Racial Differences in Social Support and the Quality of Life Among Individuals with Chronic Illnesses

Shaila Strayhorn

Data is provided by the student.

Abstract

Previous studies have indicated that the association between social support and quality of life (QOL) among individuals with chronic illnesses differs by race, yet the specifics of these association are uncertain. The purpose of this dissertation was to examine racial differences in associations between factors of social support (i.e. sources of informal social support and positive/negative social support) and four QOL domains (i.e., physical well-being, psychological well-being, social well-being, and spiritual well-being) among individuals previously diagnosed with a chronic illness. The study was guided by three aims: 1) to examine common intrapersonal-level (e.g., stress, coping, and self-esteem) and interpersonal-level constructs (e.g., major discrimination, everyday discrimination, frequency of contact, social network ties, and social network size) as mediators and moderators, 2) to examine associations between sources of informal social support and QOL domains among individuals with chronic illnesses, and 3) to examine associations between sources of positive and negative social support and QOL domains among individuals with chronic illnesses. It is hypothesized the pattern of the associations between factors of social support and the four QOL domains will differ between individuals of African descent (i.e., African Americans and Caribbean Blacks) and non-Hispanic whites. Secondary data analyses of the National Survey of American Life (NSAL) were conducted. The sample was comprised of 3,285 African Americans, Caribbean Blacks, and non-Hispanic whites. Moderation was evaluated through interaction terms. Mediation was assessed through bootstrapping procedures. Multiple imputation analyses primarily assessed the racial differences between factors of social support and QOL domains. Stress and social ties consistently moderated and mediated the relationship between factors of social support and QOL domains. A total of 10 of the 40 associations between factors of social support and QOL domains were moderated by race. In addition, the direction of 16 of the 40 associations between factors of social support and QOL domains indicated differences between individuals of African descent compared to non-Hispanic whites after stratifying the study sample by race. Future prospective longitudinal studies are needed to further assess the influence of social support and QOL domains among individuals of African descent and non-Hispanic whites with chronic illnesses.