THE CULTURAL CONSTRUCTION OF SOCIAL SUPPORT IN BRAZIL - ASSOCIATIONS WITH HEALTH OUTCOMES

The association of social support and health outcomes has received con siderable attention in recent years, but the cultural dimension of soc ial support has not been extensively investigated, In this paper, usin g data collected in a Brazilian city, we present results indicating th at those individuals whose reported access to social support more clos ely approximates an ideal cultural model of access to social support h ave lower blood pressure and report fewer depressive symptoms and lowe r levels of perceived stress. The cultural model of social support is derived using a combination of participant observation, semi-structure d interviews, and the systematic ethnographic technique of cultural co nsensus modelling. These results are then used to develop a measure of an individual's approximation to that model of social support in a su rvey of four diverse neighborhoods in the city (n = 250). We call this approximation to the ideal cultural model of social support ''cultura l consonance'' in social support. The association of health outcomes w ith cultural consonance in social support is independent of individual differences in the reporting of social support, and of standard covar iates. In the case of blood pressure and perceived stress, it is indep endent of diet, and other socioeconomic and psychosocial variables. Th e association with depressive symptoms is not independent of other psy chosocial variables. The implications of these results are discussed w ith respect to research on cultural dimensions of the distribution of disease.