Family, Social Support & Community Connections


Social Inclusion, or the ability to participate fully in society, is considered an important factor in health and wellness. In an inclusive and respectful community, all people feel safe, supported, connected and engaged. Social inclusion is an important determinant of health – without inclusion, people are more likely to experience poor physical and mental health, loneliness, isolation, and poor self-esteem. People with greater social support, less isolation, and greater interpersonal trust live longer and healthier lives than those who are socially isolated. In the 2019 DC Community Health Needs Assessment Survey, 45% of respondents report that they feel isolated from others in their community.

Social capital includes the features in society such as community trust, norms of reciprocity, community connections and associations (i.e., civic associations) that allow cooperation for mutual benefit [1]. Neighborhoods richer in social capital provide residents with greater access to support and resources than those with less social capital [1].

Family and social support is the assistance available to individuals and groups from within communities that can provide a buffer or safety net against adverse life events and living conditions. This support can provide positive resources for enhancing the quality of our lives and health, and lack of support can result in poor outcomes. For example, family violence has a strong link to homelessness. Among transgender people in the US, 48% of those who experienced domestic violence also reported having experienced homelessness, nearly four times the rate of those whose families were accepting [2]. Additionally, 38% of transgender people who experienced domestic violence also reported having worked in the underground economy, such as sex work or drug sales, a rate more than four times as high than those whose families were accepting (7%) [2].

The DC Healthy People 2020 goals related to this topic include:

1. Adults and youths experiencing disabilities are successful, socially included, and respected at work, school, and university.

2. Foreign-born District residents have equal opportunities to lead a healthy life.

3. LGBTQ communities experience social inclusion, respect, and equal access to all community benefits and services.

4. Older adults live in an age-friendly environment where all people can participate in society in a manner that enhances their personal growth, respect, and social inclusion.


Respect and Social Inclusion

People can be present or live in a community and still be socially excluded. A community that is socially inclusive provides a safe and respectful environment in which individuals [3]:

• Experience a sense of belonging

• Are accepted (for who they are) within their communities

• Have valued roles in the community

• Are actively participating in the community

• Are involved in activities based on their personal preferences

• Have social relationships with others whom they chose & share common interests

• Maintain friendships

Among adolescents in the District, only 25% feel very safe in their neighborhood, according to the 2017 Youth Prevention Survey [4]. In 2017, among middle school students 26.2% of LGB adolescents were electronically bullied (i.e., through text messages or social media platforms such as Instagram) and 22.9% were bullied on school property compared to 11.9% and 13.6% of their heterosexual peers, respectively.

Among high school students, 22.1% of LGB adolescents were bullied at school because someone thought they were gay, lesbian, bisexual or transgender [5].

Single parenthood can also bring added pressure and stress to the job of raising children. With no one to share day-to-day responsibilities or decision-making, single parents must provide greater support for their children while they themselves may feel alone [6].

Social Vulnerability Index

The CDC’s Social Vulnerability (SVI) Index refers to the resilience of communities when confronted by external stresses on human health, stresses such as natural or human-caused disasters, or disease outbreaks. The SVI and its 15 individual indicators from the U.S. Census can be used to identify communities that need support in preparing for hazards or recovering from disasters; it can also be used to identify communities that may benefit from additional support to reduce certain social and economic conditions that adversely affect health. By reducing social vulnerability, we can improve health outcomes not only in a disaster but also in daily life. [7].

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