University of Pennsylvania ScholarlyCommons Publicly Accessible Penn Dissertations 2014 Social Networks, Social Support, and Mental Health in Cross- National Comparative Perspective Ning Hsieh University of Pennsylvania, [email protected] Follow this and additional works at: https://repository.upenn.edu/edissertations Part of the Psychiatric and Mental Health Commons, and the Sociology Commons Recommended Citation Hsieh, Ning, "Social Networks, Social Support, and Mental Health in Cross-National Comparative Perspective" (2014). Publicly Accessible Penn Dissertations. 1315. https://repository.upenn.edu/edissertations/1315 This paper is posted at ScholarlyCommons. https://repository.upenn.edu/edissertations/1315 For more information, please contact [email protected]. Social Networks, Social Support, and Mental Health in Cross-National Comparative Perspective Abstract The dissertation contributes to the sociology of mental health by demonstrating that institutional and cultural settings shape the level of social cohesion and its influence on mental well-being. The dissertation consists of three independent but complementary essays. The first essay examines the influence of contexts on the link between social cohesion and suicide risk across countries in Americas, East Asia, and Europe. Using multilevel analysis, I show that marriage, parenthood, co-residence with parents, religious participation, and general social trust are all differentially related to suicide rates by region of the world. Whether a cohesive relationship is protective against suicide depends on contextual factors such as stigma against marital dissolution, welfare state regime, and the strength of religious networks. This essay contests Durkheim's theory on social cohesion and suicide by showcasing the international variation in the "benefits" of social cohesion. In the second essay, I examine the role of social cohesion and economic security in the mental health disparity between two societies in transition--China and Russia. The results show that the lower level of depressive symptoms among Chinese is in part attributed to their higher economic security and social cohesion (e.g., trust and perceived safety in the neighborhood). The findings suggest that eformr policy and institutional capacity of the state contribute to differences in social and economic resources and mental health outcomes between China and Russia. In the final essay, I compare the structure of core personal networks in three societies--China, Japan, and the U.S. The results show that structural aspects of social networks, including size, density, proportion of kin confidants, and frequency of contact, vary considerably between countries. Nevertheless, none of these countries seems to have a "better" social network structure than another. In fact, the findings challenge the conventional cultural notion of Eastern collectivism vs. Western individualism. The study suggests that the significantly lower prevalence of mental disorders in China and Japan compared to the U.S. cannot be explained by country-level differences in the strength of personal networks. Degree Type Dissertation Degree Name Doctor of Philosophy (PhD) Graduate Group Demography First Advisor Jason Schnittker Subject Categories Psychiatric and Mental Health | Sociology This dissertation is available at ScholarlyCommons: https://repository.upenn.edu/edissertations/1315 SOCIAL NETWORKS, SOCIAL SUPPORT, AND MENTAL HEALTH IN CROSS-NATIONAL COMPARATIVE PERSPECTIVE Ning Hsieh A DISSERTATION in Demography and Sociology Presented to the Faculties of the University of Pennsylvania in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy 2014 Supervisor of Dissertation _____________________ Jason Schnittker Professor of Sociology Graduate Group Chairperson in Demography Graduate Group Chairperson in Sociology _______________________ _______________________ Michel Guillot, Associate Professor of Sociology Emily Hannum, Associate Professor of Sociology and Education Dissertation Committee Jason Schnittker, Professor of Sociology Emily Hannum, Associate Professor of Sociology and Education Hans-Peter Kohler, Frederick J. Warren Professor of Demography SOCIAL NETWORKS, SOCIAL SUPPORT, AND MENTAL HEALTH IN CROSS-NATIONAL COMPARATIVE PERSPECTIVE © 2014 Ning Hsieh ACKNOWLEDGMENT The dissertation on social support and mental health was inspired by all the support I received from friends, family, colleagues, and acquaintances across the globe during my graduate years. I appreciate their encouragement, patience, generosity, as well as constructive criticism. I am especially grateful to my mentors at Penn, Jason Schnittker, Emily Hannum, and Hans-Peter Kohler, for guiding me into a challenging yet exciting research career. iii ABSTRACT SOCIAL NETWORKS, SOCIAL SUPPORT, AND MENTAL HEALTH IN CROSS-NATIONAL COMPARATIVE PERSPECTIVE Ning Hsieh Jason Schnittker The dissertation contributes to the sociology of mental health by demonstrating that institutional and cultural settings shape the level of social cohesion and its influence on mental well-being. The dissertation consists of three independent but complementary essays. The first essay examines the influence of contexts on the link between social cohesion and suicide risk across countries in Americas, East Asia, and Europe. Using multilevel analysis, I show that marriage, parenthood, co-residence with parents, religious participation, and general social trust are all differentially related to suicide rates by region of the world. Whether a cohesive relationship is protective against suicide depends on contextual factors such as stigma against marital dissolution, welfare state regime, and the strength of religious networks. This essay contests Durkheim’s theory on social cohesion and suicide by showcasing the international variation in the “benefits” of social cohesion. In the second essay, I examine the role of social cohesion and economic security in the mental health disparity between two societies in transition—China and Russia. The results show that the lower level of depressive symptoms among Chinese is in part attributed to their higher economic security and social cohesion (e.g., trust and perceived safety in the neighborhood). The findings suggest that reform policy and institutional capacity of the state contribute to differences in social and economic resources and mental health outcomes between China and Russia. In the final essay, I compare the structure of core personal networks in three societies—China, Japan, and the U.S. The results show that structural aspects of social networks, including size, density, proportion of kin confidants, and frequency of contact, vary considerably between countries. Nevertheless, none of these countries seems to have a “better” social network structure than another. In fact, the findings challenge the conventional cultural notion of Eastern collectivism vs. Western individualism. The study suggests that the significantly lower prevalence of iv mental disorders in China and Japan compared to the U.S. cannot be explained by country-level differences in the strength of personal networks. v TABLE OF CONTENTS ACKNOWLEDGMENT.................................................................................................... iii ABSTRACT ....................................................................................................................... iv LIST OF TABLES ............................................................................................................ vii LIST OF FIGURES ......................................................................................................... viii CHAPTER 1: SOCIAL RELATIONSHIPS AND SUICIDE IN COMPARATIVE PERSPECTIVE: A NEW LOOK AT DURKHEIM’S OLD INQUIRY ............................ 1 Introduction .................................................................................................................................. 1 Social Relationships and Suicide ................................................................................................. 3 Hypotheses ................................................................................................................................... 6 Data and Methods ........................................................................................................................ 7 Results ........................................................................................................................................ 12 Discussion .................................................................................................................................. 19 References .................................................................................................................................. 27 Appendix .................................................................................................................................... 44 CHAPTER 2: ECONOMIC SECURITY, SOCIAL COHESION, AND MENTAL HEALTH DISPARITIES IN TRANSITIONAL SOCIETIES: A COMPARISON OF OLDER ADULTS IN CHINA AND RUSSIA ................................................................. 45 Introduction ................................................................................................................................ 45 Literature Review ....................................................................................................................... 47 Hypotheses ................................................................................................................................