There were significant differences in the level of social support between different age groups. As a general trend, it was observable that the higher the age, the lower was the reported level of social support. The youngest age groups in return had the highest levels of support. These results fit well into the literature so far and do not contradict empirical findings by other researchers [4]. Furthermore, the growing body of literature concerning the problem of loneliness and social isolation in the elderly [24, 25], the development of screening scales to assess social isolation in this group [26], as well as the development of interventions to face that problem bolster these results [27]. Some authors refer to the social isolation of elderly people as a major social problem in Western societies [28]. In a longitudinal, population-based study from Finland [29], it was found that loneliness increased with age and that the percentage of people who feel lonely was higher in older age groups, mainly due to an increasing disability and a decreasing social integration. This is consistent with the suggestion by Sonnenberg and colleagues [30] that many swift alterations in the social networks of elderly people can occur due to abrupt changes in health, functional capacity, illness or the death of important others [30].
The consistently lower levels of social support and the problem of social isolation in elderly people in combination with the rapid demographic changes and ageing populations in Western countries might be another cause for concern. Projections of the population development in Germany by the year 2050 assume that the age structure will substantially change. The population will be older and smaller than nowadays [31]. This is mainly due to the combination of low fertility and low mortality. The critical questions in the context of the present research will be, how this population development will influence the level of social support in the affected countries, and which effects a possibly lower, general level of social support in the society will have on diverse mental and physical health issues, one major topic among them being depression and the severity of depressive symptoms.
Men and women did not differ significantly in their levels of social support. Former studies consistently reported a higher level of social support and a stronger emotional attachment to their social networks in women compared to men [4, 13, 30, 32, 33]. These findings could not be replicated in the current study what might reflect the beginning of a general change in the traditional gender roles in the present. Was it relatively common for women to take care for the family, to raise children, and to maintain social relationships, while men were mainly responsible for the family income, these traditional role allocations have begun to change substantially due to political activities as well as simultaneous changes in the respective gender role models and stereotypes. Important keywords that describe this development are gender equality and the feminization of men. Consistently, some empirical evidence for a partly changed meaning of social support comes from Sonnenberg and colleagues [30] who could demonstrate that a lack of emotional support and the lack of a partner in the household were more detrimental for men than for women with regard to depression. A small network size even predicted the onset of depression only in men but not in women.
This was the first study to present normative data for the OSSS-3, a brief and economic instrument for the assessment of the level of social support. These data can be used for several purposes. It is now possible to validly classify an individual’s score on the OSS-3 and compare it either with the reference score in the general population or in his or her respective age group. By doing so, it becomes possible to classify, which level of social support this particular individual has available relative to his or her reference group. For example, an OSSS-3 score of 12 in a 20-year-old man indicates a percentile rank of 79.7% in his reference group (males in the age between 14 and 24) and a percentile rank of 84.0% in the total population. This means that, in his reference group, 79.7% have the same or a lower score and vice versa, only 20.3% have a higher score. The application of percentiles has the advantage to be independent of distribution assumptions as well as an easy interpretability. Furthermore, it is now possible to compare levels of social support between different populations on the basis of these comparative values and to use these data as reference categories in community studies [34, 35].
Concerning the factor structure of the OSSS-3, a one-factor solution fitted the data best as the result of a Principal Component Analysis using the varimax-rotation procedure with Kaiser-normalization to obtain uncorrelated factors. Although some authors already attested the feasibility and validity of the OSSS-3 [17, 18], the factor structure has not been clarified and reported, yet. Next to the provision of normative data, this was another important objective of the current study, to address and overcome that methodological shortcoming. In the light of a very heterogeneous conceptualization and administration of the social support construct [1, 2], it is important to promote theory-based, well-validated and standardized measuring instruments. Social support can be and already has been conceptualized on different levels of specificity (e.g. [5, 13]). This makes it difficult to compare findings regarding the role of social support for different health care issues [3]. The reported one-factor solution supports the idea that social support is an overarching construct that aggregates facets such as structural and instrumental support, and thus can be interpreted on a more generic level. This is an important methodological advancement, which further contributes to the theoretical clarification of the social support construct. The reported psychometric properties of the OSSS-3 support the reliability of the scale. Although it is very short, containing only three items, the internal consistency was satisfying.
In conclusion, complementing the suggestions by Bøen and colleagues [18] as well as Glaesmer and colleagues [16] regarding the validity and feasibility of the OSSS-3 and its already widespread application in large-scale research settings (e.g. [13, 14]), this paper delivered some important, yet missing methodological findings that further support the scale’s reliability, contribute to the structural and factorial clarity, and endorse the applicability in different contexts such as individual classification and intercultural comparisons [13, 14, 17, 18]. Yet, the reliability of the scale remains a question, as e.g. test-retest reliability could not be reported.
Due to these findings, an intensified use of the OSSS-3 in future research projects might be promoted. This would help to overcome the methodological heterogeneity in the conceptualization and assessment of social support and make the results of different studies and research groups better comparable. One apparent advantage of the OSSS-3 is the brevity and economic assessment of social support with only three items. As a result, the scale can be incorporated into larger research projects, such as population-based studies, without significantly enhancing the effort for participants and researchers.
To further validate the OSSS-3, it would be interesting to assess the associations with other measures of social support. In particular, the associations with more extended or longer scales such as the DSSI [8] would be illuminating. If the OSS-3 showed substantial associations with these scales, implying that they measure the same construct, this would be another argument for an intensified administration in future projects, due to the higher economy of the OSSS-3.
Regarding the distribution of social support in the German general population, a majority of 75% reports to have at least moderate levels. One third of the population even reports to have strong levels of support. Nonetheless, there is about one quarter in the general population who report to have only poor levels of support. Since these data are descriptive in nature and no population-based studies from different countries could be identified that deliver values to compare the reported ones with, no further speculations will be undertaken concerning the meaning of these figures. Just a little note of caution shall be sounded at this juncture. Despite the majority reporting moderate and high levels of support, almost 25% of the population feels poorly supported what might be a cause for concern. The future development has to be monitored carefully.
For the purpose of intercultural comparisons with regard to the levels of social support and the valid interpretation of the reported figures, it would be desirable if future population-based studies assessed the general level of social support in different populations and delivered normative data from these cultures. For example, it is worth knowing if there are differences between individualistic, mainly Western and collectivistic, mainly Eastern cultures [36]. These two cultural types differ markedly in the construal of the self and the meaning of the community. Individualistic cultures are shaped more competitively, emphasize the importance of the individual, and have an independent view of the self, while collectivistic cultures are shaped more familial, emphasize group ties and social bonds stronger, and have an interdependent view of the self [37]. Consequently, members of collectivistic cultures emphasize the harmonious interdependence with other people, while members of individualistic cultures strive for independence of others. In consequence, this could lead to a higher level and estimation of social support in collectivistic cultures compared to individualistic cultures.
Furthermore, longitudinal studies should investigate if and how the level of social support is changing over time. This is especially intriguing in the light of rapid demographic changes such as an ageing population and major societal transformations such as an increasing technologization and digitalization. Research questions might concern if the ongoing ageing of the population leads to decreasing levels of support; which effects the rapid spread of social networks has on social relationships and social supports in the “real world”; and what meaning social support has for the generation of the digital natives.