, 1996). For instance, support can be measured by
assessing the size of a social network, the perceived availability of supportive others, or in
terms of the frequency with which support is received. Clearly, the term ‘social support’
encompasses a broad range of interactions, perceptions, and behaviours.
For the present discussion, which aims to bridge animal and human research, simple
definitions of status and support will suffice. Researchers testing the connections proposed
here will be able to examine the varying contributions and interactions of different types of
social support on health. Similarly, research related to the present model may lead to
recognition of important distinctions in measurement and definition of status.

Social status and social support as fundamental, universal dimensions

In this section I review evidence for the primacy of two basic elements of social
interactions, which have been called by different names, as seen below. In later sections I
will use the terms status and support, as these are common, unidirectional, positive, and
applicable to both humans and animals.

Status and solidarity

A prominent theorist in social psychology, Roger Brown, proposed that all human
interactions can be described in terms of two major dimensions: status and solidarity
(Brown, 1965). These dimensions are universal across cultures, and inform many aspects of
social interactions and cultural traditions. These constructs are also ubiquitous in
personality theory, where they are sometimes labelled agency and communion, or power
and love (Wiggins & Trobst, 1999).
Status is conceptualised by Brown (1965) as a vertical dimension, an asymmetrical
relationship in which individuals are in general agreement on their positions relative to
each other and behave accordingly. Dominant members of a group may possess greater
skill or seniority than others, and control more individuals and resources than those lower
in the hierarchy. Subordinates are deferential and obedient, receiving protection and group
membership in return (Brown, 1965).
188 L. Beck

Solidarity is best represented as a lateral relationship between individuals. Solidarity

includes affectionate interactions, as well as any positive experience of affiliation,
companionship and belonging. Similarity is an important source of solidarity, so
individuals with similar backgrounds, histories, goals, and activities are likely to enjoy
each others’ company.
Brown (1965) posits an inverse relationship between status and solidarity. In adult
relationships, differences in status weaken the experience of solidarity, and conversely,
similarity tends to equalise differences in rank. Thus, although humans value both status
and solidarity, a single relationship rarely provides high levels of both dimensions.
In a study of self-reports of status and solidarity in daily interactions, respondents
report that downward comparisons (with individuals of lower status or ability) and
connective comparisons (with similar others) are more helpful and mood-enhancing,
compared with upward and contrastive comparisons (Locke, 2003). This investigation also
found a negative relationship between the respondent’s perceived status in a social
exchange and reported solidarity with the target. These results illustrate the affective
consequences of status and solidarity, and support Brown’s (1965) suggestion that there is
a negative relationship between status and solidarity.

Self-esteem and affiliation

The concepts of status and support surface in investigations of negative social interactions
as well. Anderson and Lawler (1995) asked women to describe incidents that made them
angry. Half of the Type A women in the study described incidents related to self-esteem,
suggesting a status component in keeping with the Type A behaviour pattern. For Type B
women, nearly half of anger incidents related to affiliation needs, suggesting a social
support component. About 30% of both groups described incidents related to frustration
of autonomy, defined by the authors as ‘control of power or resources’. Autonomy here
may be related to social dominance, but may also be relevant to environmental control or
predictability, which will be addressed in a later section.

Competence and warmth

Building on decades of social perception research, Fiske, Cuddy, and Glick (2007) review
evidence for the primacy of two dimensions of social judgments, which they label
competence and warmth. Perception of competence includes status-related traits like
intellect, ability, agency, and worthiness of respect. Perception of warmth includes support-
related traits like sociability, morality, trustworthiness, and helpfulness. Reaction time and
priming experiments have demonstrated the immediacy and accessibility of competence
and warmth judgments. The authors report that judgments of these two basic dimensions
account for almost all variance in perceptions of social behaviour.
Similar results have been found in at least 19 countries on four continents, suggesting
that the importance of competence and warmth is universal, not merely a cultural artefact.
According to Fiske et al. (2007), these constructs represent adaptations to evolutionary
pressures. For early humans, as for most animals, surviving an encounter with another
individual required immediate assessment of his or her abilities and intentions. Today we
are less likely to die from mistakes in these judgments, but in an evolutionary context,
‘dying of embarrassment’ may be a fitting description of the significance of mistakes in
social judgments. In short, the dimensions of social perception seem to mirror the adaptive
significance of status and support concerns.
 Health Psychology Review 189

Rank and kinship

Further evidence for the primitive origins of these judgments comes from fieldwork with
baboons in Botswana, which suggest that animals categorise other individuals on the basis
of two characteristics: rank in the troop’s dominance hierarchy, and membership in a
family group. In playback experiments, baboons showed more interest in vocalisations that
signalled rank reversals between families than within families. These results indicate that
the animals make judgments of rank and kinship spontaneously and simultaneously
(Bergman, Beehner, Cheney, & Seyfarth, 2003). Moreover, these social attributes inform
baboons’ behaviour in virtually every social interaction. Extensive exploration of the lives
of these intensely social animals demonstrates the central role of status and support, and
invites comparisons with human social dynamics (Cheney & Seyfarth, 2007).

Social hierarchy and social support

In the previous examples, behavioural evidence indicates the fundamental nature of status
and support as dimensions of social interaction. A recent review by Kemeny (2007) extends
the relevance of these dimensions to physiological outcomes. Kemeny concludes that two
distinct social factors influence immune response: social hierarchy and social support.
The immune consequences of rank in a social hierarchy have been demonstrated in a
wide range of animals, including fish, rodents, and primates. After losing a conflict, low-
ranking animals show inhibited immune response sometimes lasting days or weeks. In
contrast, high-ranking animals show little or no immune suppression. The persistence and
degree of immune suppression are typically highly correlated with behavioural displays of
submission. These results indicate that physiological response is closely bound to the
animal’s social status.
Similarly, social support has a beneficial effect on immune response, at least in part by
buffering the effects of stressors. Kemeny (2007) points to an extensive literature indicating
that people with more social support enjoy better health, and to specific findings that
immune function is stronger in people and animals with social support and affiliative
opportunities than in their cohorts who are isolated or lonely.

Social self-preservation
The theory of social self-preservation (Dickerson & Kemeny, 2004) provides a framework
for understanding how social interactions affect stress responses. Physical danger is an
obvious example of a stressor, but threats to social status or self-identity are also powerful
stressors. As previously described, social subordinance or isolation may be equivalent to
physical peril, and social goals are invested with enormous adaptive significance. In
situations involving the possibility of negative judgment, rejection, and public failure,
social-evaluative threat activates physiological stress responding in humans and in many
animal species. Uncontrollability can create or exacerbate a situation of social threat, when
the individual cannot do anything to avoid failure, and goal-directed behaviour does not
affect outcomes.
Given the importance of status and support in social interactions, and Kemeny’s (2007)
demonstration that hierarchy and support are significant predictors of immune response, it
is reasonable to suppose that status and support constitute important defences against
social-evaluative threat (Dickerson & Kemeny, 2004). These factors are effective means for
190 L. Beck

preserving control over social situations, and should therefore be predicted to have effects
on the experience and consequences of stress.

Stress-related disease
When a threat is perceived, the body initiates a cascade of neuroendocrine activity.
Catecholamine (epinephrine and norepinephrine) production stimulates the sympathetic
nervous system (SNS), and the hypothalamus
pituitary
adrenal (HPA) axis releases
glucocorticoids (mainly cortisol in mammals). These changes prepare the body for action
in a number of ways. Blood glucose levels are elevated, making energy available to tissues.
Increased heart rate and blood pressure facilitate the transport of oxygen and glucose to
the muscles, providing energy for emergency action, and to the brain, improving cognitive
function. In order to make more resources immediately available for fight or flight, long-
term processes like tissue repair and growth, digestion, and reproductive functions are put
on hold while the individual mobilises emergency resources. In addition, increased levels of
circulating cortisol resulting from activation of the HPA axis inhibit immune functioning
(Dickerson & Kemeny, 2004).
Normally, these physiological changes increase the individual’s chance for surviving a
dangerous situation, after which normal functions can resume. However, if a threat is
chronically present or perceived, overexposure to catecholamines and glucocorticoids will
lead to muscle weakness and dysfunction, and generalised fatigue. Extended HPA
activation results in high blood pressure and hardening of the arteries. Stress responding
usually leads to an abrupt decline in testosterone production, and disruption of
reproductive function can also lead to impotence or amenorrhea. Effects on the digestive
tract include colitis and gastric ulcer. Tissue repair and regeneration are slowed, and
osteoporosis may result. The nervous system itself may suffer from overexposure to its own
neurochemicals (Sapolsky, 1999). Finally, chronic immunosuppression increases the risk of
contracting infections, and sets the stage for prolonged or more severe illness (Kemeny,
2007).
The HPA, SNS, and immune systems are interdependent, and can affect each other’s
functioning (Taylor, 2007). ‘Physiological stress responding’ is a general description of the
activation of one or more stress-relevant systems. In practice, stress responding is typically
measured by cortisol levels in saliva, blood, or urine, or by cardiovascular reactivity, such
as changes in heart rate or blood pressure. These discrete measures often represent a much
broader physiological response to stress, however. The many effects of stress increase the
likelihood of a wide range of physical ailments.

Social status, social support and control reduce stress responding

This section reviews evidence linking status, support, and control with health outcomes.
The present inquiry was stimulated by Kemeny’s (2007) review of the immune
consequences of hierarchy and support, and Dickerson and Kemeny’s (2004) investigation
of stress responding as a result of social threat and uncontrollability. This section will
extend this discussion by examining the effect of status and support on stress and health
indicators. Evidence from a wide range of research disciplines and perspectives indicates
that status and support are the most important means of defending against social
evaluative threat. I review the stress and health implications of status and support for both
animals and humans. Finally, I review evidence for the consequences of a potentially non-
social source of stress, uncontrollability.
 Health Psychology Review 191

Social status reduces stress responding

Observation and research in both animals and humans demonstrates that status affects
health by preventing stress, buffering physiological stress responding, and reducing the
significance of health problems. Animals and humans with high social status are protected
from many stressful situations. Status brings relative safety, security, and availability of
resources.

Evidence in animals
Extensive studies on the physiological implications of social status have been conducted
with baboons in the wild (Sapolsky, 1997). These results provide a clear picture of how
social interactions and physiological responses are intertwined.
When a male baboon reaches sexual maturity, he leaves the relative safety and comfort
of his troop of origin, where his mother, grandmother, sisters, and aunts will stay their
whole lives. He leaves his family and others he could count on to give and receive physical
signs of acceptance, like grooming, which is a vital part of baboon society. Not only does
grooming prevent discomfort and disease associated with fleas, ticks, lice, and other
parasites, but it is an important bonding ritual that assures the animal of its place in the
troop community. The young male leaves this secure existence to join a new troop,
composed entirely of strangers, not kin.
This is a painful transition. As an outsider, he is rejected by the members of the troop
he desires to join. He is not just at the bottom of the pecking order, but truly outside
society. The troop mostly ignores him, and when he gathers courage or in desperation tries
to approach, he is attacked and driven away. Eventually the low-status members take an
interest in him, but his acceptance as a member of the troop is strictly as a target for their
frustrations and as a step below them in the hierarchy. They rob him of his food, drive him
from his resting places, and assault him without provocation. He is kept on the periphery
of the troop, a target of predators, hungry, lonely, and parasite-ridden. If he is lucky, he
may develop something like a friendship with another subordinate like himself. If his
health and will hold out, he may slowly climb in the hierarchy, challenging those holding
positions just above his own and violently hazing those beneath him.
At the top of the hierarchy, the dominant male enjoys his choice of food and territory,
as well as much improved prospects for female mating partners. His life is relatively
comfortable as long as the hierarchy is stable, that is, until a subordinate male challenges
his position or the troop is threatened by a rival troop, disease, or other disturbance.
In times of threat, high-status animals show immediate and substantial increase in
circulating cortisol, necessary for an energetic response to the situation. When the danger
has passed, cortisol levels return quickly to a low baseline, indicating efficient regulation of
the HPA system. Indicators of general health, including lymphocytes, infection-fighting
white blood cells, and high-density lipoprotein, or ‘good cholesterol’ are in good supply in
high-ranking animals (Sapolsky, 1999).
Baboons at the bottom of the hierarchy show physical signs of chronic stress. With
adrenocortical systems exhausted by overuse, subordinates show sluggish cortisol response
during emergencies. When the threat has passed, cortisol levels of subordinates take longer
to return to baseline, and remain higher than the levels of their privileged superiors. They
exhibit low lymphocyte count and more low-density lipoprotein (‘bad cholesterol’). When
autopsied, low-status males show more hardening of the arteries than high-status males,
and adrenal glands are enlarged from overuse (Sapolsky, 1993b).
192 L. Beck

Stress indicators have been shown to be higher for subordinate individuals than for
dominant individuals in a range of species, including primates, rats, wolves, hyenas, pigs,
and even fish (reviewed in Sapolsky, 1999). A recent experiment with green anole lizards
found that somatic indicators of stress (skin colour and markings) are associated with
status. After forming stable dominance relationships, lizards were stressed by being chased
around a cage with a stick. Dominant lizards showed reduced stress responding and faster
recovery compared with pretest measures and with subordinate lizards’ stress indicators
(Plavicki, Yang, & Wilczynski, 2004). For many species, status is an important shield
against stress.
For others, however, status comes at a cost. For African wild dogs and dwarf
mongooses, dominant individuals have elevated glucocorticoid levels, probably due to the
high rates of aggression among high-ranking animals (Creel, Creel, & Monfort, 1996). In
primates, differences in stress responding are related to rank only for species in which low-
status animals suffer from their place in the hierarchy, or lack social support or other
coping mechanisms (Abbott et al., 2003). Thus, status alone is not a reliable predictor of
stress responding. Social support and perceived control, as well as personality, environ-
ment, and species-typical behaviour all contribute to the occurrence and impact of
stressors (Sapolsky, 1999).

Evidence in humans
Human social structure is more complicated than in animals, so simple correlations
between rank and cortisol response are unlikely. However, general measures of health,
which, as shown previously, may be related to stress response, have been found to be
correlated with social status. Poverty is a risk factor for humans, for many reasons, such as
poor nutrition, lack of access to medical care, exposure to pollutants, and higher rates of
behaviours such as smoking and alcohol use. In a nine-year longitudinal study of adults in
Oakland, California, Haan, Kaplan, and Camacho (1987) found that residents of a
federally designated poverty area had higher rates of mortality than residents of non-
poverty areas. When environmental and behavioural factors were statistically controlled,
the higher death rates for impoverished residents remained. These results suggest a direct
effect of social status on health.
Much of the research on status and health focuses on poor people. But even in
populations where status is already quite high, important health differences appear. In a
retrospective study of film actors and actresses, Academy Award winners have been shown
to live about four years longer than non-winners (Redelmeier & Singh, 2001). Multiple
wins resulted in a longevity difference of about six years. Interestingly, there was no
longevity difference between actors who were nominated but did not win, and those who
were never nominated.
An important longitudinal study focused on status-related health differences among
17,000 middle class British civil servants (Marmot, Shipley, & Rose, 1984). During the 10-
year study, male participants in the lowest employment grades (clerical workers) were three
times as likely to die of coronary heart disease, or of any cause, than administrators in the
highest grades. Significant differences were found not only between the highest and lowest
grades, but each increase in rank was associated with a corresponding decrease in mortality
rate. This ‘inverse socioeconomic gradient’ for health among people with similar access to
health care is a remarkable result. Although some allowance for promotion on the basis of
health and well-being must be made, the size of the difference suggests something else at
work. Status appears to have a protective effect on human health.
 Health Psychology Review 193

Universal access to health care should make the health-status gradient less steep.
However, a study of 38,945 stroke victims in Canada, which has federal health insurance,
showed a 9% decrease in mortality for every $10,000 increase in median neighbourhood
income (Kapral et al., 2002). There were no status-related differences in the use of
medications, but poorer patients received less rehabilitation therapy, and waited longer for
surgery. Poorer patients, older patients, and women were less likely to be treated by a
specialist. The findings of this sort illustrate some of the ways that status affects the
medical response to acute illnesses, even when the health system strives for equal
treatment.

Social support reduces stress responding

Social support, like status, is a valuable shield against social evaluative threat and other
stressors. An animal or human assured of one or two close friendships has less reason to be
concerned about conflicts with others than a solitary individual. Social relationships
provide both direct and indirect support in times of threat. Two individuals have a better
chance than one at winning a conflict, and a show of unity may serve to avoid a
confrontation altogether. Friends share resources and information, help each other care for
offspring, and provide consolation after a disappointment, visibly signalling to others that
the loser has not lost everything. Research with both animals and humans demonstrates
the stress-reducing qualities and health consequences of social support.

Evidence in animals
As described above, social support is an important correlate of immune response in a
number of species (Kemeny, 2007), and the availability of positive social interactions
determines the neuroendocrine effects of status (Abbott et al., 2003). The cortisol profiles
of female baboons vary less by rank than those of males, apparently because females have a
more stable social hierarchy and more opportunities for affiliation. Thus, the effects of low
status are counterbalanced by social support. While Sapolsky’s research focuses on the
effects and moderators of social status, Smuts (1985) emphasises the role of social support
in her field research with baboons. Friends groom one another and sleep together; females
and infants are sometimes protected by a male friend, whether he is the father or not.
Although male olive baboons weigh almost twice what females weigh, females still retain a
great deal of control over who they copulate with, and a male friend, regardless of his rank,
has an advantage when she is in estrous. Smuts does not measure physiological stress
responding directly, but her research clearly illustrates the benefits of social support in the
stressful existence of a social primate.
These observations are not surprising, in light of experiments showing the importance
of social contact in rhesus monkeys (Harlow & Harlow, 1962). The best-known
experiments showed that baby monkeys preferred a soft terrycloth-covered frame to a
hard wire frame that provided nourishment. Other experiments found that monkeys raised
in total isolation were severely debilitated, both physically and emotionally, and were
unable to function normally in social situations. Isolated juveniles given 20 minutes each
day in each others’ company at first merely clung to one another, but eventually began to
interact, explore, and play energetically. With only this limited opportunity for affiliation,
their adult behaviour was much closer to normal.
Complementing the evidence that social isolation has harmful consequences, a recent
series of experiments with Siberian hamsters has demonstrated the physiological benefits
194 L. Beck

of affiliation (Detillion, Craft, Glasper, Prendergast, & DeVries, 2004). Hamsters were
subjected to a skin wound, followed by a stressor (physical restraint) which is known to
impair wound healing. Hamsters housed alone healed more slowly, and had higher levels
of circulating cortisol following the stressor, compared to hamsters housed with a sibling.
Another indicator of the effects of social interaction on stress is found in research on
oxytocin. Oxytocin in mammals is associated with parturition, lactation, maternal
behaviour, copulation and pair bonding (Insel, 2000). This socially relevant hormone is
also secreted in response to stress, and attenuates sympathetic and HPA responding
(Taylor, Dickerson, & Klein, 2002). Higher levels of circulating oxytocin, whether in
lactating females or exogenously administered, result in increased interest in social
interactions, along with reduced anxiety and aggression. In socially isolated animals,
administration of oxytocin decreases glucocorticoid secretion and results in wound healing
similar to that of socially housed experimental animals. The effects of oxytocin reveal a
strong connection between social and physical factors, and the significant role stress
responding plays in the relationship.
Additional evidence comes from research on social correlates of endogenous opioids,
which induce analgesia and euphoria. Opioids are released in response to social contact,
and reduce behavioural and neurochemical indicators of stress. These effects have been
demonstrated in a range of species, including juvenile rats, adult mice, monkeys, and
chicks, and neuroanatomical similarities suggest that the role of social interaction in
triggering endogenous opioid release may be generalisable to humans (Nelson & Panksepp,
1998).

Evidence in humans
A sense of wordless communication and mutual understanding, coupled with physical
affection, sorrow at the other’s absence, and mutual dependence are features of intimate
human relationships (Bowlby, 1973). Bowlby’s theory of attachment parallels Harlow’s
work with monkeys, and originated with his interest in orphans and other children
deprived of maternal care. In a massive World Health Organization report, Bowlby (1951)
describes the harrowing results of institutionalising children. Symptoms include listless-
ness, unresponsiveness to social stimuli, difficulty sleeping, lack of interest in surroundings,
frequent fevers, and failure to gain weight even on an adequate diet. Bowlby states that
‘when deprived of maternal care, the child’s development is almost always retarded

physically, intellectually, and socially
and that symptoms of physical and mental illness
may appear . . . some children are gravely damaged for life’ (p. 365).
Long-term effects on physiological stress responding have been correlated with
attachment style (Taylor et al., 2002). Compared with securely attached infants, insecurely
attached infants are more likely to show elevated cortisol levels in response to routine
inoculations. Children who have been physically abused, and those who experience a high
level of negative interactions with parents show signs of abnormal HPA regulation.
Further, patterns of stress responding in adulthood have been related to the loss of a parent
during adulthood.
Formally defined, attachment is much more than mere social support, as it is the
primary and essential relationship with a caregiver (Bowlby, 1973). In the early 1900s,
infants in orphanages and hospitals were isolated to protect them from disease. These
babies, who were never held and never saw unmasked faces, died at rates approaching
100% (Blum, 2002). While early attachment is necessary for survival, attachment needs
continue throughout adulthood. Many researchers find that even relationships that do not
 Health Psychology Review 195

qualify as true attachments still serve ‘attachment-related functions’ (Fraley & Shaver,
2000). The emotional and physical significance of the infant attachment relationship is
echoed in the lifelong desire for social support, and in lifelong physiological benefits of this
support.
The health effects of social support are varied and robust. Individuals with more social
ties are less likely to develop viral infections, and have fewer complications of pregnancy,
less arthritis pain, and faster recovery from surgery (reviewed in Taylor, 2007). Presence of
siblings in the community, frequency of eating out, and perceived social support have been
linked to lower blood pressure (reviewed in Uchino, Cacioppo, & Kiecolt-Glaser, 1996).
Marriage, church membership and size of household have been shown to predict mortality
in large-scale prospective studies, even when other health risks are taken into account
(reviewed in House, Landis, & Umberson, 1988).
Numerous studies (reviewed in Burman & Margolin, 1992; Kiecolt-Glaser & Newton,
2001) have explored the link between marriage and physical well-being. Compared with
unmarried people, married people enjoy better health. However, close relationships can
also affect health adversely; unhappy marriages are a significant source of stress,
contributing to health problems for the partners involved (Kiecolt-Glaser & Newton,
2001). While social support is not found in all relationships, even in all close relationships,
humans benefit from positive interactions, and seek out close relationships throughout the
lifespan.

Control reduces stress responding

‘Control is so crucial that its impact is evident in all possible systems’ (Peterson, Maier, &
Seligman, 1993, p. 305). The ability to predict and control surroundings and social
situations is a fundamental human concern that is echoed in animal psychology. From
perceptual organisation and classical conditioning to cognitive dissonance theory, living
creatures are constantly engaged in working to make sense of information. Although
control is not necessarily a social factor, its effect on stress responding and long-term
health outcomes makes it an essential element of social self-preservation.

Evidence in animals
As already noted, high status is associated with lower stress only in stable hierarchies.
Dwarf mongooses must continually reassert their rank, and dominant individuals exhibit
higher glucocorticoid levels than their subordinates (Sapolsky, 2005). In wild baboons,
hierarchical stability is an important determinant of stress responding (Sapolsky, 1993a). If
the troop’s territory is chronically threatened, or if an ambitious newcomer mounts a
credible campaign to seize control, the cortisol responses of the high-ranking males look
quite similar to those of the low-ranking males. In this situation, the high-ranking animals
lose a great deal of control, as environmental factors or new individuals can affect troop
life in unpredictable ways. Loss of control and predictability is a significant source of stress.
In the laboratory, lack of control is at the heart of the learned helplessness phenomenon
(Peterson et al., 1993). Dogs exposed to inescapable shock soon learn that their responses
are ineffectual, and give up trying to escape. In later trials, when the shock could be
avoided by jumping a low hurdle, the helpless animals did not make the responses that
would enable them to learn the new contingency. Conversely, dogs that had first been
permitted to learn escape behaviours were ‘immunised’ against helplessness. After
experience with inescapable shock, they were quick to learn a new escape response when
196 L. Beck

the contingency changed. Their experiences of control over the situation prevented learned
helplessness, and promoted effective responding in new situations.
An uncontrollable stressor, like the helplessness procedure, creates immediate, wide-
spread, and significant changes in neurochemical activity. The effects are very broad, as
nearly every neurotransmitter and many regions of the brain have been implicated in
helplessness effects (Peterson et al., 1993). After inescapable shock, norepinephrine is
depleted for as long as several days, with consequent motor deficits and hypersensitivity to
new stressors. The function of gamma-aminobutyric acid (GABA), an inhibitory
neurotransmitter, is reduced, permitting increased neural activity and leading to anxiety
and behavioural expressions of fear, such as freezing in rats. Endogenous opiates, which
produce analgesia, are activated in response to a minor shock in animals that have been
trained with inescapable shock. Yet when animals have had experience with avoidable
shock, a minor shock triggers no opiate response. Thus, control appears to provide
immunisation against neurochemical, as well as behavioural, responses to stressors.
After examining these wide-ranging physiological consequences Peterson et al. (1993)
proposed that corticotropin-releasing hormone (CRH), produced during HPA activation,
may be the chief mediator between uncontrollability and physiological stress responses. In
addition to its adrenergic effects, CRH is associated with GABA production and direct
activation of the SNS. CRH production is concentrated not only in the hypothalamus, but
also in the amygdala, which is involved in conditioned fear responses.
The health consequences for animals exposed to uncontrollable shock are intriguing.
Rats injected with tumour cells, then immediately exposed to a single session of inescapable
shock, quickly succumb to cancer. Tumour growth in animals exposed to escapable shock
does not differ from tumour growth in those who received no shocks at all (Peterson et al.,
1993). These results show the expected effect of a stressor on resistance to disease.
However, the findings are quite different when the stressor was repeated daily after
introducing the pathogen. In this case, tumour growth is not exaggerated in animals
exposed to repeated inescapable shock. Some research has shown that chronic exposure to
stress in the laboratory can even protect animal subjects against pathology (reviewed in
Peterson et al., 1993). These two sets of findings appear to conflict with each other.
The key to this seeming discrepancy may be that repeated exposure to shocks in the
laboratory, possibly at the same time each day, certainly in the same apparatus, became
predictable. The end of the shock session was also predictable, so the animals learned that
the shocks would end and not return until the next day. In other words, repeated sessions of
inescapable shock become less stressful because they are more predictable.
Learned helplessness research thus indicates that the concept of control encompasses
not only agency, but also predictability. The effectiveness of goal-directed behavioural
responses is an important aspect of control, but a sense of control can also come from
predictability of events. A contingency relationship allows the animal to prepare for an
event, thereby limiting the harmful effects of uncontrollability, reducing a goal-threatening
stressor to an expected, unpleasant, but temporary experience.

Evidence in humans
Human research on learned helplessness has typically focused on response to unsolvable
problems rather than inescapable shock. Research participants exposed to uncontrollable
events report feeling anxious and depressed, and show a preference for hostile humour over
innocent humour (Peterson et al., 1993). Physiological changes associated with anxiety,
such as higher concentrations of adrenocorticotropic hormone, and changes in skin
 Health Psychology Review 197

conductance have also been reported. These findings seem to parallel the results of animal
research, despite the barriers to conducting invasive physiological examination on humans,
and to measuring subjective emotional states in animals.
‘Immunisation’ against helplessness is an important point of correspondence between
the animal and human helplessness literatures. Previous experience with controllability can
neutralise the effects of helplessness training, and protect against deficits in later problem
solving. This immunisation effect of control has been called ‘learned optimism’ (Seligman,
1990), signalling an expansion of the helplessness model to include a variety of human
psychological behaviours related to perceptions of contingency and controllability. Within
the framework of attribution theory, optimism has been defined as an expectation of
control, or mastery (Peterson & Steen, 2002). Subjective perceptions of controllability and
contingency underlie measures of explanatory style (Peterson & Seligman, 1987), which
originate from learned helplessness and attribution theories.
College students with optimistic explanatory styles report significantly better past and
current health than those with pessimistic explanatory styles (Peterson et al., 1993). Long-
term health effects of causal attribution have also been demonstrated. In the Harvard
Study of Adult Development, begun in 1946, healthy, high-functioning Harvard students
or recent graduates were asked to describe ‘difficult personal situations’ (Peterson et al.,
1993). Those who gave optimistic causal explanations at age 25 were healthier at age 45
than those who gave pessimistic explanations (partial r0.42).
Another parallel with animal research is in findings that while a single stressful
experience has a deleterious effect on health, repetition of the same stressor appears to be
harmless, or has a protective effect. ‘Toughness’ refers to the beneficial effect that physical
exertion or hardship has on mental functioning (Dienstbier & Pytlik Zillig, 2002).
Presumably, experience with an intermittent stressor allows the individual to prepare for
the event, and to treat it as a temporary unpleasantness that need not interfere with
important goals. Thus, predictability and agency define the difference between a stressor
and an inconvenience.
Infants have been shown to be remarkably responsive to control, and in a surprising
way. During an investigation of contingency learning in infants, Watson and Ramey (1972)
discovered that two-month-old infants were making social responses
smiling and cooing

towards a mobile that moved in response to their head movements. These responses to
the mobile in some cases predated social smiling at the parents. The infants were so
interested in the apparatus that some mothers reported using it as a babysitter, or building
their own versions. (The experimenters deserve credit for recognising that this might
disrupt the babies’ normal social development, and discontinuing the experiment rather
than patenting this invention as a labour-saving device.) Typically, an infant’s only control
over the environment is through relationships with caregivers, so it makes evolutionary
sense for social response to be linked to contingency. Watson’s findings demonstrate how
salient control is to infants who have had little experience of autonomy, and suggest that
control is a fundamental aspect of human social development.
In a follow-up to the Whitehall study (Marmot et al., 1984), 7372 British civil servants
were followed over several years, and measures of coronary heart disease were recorded
(Marmot, Bosma, Hemingway, Brunner, & Stansfeld, 1997). Once again, health measures
were found to be inversely related to employment grade. In Whitehall II, however, a
measure of perceived job control was included, and proved an even better predictor of
health differences in both men and women than either employment grade or standard risk
factors. Thus, in this major study, perceptions of control were more directly related to
health consequences than measures of status.
198 L. Beck

Johnson and Krueger (2005) report similar findings in a study of 719 same-sex twin
pairs in the USA. Increased perceptions of control over work situation, finances,
relationships, and life in general were associated with decreased incidence of chronic
illness and lower body mass index, a predictor of health problems. Comparison of control-
health interactions between monozygotic and dizygotic twins led the investigators to
conclude that genetic variance in chronic health problems is related to perceived control.
The authors speculate that lack of control leads to chronic stress responding. Control
apparently protects against genetic vulnerabilities, as well as against environmental
stressors.
Uncontrollability is such an important source of stress that it has been proposed as the
specific stress-producing aspect of a situation (Sapolsky, 1993a). Research with animals,
and, to some extent, humans, seems to support this proposal (Dickerson & Kemeny, 2004).
Control may even be at the root of social defences against stress. Status and support are
essentially tools for achieving and maintaining control over the social environment. Thus,
it may be helpful to consider status and support as dimensions of ‘social control’.

The social control model

The association between stress responding and health problems is well established.
Likewise, there is much evidence that the fundamental dimensions of social status and
social support are means of obtaining control over social and environmental stressors, with
important health consequences. Figure 1 shows a model of the relationship between these
social control factors and stress-related health problems. At the bottom of the figure is a
representation of the relationship between stress and health. Two general categories of
stressors are represented, in accordance with Dickerson and Kemeny’s (2004) framework.
Lack of control over the environment is stressful when it interferes with important goals;
physical danger is the primary example. The threat of negative evaluation by others
interferes with important social goals and is also a source of stress. Social-evaluative threat
and uncontrollability initiate a host of physiological responses via the SNS, HPA, and
immune systems, resulting in generalised arousal, metabolic changes, immune suppression,
and secretion of neurochemicals and circulating hormones. If stress responding is
persistent, health problems may result.
The top half of Figure 1 shows the key social control factors implicated in the
attenuation of stress-related illness or dysfunction. Status and support are fundamental
dimensions of social interactions, and both are correlated with stress responding and
health problems. Ultimately, both are valuable sources of control over the social
environment, and hence the physical environment as well.

Figure 1. The social control model. Status and support can influence physical health by decreasing
the incidence or severity of stressors, reducing physiological stress response, and limiting the effects of
illness.
 Health Psychology Review 199

It is important to note that many factors contribute to an individual’s experience of

social interactions, stress and illness. For instance, local norms may relegate individuals to
low status because of their gender or heritage. Social support may be hard to find for
individuals with physical deformities, or who are simply unattractive. Personality
differences and past experience affect individuals’ appraisal of potential stressors.
Individual differences in emotional reactivity and biochemistry affect the size and
persistence of physiological stress responding. Finally, some individuals are genetically
predisposed to be susceptible to certain diseases, while others may be particularly resistant.
Thus, individual differences and cultural norms affect every aspect of the proposed model.
However, the findings reviewed earlier demonstrate that status and support exert
significant influence on stress and health, across a wide range of situations and species.
Status and support may affect health directly, by influencing behaviour or physiological
functioning. These dimensions may also act indirectly, by buffering the perception or effect
of stressors. In an important paper on the relationship between social support and stress,
Cohen and Wills (1985) conclude that there is evidence for the effectiveness of both direct
and buffering effects of social support. Further, direct and indirect effects may take place at
different stages of the progression from stress to illness (Cohen & Wills, 1985; Taylor,
2007). Figure 1 shows three ways that social control dimensions can block or weaken the
connections between stressors, stress responding, and physical illness.
First, social support and status affect the occurrence of stressors. During a natural
disaster, everyone suffers from catastrophic uncontrollability: physical danger, loss of
shelter, food and water shortages, and lack of medical attention when it is most needed.
Social sources of stress abound as well: community networks are broken, individuals are
unable to provide adequate food or care for dependents, and may be reduced to begging for
help instead. Stressors are often random and unavoidable, but status and support offer a
degree of control in many cases. For example, high-status residents of New Orleans were
more likely to have the means to leave before Hurricane Katrina hit, and their houses
tended to be on higher ground, safe from flood damage. Residents with larger or stronger
social networks were more likely to have a safe place to take shelter. In contrast, their low-
status neighbours were more likely to face physical injury, property damage, homelessness,
and loss of community. Status and support can act on an individual’s appraisal of the
stressful situation
‘at least my family is safe’. Thus, stressors can be mitigated or avoided
altogether by status or support.
The second effect of control factors on health is perhaps the most intriguing. As
indicated in Figure 1, both social support and social status can reduce the individual’s
physiological response to threats, either by establishing a well-regulated stress system, or by
attenuating stress responding with all its endocrine, cardiovascular, and immune effects.
The result is decreased intensity or shorter duration of stress responding. The old saying
‘misery loves company’ describes the desire for social affiliation during stressful
circumstances. It is likely that hurricane victims who faced the storm’s consequences
with others fared better, at least in neuroendocrine terms, than those who remained
isolated. Similarly, individuals who achieved or maintained positions of status and respect
during the crisis, like church leaders and boat owners, may have experienced similar
benefits.
The third effect of social control is on health problems, including ailments unrelated to
stress. Social support can contribute to positive health behaviours in people who are
already ill: concerned family members can make sure an individual takes prescribed
medicine and gets to the doctor. Social status may help to secure better medical care and a
better environment for recovery. In many ways, social support and status can influence the
200 L. Beck

progression and duration of illness, and can mitigate the effects of ongoing health
problems on daily functioning.
Status and support can also be sources of stress. During the Hurricane Katrina crisis,
doctors and administrators bore the responsibility for patients suffering in a hospital with
no power and no sign of outside help for days. They reportedly discussed euthanizing
patients to relieve their misery (Johnston, 2005). The question itself is both an indicator
and a source of extreme stress. A large support network can also be a source of stress, as
support is often reciprocal (Taylor, 2007). More friends and family might mean more loss,
more help needed, and more people who need support and comfort at an already difficult
time. These are extreme examples, but everyday experience of status and support may
include some negative aspects as well. Thus, potential costs of status and support may
counteract the benefits they provide, to some degree. Where these costs are sizable, they
may help to explain inconsistencies in the evidence of health benefits of social support (e.g.,
Seeman, Berkman, Blazer, & Rowe, 1994). Overall, however, a large body of evidence
indicates that the benefits of social support far outweigh the costs (e.g., Uchino et al.,
1996), as do the benefits of status for humans (e.g., Sapolsky, 2005).
Predictability and control are important predictors of stress responding (Dickerson &
Kemeny, 2004; Sapolsky, 2005), and the fundamental relationship dimensions of status and
support are the primary social means of obtaining control over the environment. Although
non-social factors (such as knowledge or possession of resources) can increase the amount
of control and contribute directly to the stress-health sequence, these factors often
contribute to social support and status as well. Thus, while social support and status are
not the only possible means of gaining control, they are sometimes difficult to disentangle
from physical or cognitive resources.

Discussion
Social status and social support are fundamental and universal dimensions of social
interactions. I propose that status and support are the chief social sources of control over
the physical and social environment. Control decreases the individual’s experience of stress
and its physiological consequences. Evidence from laboratory and observational research
with animals, and from diverse investigations in human medicine and psychology, indicates
that status and support are indeed related to stress responding, and have long-term
physiological consequences. The effects of social support on health are robust and well
known. Social status, an equally important dimension of social interaction, has also been
associated with reduced stress responding and improved health. Recognising the relevance
of both dimensions to physical well-being will facilitate progress in understanding how
social factors affect health.

Effects of social control

The social control model lends itself to specific predictions about the effect of status and
support on different aspects of the association between stress and illness. For instance,
status and support are expected to prevent the occurrence of some stressors in the first
place. Individuals scoring high on status and support measures should report fewer or
milder stressors than those scoring low on these dimensions.
The model also predicts that status and support will attenuate physiological stress
responding to perceived stressors. Relatively non-invasive measures, like blood pressure
and salivary cortisol, might be used to test responding during stressful tasks like public
 Health Psychology Review 201

speaking. More invasive measures, such as tests for circulating cortisol, may be obtainable
during medical interventions for injury or illness. Baseline levels of these measures, stress-
related increase, and recovery are potential sources of differences between individuals with
differing amounts of status and support.
A third effect of status and support is predicted to be on how illness affects the
individual. The same condition can play a significant or inconsequential role in daily
functioning, depending on the individual’s experience of social control dimensions. To test
this assumption, individuals with chronic ailments like diabetes, or acute injuries like
fractures can be asked to provide self-reports of perceived disability and inconvenience.
Individuals with higher status and more support should report less interference from the
same medical conditions than those with lower status and less support.

Relationship between social control dimensions

The proposed model raises interesting questions about the relationship of social status and
social support to each other and their relative contributions to health. Social status and
social support are not necessarily independent of each other. Empirical evidence of a
correlation between socioeconomic status and size or quality of social networks is mixed
(Turner & Marino, 1994). However, examples of a link between social status and support
are easy to find. Individuals with high social status are likely to find themselves surrounded
by ‘yes-men’ and others eager to provide support, as well as leisure to attend social events
and build relationships. Those who are low in status may be socially isolated due to
inflexible work schedules, dangerous neighbourhoods, temporary housing, and lack of
money or time for socialising. Thus, the contributions of status and support may often be
correlated.
An intriguing example of how status and support may interact within specific
interactions is provided by Bolger and Amarel (2007). They describe a series of
experiments in which female participants expecting to give a speech received advice or
reassurance from a confederate peer. In some conditions the support was ‘visible’, directly
aimed at the participant (‘you’ve got nothing to worry about’) while in others the support
was ‘invisible’, or indirect (‘she’s got nothing to worry about’). Participants receiving
invisible support reported less distress about the task than those who received visible
support. Recipients of visible support apparently interpret the peer’s helpful comments as
an assessment of their own inferior ability. Thus, certain kinds of support can backfire by
triggering status appraisal and may even create or exacerbate a perception of social threat.
Status and support may also have a complementary relationship. In primates, high
levels of social support counteract the effect of low status (Abbott et al., 2003). Further
study is likely to demonstrate a similar relationship in humans. Interestingly, popular
culture casts doubt on the opposite situation, where high status can offset lack of social
support. From the classic film Citizen Kane to tabloid accounts of celebrity suicides,
conventional wisdom seems to be that status is an insufficient substitute for close, caring
relationships. Yet there may be some individuals for whom low social support is not a
burden, if social status is sufficiently high.

Individual differences
Perhaps more important than finding general rules is understanding the role individual
and cultural differences play in determining the relative contributions of status and
support for a particular individual. As mentioned previously, individual differences are
202 L. Beck

likely to play a role in every aspect of the association between social control factors and
stress. Sapolsky (1999) cautions that the effects of status can only be understood in the
context of species-typical behaviour, social norms, personality, and individual differences
in physiology. Similarly, social support is largely in the eye of the beholder, and many
factors may contribute to an individual’s perception of and response to support. Awareness
of individual differences relevant to status and support can increase the predictive power of
these constructs.

Sex differences
Behavioural responses to stress are often quite distinct for males and females, even when
physiological stress responding is the same (Taylor et al., 2000). Research on the well-
known ‘fight or flight’ response has been mostly conducted with male subjects (both
human and animal). In contrast, most studies of affiliation under stress have used only
female participants. In both cases, sex differences are so consistent that the sought-after
effects are found reliably only in males or females, not both.
‘Fight or flight’ behaviours may increase an individual’s immediate chance for survival
in the short term, and have been the focus of the study of behavioural responses to stress
for decades. The inconsistent pattern of results with females has been blamed on
neuroendocrine variability during the female reproductive cycle, but further investigation
suggests that females reliably display, and benefit from, ‘tend and befriend’ behaviours in
response to threat (Taylor et al., 2000). These affiliative behaviours promote safety in
numbers, and are more conducive to the protection of young, which are typically in the
care of females.
In the context of the current discussion, ‘fight or flight’ behaviours are related to status
concerns
compete or admit defeat
while ‘tend and befriend’ behaviours are related to
social support opportunities for self and others. In humans, differences between men and
women on tendencies to seek status and support have been clearly demonstrated (Taylor
et al., 2000). Women seek and benefit from egalitarian social networks to a much greater
extent than men, who tend to form goal-directed, hierarchical groups.
Some neuroendocrine responses to stress coincide with behavioural sex differences.
Oxytocin production in response to stress appears to be more pronounced in females, and
is inhibited by androgens. The effects of endogenous opioids are similarly more
pronounced in females, with behavioural effects on affiliation as well as moderation of
other stress-related neurohormones, including oxytocin.
Of course, females are capable of fight-or-flight responses, and males benefit from
social support. Variation in the expression of these behaviours, however, is brought into
clearer focus with the recognition of sex differences in behavioural response to threat.
Awareness of these crucial adaptations will lead to a better understanding of stress
responding and its health correlates.

Potential sources of social control

The social control model predicts that some relationships are better than others at reducing
stress and its harmful consequences. Relationships that afford high status, social support,
or both, should have beneficial effects on physical health. This insight points to ways of
refining the study of relationships and their effects on physical functioning. For example,
specific relationships in an individual’s social network are more relevant to status and
support concerns, and thus will be more relevant to health outcomes. Further, it may be
 Health Psychology Review 203

more profitable to measure the experience of status and support in relationships than to
simply assess the size or structure of social networks.

Family relationships
As discussed above, marriage is consistently associated with health benefits. For many
couples, marriage relationships provide a great deal of mutual support. Other couples
employ a hierarchical model in which one member enjoys particularly high status in the
relationship. In practice however, the distinctions between different ‘types’ of marriage may
be less clear. For instance, Oriya Hindu women do not own property, have arranged
marriages, and move in with the husband’s family after marriage. Yet men have relatively
weak influence within the home, and as a young woman matures and assimilates into the
multigenerational household, she has increasing authority over the management of
finances, relationships, and religious observance. These women see themselves, and are
seen by others, as indispensible, respected, and powerful (Menon, 2000). This example
illustrates how the variety of roles held by partners can make marriage a source of both
status and support. It also demonstrates the dangers of using cultural or demographic
attributes, rather than self-reports, to categorise relationships.
Parenthood is another close relationship involving status and support concerns.
Individual and developmental differences are likely to be important
toddlers and
teenagers provide their parents with very different signals about status and support. More
generally, the instability inherent in a relationship with a constantly growing and changing
child may interfere with the stress-reducing aspects of the parents’ role. Perhaps owing to
this instability, there has not been much research published on health consequences of
parenting (Umberson, 1987). Appreciation of the implications of status, support and
control may contribute to a better understanding of such complex, but significant
relationships.

Pet ownership
A common relationship with marked status and support implications is pet ownership. The
potential importance of pet relationships is indicated by recent findings that on measures
of attachment security, dog and cat owners indicate that their relationships with pets are
more secure than their relationships with romantic partners (Beck & Madresh, 2008). Few
human relationships provide an individual with a consistent source of both status and
support, while relationships with pets may be a reliable source of both. The social control
model may help to explain the remarkable pattern of physiological effects of interactions
with pets, which is often more immediate, consistent, and persistent than the effects of
human interactions.
In a number of investigations, pet ownership has been shown to be better correlated
with health outcomes than relationships with humans. In a large study investigating the
effects of many different kinds of social support, pet ownership was the best predictor of
one-year survival in people with cardiac disease (reviewed in Friedmann, Thomas, & Eddy,
2000). Another study of Medicare patients found that pet owners visited the doctor less
frequently than non-pet owners. Stressful life events such as divorce, bereavement, and
financial difficulties were followed by more doctor visits for all participants except dog
owners, for whom there was no relation (Siegel, 1990). These results point to significant
long-term effects on stress-relevant health problems.
204 L. Beck

Pets also reduce the short-term effects of acute stressors. In experiments on

cardiovascular reactivity, participants whose pets were present had the lowest increase in
heart rate and blood pressure in response to stressful situations (such as serial subtraction).
Reactivity was higher when a spouse or friend was present than when the participant was
tested alone. Even when the pet was not present, pet owners exhibited less cardiovascular
reactivity to stressors than non-pet owners (Allen, Blascovich, & Mendes, 2002). In a
related experiment, stockbrokers receiving drug therapy for high blood pressure were
randomly assigned to acquire a pet. Interestingly, while medication reduced resting blood
pressure for all participants, only the pet owners showed significantly less reactivity
compared to pre-medication baseline measures (Allen, Shykoff, & Izzo, 2001).

Conclusion
Of course neither humans nor animals seek out social interactions because of their health
effects, though these effects are substantial. Indeed these effects have only recently come to
light. Rather it seems likely that evolution has invested status and support with hedonic
value. These survival strategies have become sources of direct reward, and their loss or
absence is directly experienced as punishing. The rewards of status, support and control
seem particularly obvious for animals. Dominant baboons have choices about food and
mating partners, and are assured of grooming partners and relative safety within the troop
(Sapolsky, 1993b). Individuals with friends don’t have to sleep alone, and don’t have to face
hardships on their own (Smuts, 1985). When an animal perceives that its behaviour can
affect its environment, it can develop strategies for coping with new situations and
achieving its goals (Peterson et al., 1993).
The situation is not all that different for humans, who also value status, support, and
control. These are resources that prevent, reduce, or mitigate the effects of social and
physical threat, and all three have been found to have beneficial effects on human health.
Many human relationships incorporate status and support but few consistently include
both. Further, most human interactions are quite complex, changing over time and varying
in different situations, with frequent potential for social threat. To the extent that human
relationships provide control over social outcomes, they can serve as buffers against
sources of social threat, thus reducing stress responding. The social control model of status
and support provides a framework for continuing investigations of the social correlates of
physiological functioning, and a rationale for the development of health-relevant measures
of social interactions and relationship quality.
Throughout evolutionary history, status and support have been closely associated with
the ability to obtain resources
like food, shelter, and mating opportunities
that increase
chances for survival and reproduction. Given the survival value of these social resources, it
is perhaps not surprising that status and support have direct physiological effects and
health benefits.

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