The Role Of Social Support In Outcomes Of African Americans With Disabilities

Several studies have investigated the role of social support on outcomes of African Americans with disabilities. Some of these studies have been conducted by the author and are reviewed below.

Belgrave, Lewis, & Scott (1994) investigated the role of social support on health care adherence in a population of African Americans with sickle cell disease and diabetes. One hundred twenty-seven persons (49 with sickle cell disease and 78 with diabetes) completed a questionnaire that assessed the availability of emotional, cognitive, and material support. Health care adherence regarding appointments and health behaviors (i.e., diet, exercise, regular blood pressure tests, taking medication) were also obtained through this self-report questionnaire. The results of this study indicated a significant correlation between the availability of social support and health care adherence. Social support was related to whether or not the person kept his or her medical appointments and whether or not the person engaged in good health behaviors such as eating nutritiously, having regular checkups, and having blood pressure monitored.

The findings of this study are consistent with that of studies using non-African American populations that have shown a positive benefit of social support on compliance. Social support may assist persons in carrying out health care recommendations they could not do alone. For example, eating behaviors may be determined by the food that is bought and prepared within the house. Adherence to medical appointments may be contingent upon the availability of transportation. Finally the encouragement and concern of significant others may encourage the person to take care of themself. The support of others within the family may be especially needed by African Americans, whose family unit may be very interdependent.

In another study the author was interested in the influence of social support on employment status, that is, whether or not the person was employed (Belgrave & Walker, 1991b). In this study social support was included as a variable, along with other psychological and demographic variables. The availability of emotional, cognitive, and material support was assessed, along with employment status, via a questionnaire.

The results of this study indicated that a significant percentage of the variance in employment status could be explained by the variables in the study. Social support was a significant contributor—in fact, social support and source of transportation were the only two variables that made significant contributions to explaining employment. Persons who reported high availability of social support and those who had cars (or private vehicles) were more likely to be employed than those without social support and without access to private vehicles. The finding of this study highlights the contribution of social support as a contributor to an important outcome—employment.

In a related study, Walker, Belgrave, Jarama, Ukawuilulu, and Rackley (1995) investigated the relationship between the availability of social support and employment efficacy among ethnic minority individuals with disabilities. The majority (68%) of these individuals were African Americans. The relationship between social support and job efficacy was examined, and job efficacy was defined as beliefs that employment could be secured and maintained.

Participants included forty-four clients of rehabilitation agencies. They were administered questionnaires that obtained measures of social support and job efficacy at two points in time. The results showed a significant correlation between social support and job efficacy at both time periods. That is, respondents who reported that social support was available at time one and six weeks later (time two) were more likely to have favorable beliefs in their ability to obtain and keep a job. Of particular rele vance here was the finding that the availability of support from professional sources was negatively correlated with job efficacy. That is, respondents who reported receiving more support from professional sources were less likely to believe that they could obtain and maintain employment. On the other hand, the availability of support from family, that is, parents, was positively correlated with job efficacy. One interpretation of these findings is that those who need more support from professionals are less functional. However, an alternative interpretation, consistent with the thesis of this chapter, is that social support from the family is more culturally congruent for this population.

Another study by Belgrave (1991) was conducted to explore the influence of social support in an interpersonal domain—acceptance of disability. The study was concerned with the extent to which social support along with other variables (i.e., self-esteem, locus of control, disability severity, and demographic variables) contributed to acceptance of the disability. Data were gathered from 170 African Americans with disabilities. Disabilities included (a) speech and hearing impairments, (b) orthopedic impairments, (c) mental illness and substance abuse, and (d) other impairments.

The results of a regression analysis indicated that three of the psychosocial variables—perception of disability severity, social support, and self-esteem—were significant contributors and accounted for 50% of the variance in explaining acceptance of disability in the study's sample. None of the demographic variables were significantly related to acceptance of disability. The results of this study suggest that social support may be more influential than socioeconomical factors such as education and income as a contributor to employment.

The finding of the contribution of social support to acceptance of disability is underscored because acceptance of disability is an important outcome. When a person accepts and feels comfortable with having a disability, self-esteem and overall mental health will be positive.

In summary, the research has shown a positive benefit of social support across diverse outcomes for African Americans with disabilities. Adherence to health care and rehabilitation recommendations can be expected to be facilitated by the availability of social support. Adherence to appropriate rehabilitation regimens should facilitate mental and physical health outcomes. Given the lower participation of African Americans in rehabilitation programs, increased social support may be especially beneficial in this regard. Social support also has been associated with improved employment and mental health outcomes. These outcomes impact the quality of life, and efforts to improve these outcomes can be targeted in interventions.

While research has shown social support to be generally beneficial for African Americans with disabilities, we know less about the mechanism by which this support works. An understanding of the mechanism is necessary to develop programs and services that use social support to improve outcomes. For example, who are the providers of social support for African Americans with disabilities? Are some types of support more beneficial than others? Does support relate to functional outcomes, and does the relationship between social support and functional outcomes differ for African Americans and other ethnic groups with disabilities?

These and other questions were addressed in a study conducted by the author and colleagues (Belgrave, Davis, & Vadja, 1994) on aspects of social support among African Americans. Funding for this study was provided by the National Institute of Mental Health. The study was developed to comprehensively examine the nature of social support among African Americans with disabilities.

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