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The importance of participation in voluntary formal associations for enhancing health is supported by four kinds of evidence. (1) Seven prospective studies of social relations and mortality show the independent effect of formal social participation, net of informal ties. (2) Conceptual analysis demonstrates that voluntary formal associations constitute a separate class of social causation. (3) Our factor analysis of data from a sample of 629 nonmetropolitan elderly identified two types of formal social participation: "instrumental," as in associations that are community oriented, and "expressive," as in those that exist for the benefit of the members. (4) Regression analysis showed that the instrumental participation factor is linked, net of controls, to the perceived health of both men and women, whereas the expressive factor predicts for women only.
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