May 4th, 2021
Levels of loneliness across the world have reached epidemic proportions, and their impact upon population health is increasingly apparent. In response, policies and initiatives have attempted to reduce loneliness by targeting social isolation among residents of local communities. Yet, little is known about the social psychological processes underpinning the relationships between community belonging, loneliness, and well‐being. We report three studies which apply the Social Identity Approach to Health to examine the mechanisms underpinning the relationships between community identity, health, and loneliness. Hypotheses were tested through secondary analyses of the 2014–2015 UK Community Life Survey (N = 4,314) as well as bespoke household surveys in a more (N = 408) and less (N = 143) affluent community at high risk of loneliness. Studies 1 and 2a demonstrated that the relationship between community identification and well‐being was mediated by increased social support and reduced loneliness. In Study 2b, community identification predicted well‐being through reduced loneliness, but not through social support. Our results are the first to evidence these relationships and suggest that community‐level interventions that enhance community identification and peer support can promote a potential Social Cure for loneliness.
April 5th, 2021
Communities are vital sources of support during crisis, providing collective contexts for shared identity and solidarity that predict supportive, prosocial responses. The COVID‐19 pandemic has presented a global health crisis capable of exerting a heavy toll on the mental health of community members while inducing unwelcome levels of social disconnection. Simultaneously, lockdown restrictions have forced vulnerable community members to depend upon the support of fellow residents. Fortunately, voluntary helping can be beneficial to the well‐being of the helper as well as the recipient, offering beneficial collective solutions. Using insights from social identity approaches to volunteering and disaster responses, this study explored whether the opportunity to engage in helping fellow community members may be both unifying and beneficial for those engaging in coordinated community helping. Survey data collected in the UK during June 2020 showed that coordinated community helping predicted the psychological bonding of community members by building a sense of community identification and unity during the pandemic, which predicted increased well‐being and reduced depression and anxiety. Implications for the promotion and support of voluntary helping initiatives in the context of longer‐term responses to the COVID‐19 pandemic are provided.
March 23rd, 2021
The stressors of immigration detention and negative host country experiences make effective access to health care vital for migrant detainees, but little is known regarding the health experiences of this populations and the barriers to healthcare access. The present research investigates immigration detainees’ experiences of health‐related help‐seeking in the distressing and stigmatised environment of UK immigration removal centres (IRCs), as well as staff members’ experiences of providing help. Semi‐structured interviews were conducted with 40 detainees and 21 staff and analysed using theoretical thematic analysis guided by the social identity approach. The findings indicate that the practical constraints on help provision (e.g. lack of time and resources, the unpredictable nature of detention) are exacerbated by the complex and conflictual intergroup relationships within which these helping transactions occur. These transactions are negatively affected by stigma, mutual distrust and reputation management concerns, as well as detainees’ feelings of powerlessness and confusion around eligibility to receive health care. Some detainees argued that the help ignores the systematic inequalities associated with their detainee status, thereby making it fundamentally inappropriate and ineffective. The intergroup context (of inequality and illegitimacy) shapes the quality of helping transactions, care experiences and health service engagement in groups experiencing chronic low status, distress and uncertainty.
February 5th, 2021
We explored Social Cure and Social Curse processes within families in the context of severe human rights violations. Although Social Cure research shows the importance of family identification in one’s ability to cope with stress, there remains little understanding of family responses to human rights violations. This is the first study to explore the role of family identity in the collective experience of such violations: meanings ascribed to suffering, family coping strategies, and family‐based understandings of justice. Semi‐structured interviews (N=27) with Albanian dictatorship survivors were analysed using Social Identity Theory informed thematic analysis. The accounts reveal Social Cure processes at work, whereby family groups facilitated shared meaning‐making, uncertainty reduction, continuity, resilience‐building, collective self‐esteem, and support, enhanced through common fate experiences. As well as being curative, families were contexts for Social Curse processes, as relatives shared suffering and consequences collectively, whilst also experiencing intergenerational injustice and trauma. Although seeking and achieving justice remains important, the preservation of family identity is one of the triumphs in these stories of suffering.
We examined whether the Social Cure (SC) perspective explains the efficacy of a Social Prescribing (SP) pathway which addresses healthcare needs through enhancing social connections. Data were collected at pathway entry from patients with long-term health conditions, or who felt isolated/lonely/anxious (N = 630), then again 4 months later (N = 178), and 6-9 months later (N = 63). Being on the pathway was associated with increased group memberships between T0 and T1. The relationship between increased group memberships and quality-of-life was serially mediated by belonging, support and loneliness. This study is the first to show SP enhances health/well-being via SC mechanisms.
Cohesive, resilient communities are vital to the well‐being of residents. Uncovering the determinants of successful community identities is therefore essential to progressing the community health agenda. Engaging in community participation through volunteering may be one pathway to building local community identity and enhancing residents’ health and well‐being but the group processes connecting them remain unexplored. We conducted two studies investigated these dynamics using the ‘Social Cure’ perspective. First, we analysed 53 in‐depth interviews with volunteers, finding that community relationships shaped their experiences and that volunteering influenced their sense of community belonging, support, and well‐being. Second, a community survey (N =619) revealed that volunteering predicts well‐being through the serial mediators of community identification and social support. Our paper demonstrates the Social Cure processes involved in community‐based volunteering, their impact on community identity, support and well‐being, and the implications for community health, and the provision and sustainability of community voluntary action and interventions.
Family financial stress research has typically examined negative effects of deprivation on mental health, which in turn erode financial coping. While this work acknowledges family support’s role in buffering these effects, it has typically overlooked how family identification can act to structure the experience of, and response to, economic challenge. We adopt a Social Identity approach, arguing that family identification predicts increased social support and improved well-being, which predicts more effective coping with financial problems. We explore this in two community surveys (N=369; N=187). In the first we show that stronger family identification and support predict better well-being, which predicts better evaluation of economic coping. In the second we replicate these findings, and also show that the relationship between well-being and financial distress is fully mediated by perceptions of ‘Collective Family Financial Efficacy’. These findings point to a more positive understanding of how family cohesion can promote mental well-being/resilience.
A substantial literature supports the important role that social group memberships play in enhancing health. While the processes through which group memberships constitute a “Social Cure” are becoming increasingly well defined, the mechanisms through which these groups contribute to vulnerability and act as a “Social Curse” are less understood. We present an overview of the Social Cure literature and then go beyond this to show how the processes underpinning the health benefits of group membership can also negatively affect individuals through their absence. First, we provide an overview of early Social Cure research. We then describe later research concerning the potential health benefits of identifying with multiple groups, before moving on to consider the “darker side” of the Social Cure by exploring how intra‐group dynamics can foster Curse processes. Finally, we synthesise evidence from both the Cure and Curse literatures to highlight the complex interplay between these phenomena and how they are influenced by both intra‐ and inter‐group processes. We conclude by considering areas we deem vital for future investigation within the discipline.
Objectives This study aimed to assess the degree to which the ‘social cure’ model of psychosocial health captures the understandings and experiences of healthcare staff and patients in a social prescribing (SP) pathway and the degree to which these psychosocial processes predict the effect of the pathway on healthcare usage.
Design Mixed-methods: Study 1: semistructured interviews; study 2: longitudinal survey.
Setting An English SP pathway delivered between 2017 and 2019.
Participants Study 1: general practitioners (GPs) (n=7), healthcare providers (n=9) and service users (n=19). Study 2: 630 patients engaging with SP pathway at a 4-month follow-up after initial referral assessment.
Intervention Chronically ill patients experiencing loneliness referred onto SP pathway and meeting with a health coach and/or link worker, with possible further referral to existing or newly created relevant third-sector groups.
Main outcome measure Study 1: health providers and users’ qualitative perspectives on the experience of the pathway and social determinants of health. Study 2: patients’ primary care usage.
Results Healthcare providers recognised the importance of social factors in determining patient well-being, and reason for presentation at primary care. They viewed SP as a potentially effective solution to such problems. Patients valued the different social relationships they created through the SP pathway, including those with link workers, groups and community. Group memberships quantitatively predicted primary care usage, and this was mediated by increases in community belonging and reduced loneliness.
Conclusions Methodological triangulation offers robust conclusions that ‘social cure’ processes explain the efficacy of SP, which can reduce primary care usage through increasing social connectedness (group membership and community belonging) and reducing loneliness. Recommendations for integrating social cure processes into SP initiatives are discussed.
Food insecurity in developed countries has increased rapidly. Research has suggested that stigma may inhibit food‐aid help‐seeking, but has failed to determine how such barriers might be overcome. Adopting a social identity perspective, this study explored the processes involved in food‐aid helping transactions and sought to identify conditions that facilitate positive helping outcomes. Interviews were conducted with 18 clients and 12 volunteers at two English foodbanks, and a theoretically guided thematic analysis was conducted. Two primary themes were identified: ‘Here to Help’ and ‘The Legitimate Recipient’. This article offers a distinct and novel contribution by applying a social identity perspective to foodbank helping transactions, thereby demonstrating how group dynamics and behaviours are integral to these interactions, and by moving beyond the typical ‘Social Curse’ focus on barriers to help‐seeking to explore how such obstacles may be overcome. Suggestions for addressing stigma‐laden helping transactions and promoting successful delivery of aid are provided.
Over 29,000 foreign nationals are detained yearly in British Immigration Removal Centres for undefined periods. This study investigated the role played by social identities in the way detainees are affected by, make sense of, and deal with detention. An opportunity sample of 40 detainees was interviewed on topics including support, identity, and well‐being, and data were analysed using theoretical thematic analysis. Participants struggled with loss of social networks, loss of rights, loss of agency, and joining a stigmatised group. Social identities guided exchange of support, aided meaning‐making, and mitigated distrust, serving as ‘Social Cures’. However, shared identities could also be sources of burden, ostracism, and distress, serving as ‘Social Curses’. Inability to maintain existing identities or create new ones fuelled feelings of isolation. Participants also reported rejection/avoidance of social identities to maximise their benefits. This study is the first to apply the Social Identity Approach to the experience of immigration detention.