Author: Planning Unit, Vermont Department of Health

Updated: August 2023

The percentage of adults with low socioeconomic status who always or usually receive social and emotional support has been statistically consistent over the years.

However, adults with low socioeconomic status (defined as adults with a high school education or less and earning less than 250% of the federal poverty level) were less likely than Vermont adults in general to always or usually receive social and emotional support (65% in 2018/2020 vs. 80% in 2020 respectively).

Adults with low socioeconomic status report receiving social and emotional support at a rate over ten percentage points lower than Vermont adults on average.

Social and emotional support—including living in communities that are cohesive and have social capital—support physical and mental health and serve as protective factors against numerous adverse health outcomes. It can reduce the risk of depression among adults with adverse childhood experiences (ACEs)^[i],  improve functioning among people with Chronic Obstructive Pulmonary Disease (COPD)^[ii], reduce the likelihood of violent behavior^[iii], and support cardiovascular health. Social isolation and loneliness are also linked to behaviors such as overeating and tobacco use among adults and increased risk of illness, mental health problems, and mortality.^[iv]

Many in Vermont pride themselves in being welcoming and trying to create welcoming environment to all. Despite this, due to bias, stereotypes, prejudice, and both implicit and explicit classism Vermonters living in poverty do not always feel welcomed, fully accepted, or part of their communities, neighborhoods, workplaces, or healthcare settings.^[v] This process of “othering” can lead to stress, isolation, and a lack of social and emotional support. These, in turn, can affect the social conditions in which people live, learn, work, and play, as well as their mental health, physical health, and health behaviors.

^[i] Social and emotional support as a protective factor against current depression among individuals with adverse childhood experiences

^[ii] Relationships Between Social/Emotional Support and Quality of Life, Depression and Disability in Patients With Chronic Obstructive Pulmonary Disease

^[iii] Connectedness and Health: The Science of Social Connection

^[iv] County Health Rankings: Family and Social Support

The Health Department understands that to address this issue we need to partner with traditional public health programs and other partners like social service organizations and other government agencies.

We also need to build relationships and share decision-making with organizations that are led by, or specifically serve, populations who experience socioeconomic inequities. These people have historically held less social and political power.

Improving the health of everyone living and working in Vermont will require trusting and equitable partnerships with many organizations, communities, and people. 

Some of our current partners include:

• Agency of Human Services
• Department of Mental Health
• Department for Children and Families
• Agency of Education and local schools
• Designated Agencies that support mental health, substance use, and people with disabilities
• Community Coalitions

No single approach alone can increase the number of people reporting that they always or usually receive emotional support. Building this requires a multiprong approach involving all levels of the Vermont Prevention Model (see below). In the State Health Improvement Plan we are doing this by investing in programs that promote resilience, connection, and belonging. Some evidence-based approaches include^[i]:

• Individual: crisis lines
• Relationships: Nurse-Family Partnership (NFP) and early childhood home visiting programs*; mental health first aid; group parenting classes
• Organizations: youth leadership programs; community centers; Employee Assistance Programs (EAP); Culturally and Linguistically Appropriate Services; affirmative recruitment.
• Community: activity programs for older adults; community centers; extracurricular activities for school-aged youth*; Open Streets; social media connections with others with shared experiences; participatory budgeting.
• Policies and Systems: addressing systems of oppression

*Strategy specifically named in State Health Improvement Plan.

^[i] County Health Rankings: collection of evidence-based public health approaches

Using data to recognize and communicate disparity in outcomes and experiences across different people in our state is a first step but it must be used to be meaningful. Data should be used as information to inform action for becoming better.

Through the State Health Improvement Plan we aim to build meaningful community engagement, develop equitable programs, policies, and budgets, and provide respectful care and services.

• Developing and strengthening relationships with communities and people with fewer social assets and opportunities is an important strategy in this work. These relationships will help us to better understand how our systems and institutions have contributed to such disparities.
• Collaboration between the Department of Health, the Agency of Human Services, and our partners to better understand and address structural inequity is another key to succeeding in this work.
• Increasing trauma-informed care of individuals through our programs and services is another important piece toward building organizations that can appropriately address the needs of people living in poverty. 

Two years of data are combined for this measure and data is shown on the graph for the most recent year. The emotional and social support question is only asked in even years on the BRFSS. Adults with low socioeconomic status are defined as individuals who have a high school or less education and live in households with annual incomes less than 250% of the federal poverty level (FPL).

The results are weighted to represent the Vermont adult population (18 or older). The baseline year is 2014, 2016 and the 5-year target for the SHIP was calculated as a 5% improvement over the baseline.

The Behavioral Risk Factor Surveillance System (BRFSS) tracks risk behaviors, chronic disease and health status of adults using an annual telephone survey. Vermont participates in the BRFSS along with all other US states and territories with the support of the Centers for Disease Control and Prevention. You can read more about the survey on the department's BRFSS information page.