Neighborhood linking social capital as a predictor of lung cancer: A Swedish national cohort study

Community-level group sports participation and all-cause, cardiovascular disease, and cancer mortality: a 7-year longitudinal study

BACKGROUND

Community-level group sports participation is a structural aspect of social capital that can potentially impact individual health in a contextual manner. This study aimed to investigate contextual relationship between the community-level prevalence of group sports participation and the risk of all-cause, cardiovascular disease (CVD), and cancer mortality in older adults.

METHODS

In this 7-year longitudinal cohort study, data from the Japan Gerontological Evaluation Study, a nationwide survey encompassing 43,088 functionally independent older adults residing in 311 communities, were used. Cause of death data were derived from the Japanese governmental agency, The Ministry of Health, Labour and Welfare, for secondary use. "Participation" was defined as engaging in group sports for one or more days per month. To analyze the data, a two-level survival analysis was employed, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated.

RESULTS

Among the participants, 5,711 (13.3%) deaths were identified, with 1,311 related to CVD and 2,349 to cancer. The average group sports participation rate was 28.3% (range, 10.0-52.7%). After adjusting for individual-level group sports participation and potential confounders, a higher community-level group sports participation rate was found to be significantly associated with a lower risk of both all-cause mortality (HR: 0.89, 95% CI: 0.83-0.95) and cancer mortality (HR: 0.89, 95% CI: 0.81-0.98) for every 10% point increase in the participation rate. For CVD mortality, the association became less significant in the model adjusted for all covariates (HR: 0.94, 95% CI: 0.82-1.09).

CONCLUSIONS

Our findings support the existence of a preventive relationship between community-level group sports participation and the occurrence of all-cause and cancer mortality among older individuals. Promoting group sports within communities holds promise as an effective population-based strategy for extending life expectancy, regardless of individual participation in these groups.

Association between neighborhood deprivation and mortality in patients with schizophrenia and bipolar disorder-A nationwide follow-up study

OBJECTIVES

The aim was to explore the association between neighborhood deprivation and all-cause mortality and cause-specific mortalities in patients with schizophrenia and bipolar disorder. A better understanding of this potential relationship may help to identify patients with schizophrenia and bipolar disorder with an increased mortality risk.

METHODS

This nationwide study included practically all adults (≥30 years) diagnosed with schizophrenia (n = 34,544) and bipolar disorder (n = 64,035) in Sweden (1997-2017). The association between neighborhood deprivation and mortality was explored using Cox regression. All models were conducted in both men and women and adjusted for individual-level sociodemographic factors and comorbidities.

RESULTS

There was an association between level of neighborhood deprivation and all-cause mortality in both groups. The adjusted hazard ratios for all-cause mortality associated with high compared to low neighborhood deprivation were 1.18 (95% confidence interval 1.11-1.25) in patients with schizophrenia and 1.33 (1.26-1.41) in patients with bipolar disorder. The two most common mortality causes in both groups were coronary heart disease and cancer. The mortality due to coronary heart disease increased when neighborhood deprivation increased and reached 1.37 (1.18-1.60) in patients with schizophrenia and 1.70 (1.44-2.01) in patients with bipolar disorder living in the most deprived neighborhoods.

CONCLUSIONS

This study shows that neighborhood deprivation is an important risk factor for all-cause mortality and most cause-specific mortalities among patients with schizophrenia and bipolar disorder. These findings could serve as aid to policymakers when allocating healthcare resources and to clinicians who encounter patients with these conditions in deprived neighborhoods.

Neighborhood deprivation in relation to lung cancer in individuals with type 2 diabetes-A nationwide cohort study (2005-2018)

BACKGROUND

Neighborhood deprivation has been found associated with both type 2 diabetes and lung cancer. The aim of this study was to examine the potential association between neighborhood deprivation and lung cancer incidence or mortality in individuals diagnosed with type 2 diabetes. The results may identify a new risk or prognostic factor for lung cancer in this important subgroup and help develop a more contextual approach to prevention that includes neighborhood environment.

METHODS AND FINDINGS

The study population included adults (n = 613,650) aged ≥ 30 years with type 2 diabetes during 2005 to 2018 in Sweden. Cox regression was used to compute hazard ratios (HRs) and 95% confidence intervals (95% CIs) for incidence or mortality of lung cancer associated with neighborhood deprivation. All models were conducted in both men and women and adjusted for individual-level characteristics (e.g. age, smoking- and alcohol-related comorbidities, sociodemographic factors). The cumulative incidence and mortality for lung cancer were 1.08% (95% CI, 1.06 to 1.11) and 0.93% (0.90 to 0.95), respectively, in the study population during the study period. Neighborhood deprivation was associated with both incidence and mortality of lung cancer in patients with type 2 diabetes independently of the individual-level characteristics. In the fully adjusted models, comparing high- with low-deprivation neighborhoods, the HRs for lung cancer incidence were 1.21 (1.10 to 1.33) in men and 1.08 (0.95 to 1.21) in women. The corresponding HRs for lung cancer mortality were 1.04 (1.00 to 1.07) in men and 0.97 (0.94 to 1.00) in women. Competing risk analyses including cardiovascular mortality attenuated the results.

CONCLUSION

In this large cohort of individuals with type 2 diabetes, we found higher lung cancer incidence and mortality in patients living in areas with high neighborhood deprivation, even after adjusting for individual-level characteristics. These findings may help develop a more contextual approach that includes the neighborhood environment when allocating resources for disease prevention and care in patients with type 2 diabetes. These findings could also help inform clinical care for patients with type 2 diabetes, particularly those living in deprived neighborhoods.

Effects of types and levels of social capital on emotional well-being for older people in Indonesia: A longitudinal study

OBJECTIVES

The purpose of this study was to examine the effects of different types and levels of social capital and emotional well-being in older adults in Indonesia by a longitudinal data.

METHODS

The fourth and the fifth waves of Indonesian Family Life Survey data were used for this study. The participants aged 60 years or older who participated in both waves were included for analysis (n = 1374). Depressive symptoms and happiness were used to assess emotional well-being. Cognitive social capital (neighborhood trust) and structural social capital (participating in arisan, community meetings, volunteers, village improvement programs, and religious activities) were the main independent variables. The generalized estimating equations model was used for analysis.

RESULTS

Participation in arisan (B = -0.534) and attending religious activities (B = -0.591) were related to lower depressive symptoms, but the effect of religious activities would offset over time. Both a low or high social participation showed protective effects on depressive symptoms at the intercept and the time slope. Having higher neighborhood trust was related to more chance of feeling very happy (OR = 1.518).

CONCLUSION

Structural social capital is protective from depressive symptoms, while cognitive social capital contributes to happiness. Facilitating social participation and improving neighborhood trust through policies and programs is suggested to promote emotional well-being for older people.

Neighborhood social capital and incidence and mortality of prostate cancer: a Swedish cohort study

BACKGROUND

There is a growing interest in the contextual effect of neighborhood linking social capital on different health outcomes, including cancer.

AIMS

To examine associations between neighborhood linking social capital and incidence and mortality of prostate cancer.

METHOD

This cohort study was based on national registers. Between 2002 and 2015, we included 1,196,563 men aged 50 years and above in the analyses. Multilevel logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) for the association between exposure and outcome, adjusting for potential confounding factors.

RESULTS

The total incidence of prostate cancer and mortality in patients with prostate cancer were 8.22 (per 100) and 1.80 (per 100), respectively, during the follow-up period. Individuals living in neighborhoods with low (OR 0.90; 95% CI 0.88-0.93) and intermediate (OR 0.94; 95% CI 0.92-0.96) linking social capital were less likely to be diagnosed with prostate cancer than those living in neighborhoods with high linking social capital. Opposite effects were observed for mortality; prostate cancer patients living in neighborhoods with low (OR 1.15; 95% CI 1.08-1.23) and intermediate (OR 1.09; 95% CI 1.03-1.14) linking social capital were more likely to die from prostate cancer than those in neighborhoods with high linking social capital.

CONCLUSIONS

Lower neighborhood linking social capital was associated with lower incidence but higher mortality in patients with prostate cancer. These findings suggest that men living in neighborhoods with low linking social capital may need additional surveillance for prostate cancer.

The challenge of assessing social cohesion in health impact assessment

Health impact assessment (HIA) is a method by which a policy, programme or project falling outside traditional health fields, may be judged as to its potential effects on the health of a population to mitigate negative impacts and strengthen the positive ones. Proposals are analysed from the perspective of all the determinants of health. In France, HIAs are mainly applied to urban development projects where social cohesion (SCo) is a major issue. Although the HIA method is well structured as a step-by-step process, there are no guidelines for assessing SCo. This article opens with literature review to clarify the concept of SCo and to understand how the built environment influences SCo and how social environment influence health. Drawing on this work, this paper presents an analytical framework to assess SCo, integrating both the spatial and physical dimensions of urban design and the perceptions of the neighbourhood characteristics. Following a brief overview of the key findings from applying this framework to HIA of an urban development project, the paper discusses its related strengths and weaknesses. The framework could be a useful tool for HIA as it embraces knowledge from both urban planning and social sciences. It also allows for an overall analysis of all the indicators without relying on a checklist. Nevertheless, it should be tested further to improve its validity.