Gender differences in relationships between social capital and individual smoking and drinking behavior in Taiwan

Impact of Social Capital on Health Behaviors of Middle-Aged and Older Adults in China-An Analysis Based on CHARLS2020 Data

To actively respond to the challenges posed by population aging, people are paying more and more attention to healthy behavioral lifestyles, and the impact of social capital as an informal system on health behaviors cannot be ignored. This paper explores the impact of social capital on health behaviors of middle-aged and older adults based on 2020 CHARLS data. Using binary logistic regression models, we discussed the association between social capital and five health behaviors. The results suggest that structural social capital significantly increases physical activity and physical examination behaviors among middle-aged and older adults but also decreases the probability of abstinence behaviors. Cognitive social capital increases the probability that middle-aged and older adults will have a reasonable amount of sleep and physical activity. However, it also decreases the probability that smoking cessation behaviors will occur. Further attention needs to be paid to the role of social capital, the creation of a harmonious social environment and the enhancement of social trust, the strengthening of communities and grass-roots social organizations, and the provision of more platforms for the participation of middle-aged and older adults in social activities, to improve the quality of the healthy lives of middle-aged and older adults and, in turn, to promote the establishment of healthy behaviors.

Alcohol abuse may increase the risk of autoimmune connective tissue disease: a nationwide population-based cohort study

Objectives

Altered immune and inflammatory responses resulting from alcohol abuse have been implicated in increasing the risk of autoimmune connective tissue disease (ACTD). However, limited research has been conducted on this topic in the Asian population. Therefore, this study was undertaken to investigate and address this knowledge gap.

Methods

Using data from Taiwan's National Health Insurance Research Database, we identified all patients with alcohol abuse between 2000 and 2017. We selected a comparison cohort without alcohol abuse, matching them in terms of age, sex, and index date at a 3:1 ratio. We collected information on common underlying comorbidities for analysis. Both cohorts were followed up until the diagnosis of ACTD or the end of 2018.

Results

A total of 57,154 patients with alcohol abuse and 171,462 patients without alcohol abuse were included in the study. The age and sex distributions were similar in both cohorts, with men accounting for 89.8% of the total. After adjusting for underlying comorbidities, patients with alcohol abuse had a higher risk of developing ACTD [adjusted hazard ratio (AHR): 1.12, 95% confidence interval (CI): 1.01-1.25]. The stratified analysis revealed that this increased risk was specific to the male population. Additionally, besides alcohol abuse, liver disease, renal disease, coronary artery disease, and chronic obstructive pulmonary disease were identified as independent predictors for ACTD.

Conclusion

This study demonstrates that alcohol abuse increases the risk of developing ACTD in the Asian population, particularly among men. Therefore, it is important to implement alcohol cessation, especially in individuals with liver disease, renal disease, coronary artery disease, and chronic obstructive pulmonary disease.

Association between modifiable lifestyle pattern and periodontitis: a cross-sectional study based on NHANES

BACKGROUND

Periodontitis can be avoided with a healthy lifestyle. However, studies have only looked at one lifestyle, ignoring the connection between lifestyle patterns and periodontitis. The purpose of this study was to look at the association between modifiable lifestyle patterns and periodontitis.

METHODS

Data were obtained from the National Health and Nutrition Examination Survey in 2009-2010 and 2011-2012. Smoke, drink, exercise, sleep duration, oral exams, and self-rated oral health were all lifestyle factors. The CDC/AAP classification/case definition was used to evaluate periodontitis. Drawing upon latent class analysis, distinct patterns of lifestyle were identified, with each participant exclusively affiliated with a single pattern. The association between lifestyle classes and periodontitis was then examined using ordinal logistic regression.

RESULTS

4686 (52%) of the total 9034 participants, with a mean age of 54.08, were women. Three lifestyle latent classes were found by fitting 2-10 models: "Class 1" (52%), " Class 2" (13%), and " Class 3" (35%). The "Class 1" displayed a prevalence of oral examination (75%), favorable self-rated oral health (92%), and engagement in physical activity (50%). The 'Class 2' exhibited the lowest alcohol consumption (64%) and smoking rates (73%) but the highest prevalence of physical inactivity (98%). The 'Class 3' showed a tendency for smoking (72%), alcohol consumption (78%), shorter sleep duration (50%), absence of oral examinations (75%), and suboptimal self-rated oral health (68%). The influencing variables for the latent classes of lifestyle were age, education, and poverty level. Periodontitis risk may rise by 24% for each additional unhealthy lifestyle practiced by participants (OR = 1.24, 95% CI: 1.18-1.31). The 'Class 3' (OR = 1.80, 95% CI: 1.52-2.13) had a greater risk of periodontitis compared to the 'Class 1'.

CONCLUSIONS

Our analysis revealed that unhealthy lifestyle patterns are associated with periodontitis. These different lifestyle patterns need to be taken into account when developing public health interventions and clinical care.

Association between workplace social capital and systolic blood pressure among 23 173 workers at 367 small-sized and medium-sized enterprises in Japan: a cross-sectional study

OBJECTIVES

Social capital (SC) has been shown to be inversely associated with elevated blood pressure. While SC in the workplace may also be associated with blood pressure, it has not been extensively studied. We aimed to investigate the association between workplace SC and systolic blood pressure (SBP).

DESIGN

A cross-sectional study.

SETTING

367 small-sized and medium-sized companies in Japan.

PARTICIPANTS

A total of 23 173 participants (15 991 males and 7182 females) aged ≥18 years.

EXPOSURE OF INTEREST

SC was assessed using individual responses to eight 4-point Likert questions used in the Brief Job Stress Questionnaire. Workplace SC was assessed as the mean of individual-level responses to the SC questions from those working in the same company.

OUTCOME MEASURE

Systolic blood pressure (SBP) RESULTS: A multilevel linear regression model revealed that higher workplace-level SC was linked with lower SBP (coef.=-0.53 per 1SD increment in workplace SC, 95% CI=-1.02 to -0.05) among females in the age-adjusted model, which remained statistically significant after adjusting for other covariates. After adjusting for individual-level SC, this association was attenuated and became non-significant (coef.=-0.41, 95% CI=-0.87 to 0.05), while individual-level SC was inversely associated with SBP (coef.=-0.43, 95% CI=-0.73 to -0.13). Among males, we did not find any evidence of significant inverse associations either in relation to workplace SC (coef.=-0.12, 95% CI=-0.46 to 0.21) or individual-level SC (coef.=0.19, 95% CI=-0.01 to 0.39).

CONCLUSIONS

Our study findings suggested that workplace-level SC can affect SBP differently by sex.

Social Participation and Persistent Smoking Among Older Chinese With Smoking-Related Morbidity

OBJECTIVES

Chronic diseases are common in midlife and old age and smoking can pose more health and longevity challenges for older people with chronic illnesses. In China where smoking is highly prevalent, older adults are likely to continue smoking even after developing severe chronic diseases. We examined the national prevalence of persistent smoking among older adults. We also investigated the sociodemographic characteristics of persistent smoking among ever-smokers with chronic diseases and its association with social participation (of various types).

METHODS

We used data from a nationally representative sample of older adults aged 45-80 in the China Health and Retirement Longitudinal Study (2011-2018). Multinomial logistic and multilevel logistic models were fitted.

RESULTS

The national prevalence of persistent smoking was around 24% of older men and 3% of older women. Among those with a history of smoking and chronic illness, younger, nonmarried/partnered, nonretired, or less educated individuals are more likely to continue smoking. Social participation is significantly associated with persistent smoking among those with chronic diseases, but the association differs across different forms of activities. Although the most popular but sedentary activities in China (playing Mahjong, chess, or cards) are associated with an elevated risk of persistent smoking, physical social activities (community-organized dancing, fitness, and qigong) are associated with a reduced risk of persistent smoking.

DISCUSSION

Given the enormous burden of persistent smoking on individuals and society, public smoking cessation inventions should address sociocultural factors of persistent smoking and target older adults who participate in specific social activities.

The Association of Gender Role Attitudes and Risky Drinking: Changes in the Relationship between Masculinity and Drinking in Korean Young Men

Recently, younger men in Korean society tend not to view drinking as a proud feature of men who work. The relationship between gender role attitudes and high-risk drinking is expected to change accordingly. An online survey was conducted in January-February 2022, and the frequency of drinking, the amount of drinking, and traditional gender role attitudes, such as "men should be independent and women should take care of the children", were measured. Participants were 786 men aged between 19 and 69 years. When comparing men in their 20s and 30s with those in their 40s to 60s, the younger men reported drinking relatively high amounts of alcohol in one place, and older men had a relatively high frequency of drinking. High-risk drinking was significantly higher in the older group. Gender role attitudes were more traditional in the older group and were a predictor of high-risk drinking in older men, but there was no significant relationship between the two variables in the younger age group. The results indicate that different generations have different perceptions of how men should drink. In addition to more detailed qualitative research on drinking motivation by generation, research on whether similar changes are occurring in other countries is needed.

Dark Side or Bright Side: The Impact of Alcohol Drinking on the Trust of Chinese Rural Residents

Existing studies have explored the causal effect of social capital on harmful drinking, while the effect of drinking habits on trust is scant. In China, drinking rituals and drinking culture are considered important ways of promoting social interaction and trust, especially in rural areas where traditional culture is stronger. Based on a field survey in rural China in 2019, this paper explores the relationship between drinking habits and trust. First, we found a negative relationship between drinking habits and trust, indicating that those people who drink alcohol are more likely to have a lower trust. Second, we found significant heterogeneity in the effect of alcohol consumption on social trust across various groups. Specifically, the negative effects of alcohol consumption on trust were stronger for the females than for males; drinking alcohol did not reduce the level of trust among the Chinese Communist Party (CCP) in rural China; compared with the Han nationality, we found that the effect of drinking on trust was not significant for the ethnic minority. Third, we observed that the negative effects of alcohol consumption on trust had thresholds across age and income. Among people under 51, the risk of trust from drinking was greater than for those over 51; the negative effect of drinking on residents’ trust was more obvious in low-income families, but not significant in the group with an annual household income of more than CNY 40,000. Our empirical study provides a deeper understanding of drinking culture in rural China from a dialectical perspective.

Social capital and alcohol risks among older adults (50 years and over): analysis from the Drink Wise Age Well Survey

Although there has been significant research on the relationship between alcohol consumption and demographic and psychological influences, this does not consider the effect of social influence among older drinkers and if these effects differ between men and women. One aspect of social influence is social capital. The aim of this paper is to examine whether relational and cognitive social capital are associated with higher or lower risk of alcohol use among adults aged 50 years or older and to assess the extent to which this relationship differs between men and women. To investigate this, data were collected from a cross-sectional questionnaire survey of adults over the age of 50 in the United Kingdom who were recruited from general practitioners. The sample consisted of 9,984 individuals whose mean age was 63.87 years. From these data, we developed proxy measures of social capital and associate these with the respondent's level of alcohol consumption as measured on the Alcohol Use Disorders Identification Test (AUDIT-10) scale. In the sample, just over 20 per cent reported an increasing risk or dependency on alcohol. Using two expressions of social capital – relational (social relationships) and cognitive (knowledge acquisition and understanding) – we found that greater levels of both are associated with a reduced risk of higher drinking risk. Being female had no significant effect when combined with relational capital but did have a significant effect when combined with cognitive capital. It is argued that interventions to enhance social relations among older people and education to help understand alcohol risks would be helpful to protect older people from the damaging effects of excessive alcohol consumption.

Gender Disparities of Heart Disease and the Association with Smoking and Drinking Behavior among Middle-Aged and Older Adults, a Cross-Sectional Study of Data from the US Health and Retirement Study and the China Health and Retirement Longitudinal Study

Heart disease remains the leading cause of death globally by gender and region. Smoking and alcohol drinking are known modifiable health behaviors of heart disease. Utilizing data from the US Health and Retirement Study and the China Health and Retirement Longitudinal Study, this study examines heart disease disparities and the association with smoking and drinking behavior among men and women in the US and China. Smoking and drinking behavior were combined to neither, smoke-only, drink-only, and both. In the US, the prevalence was higher in men (24.5%, 95% CI: 22.5-26.6%) than in women (20.6%, 95% CI: 19.3-22.1%) and a higher prevalence was found in the smoke-only group for both genders. In contrast, women in China had higher prevalence (22.9%, 95% CI: 21.7-24.1%) than men (16.1%, 95% CI: 15.1-17.2%), and the prevalence for women who smoked or engaged in both behaviors were ~1.5 times (95% CI: 1.3-1.8, p < 0.001) those who did not smoke or drink, but no statistical difference were found in men. The findings might be due to differences in smoking and drinking patterns and cultures by gender in the two countries and gender inequality among older adults in China. Culturally tailored health promotion strategies will help reduce the burden of heart disease.

Associations of functional disability and behavioural risk factors with social participation of older adults: a cross-sectional analysis from the Canadian Longitudinal Study on Aging

OBJECTIVES

To examine: (1) the associations of functional disability and behavioural risk factors with social participation; and (2) whether the association between functional disability and social participation is modified by co-occurrence of behavioural risk factors.

DESIGN

A cross-sectional analysis of data from the Canadian Longitudinal Study on Aging.

SETTING

A national stratified sample of 51 388 individuals living in the 10 Canadian provinces at the time of baseline data collection (2011-2015).

PARTICIPANTS

Participants included men and women aged 45-85 years and residing in the communities in the 10 Canadian provinces.

OUTCOME MEASURES

Social participation was assessed using frequency of participant involvement in eight different social activities in the past 12 months. Responses for each category were converted into number of days per month. Total social participation score (range: 0-180) was based on summing frequencies over all eight activities representing number of social activities per month.

RESULTS

Functional disability was associated with participating in fewer social activities (difference in mean total social participation score, b=-1.1, 95% CI -1.5 to -0.7). In comparison to no behavioural risk factors, presence of any one (b=-2.7, 95% CI -3.1 to -2.3), any two (b=-4.6, 95% CI -5.0 to -4.2), any three (b=-6.3, 95% CI -6.8 to -5.9) and all four (b=-7.8, 95% CI -9.0 to -6.6) behavioural risk factors was associated with lower social participation. The association between functional disability and social participation was modified by the presence of behavioural risk factors with the lowest social participation observed for adults with disability and all four behavioural risk factors (b=-4.3, 95% CI -7.5 to -1.2).

CONCLUSIONS

Individuals with functional disabilities and behavioural risk factors are more likely to experience restrictions in social participation. Public health interventions that encourage healthy lifestyle behaviours may help mitigate the impact of functional disabilities on social participation in the ageing population.

Communication Infrastructure in an Asian Immigrant Community

The health benefits of having a supportive community and access to community resources are well documented and for many immigrant communities, community-based organizations (CBOs) play an important role by providing culturally competent services. The current study uses communication infrastructure theory (CIT) to examine the associations between connections to CBOs, civic engagement, and protective health behaviors within the context of Boston Chinatown's Chinese immigrant community. According to CIT, neighborhood communication resources encourage residents to engage in civic activities and health-related problem-solving behaviors. To assess these associations, data from a needs assessment survey (N = 360) were analyzed. Results showed that connections to CBOs had a positive association with total number of protective health behaviors. Civic engagement was not found to be associated with health behaviors. We also found no indirect effect of connections to CBOs on the protective health behaviors via civic engagement. These results carry important theoretical and practical implications.

A cross-sectional national survey to explore the relationship between smoking and political abstention: Evidence of social mistrust as a mediator

Rationale

Smoking prevalence is well known to vary socioeconomically but has been less studied in relation to political participation. Growing evidence suggests that health disparities and political nonparticipation are intertwined, but the underlying mechanism is unclear.

Objective

We investigated the relationship between smoking and voter registration, testing various forms of trust as possible mediators, in U.S. national survey data collected around the 2012 presidential election.

Methods

A random half (n = 9757) of adults who completed The Attitudes and Behaviors Survey on Health (TABS) in 2012 (response rate was 58.4% for landline and 24.3% for cell phone) also answered a section on voter registration, voting behavior, and trust in people and selected institutions. Multivariable logistic regression was used to examine the association between smoking and registering to vote and potential mediation by trust in people and various institutions, adjusted for covariates known to be associated with both. Analyses used design-based methods with weights to account for sampling probabilities, nonresponse, and calibration to the U.S. adult population in 2012.

Results

Compared with nonsmokers, daily smokers had significantly lower adjusted odds of being registered to vote (aOR: 0.33, 95% CI: 0.21–0.52) and higher adjusted odds of having low trust in people (aOR: 2.50, 95% CI: 1.29–4.83). Low trust in people predicted lower odds of registering to vote (aOR: 0.55, 95% CI: 0.36 to 0.84) and partially mediated the smoking-registration relationship.

Conclusion

Lower electoral participation among daily smokers is partly attributable to lower trust in people, a factor that could also affect willingness to use cessation support resources such as quitlines. Low trust and low political participation among daily smokers may have important political and public health consequences.

•

Smoking behavior and political participation are closely related.

•

Daily smokers were less likely to register to vote and to vote.

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Lower electoral participation is partly attributable to lower trust in people.

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Smokers' abstention from electoral decisions may bias public health policymaking.

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Cessation programs should reduce stigmatization and promote trust among smokers.

Associations between trust and drinking among adolescents

INTRODUCTION

Trust is closely linked with health, but previous research on its association with alcohol use has yielded mixed findings. The aim of this study is to examine: (i) how two different dimensions of trust (general/institutional) are associated with alcohol use among adolescents; (ii) how these dimensions interact with alcohol use; and (iii) whether the associations are moderated by sex, parenting, health, school satisfaction or economic disadvantage.

METHODS

A nationwide sample of 5549 adolescents (aged 15-16 years) in Sweden answered a questionnaire in school. General and institutional trust were measured with five items each. Logistic regressions were used to examine associations between drinking and the trust dimensions, and the cross-combinations of these. Moderation by sex, parenting, health, school satisfaction and economic disadvantage was tested.

RESULTS

General and institutional trust were both significantly associated with drinking. High scores on both dimensions simultaneously were associated with the lowest probability of drinking, and low scores on both with the highest. Low institutional trust had a stronger association than low general trust. The combination of high institutional/low general trust was more protective than low institutional/high general trust. The association between general trust and drinking was moderated by school satisfaction, and the relationship between institutional trust and drinking was moderated by parental support and control.

DISCUSSION AND CONCLUSIONS

High trust is associated with a lower probability of past-year drinking among 15-16-year-olds. Parents and schools can be useful in endeavours to prevent low-trusting individuals in this age group from drinking.

Association between Parents' Social Capital and Physical Status in Preschool Children in Japan: A Cross-Sectional Multicentre Study

OBJECTIVE

According to a World Health Organization report, in 2016, 41 million young children globally were overweight or obese. The connection between parents' social capital and their children's health has been studied, but associations between parental social capital and children's weight are largely unexamined. Hence, we assessed the relationship between preschool children's weight and parents' social capital.

METHODS

We used BMI assessment data for 357 children (46.5% girls; mean age 5.3 years) in Japan. We examined parents' structural and cognitive social capital using a self-report questionnaire.

RESULTS

Multiple logistic regression analysis revealed associations between parents' social capital and children's BMI. Seventy-two (20.2%) of the children had poor BMI (body mass index; overweight or thin). Interpersonal trust was significantly associated with normal BMI in children after adjustment for all confounding factors (OR 2.68; 95% CI, 1.33-5.44; P = .006) and was independently associated with other social capital factors, including norm of reciprocity (OR 3.38; 95% CI, 1.68-6.79; P < .001) and trust in organization (OR 1.24; 95% CI, 1.09-1.42; P = .001).

CONCLUSION

Social capital factors were independently associated with each other. Japanese parents' high social capital was an independent predictor of normal BMI among preschool children.

Sex differences in the association between latent class of lifestyle and disability among older adults in China

Background

A healthy lifestyle may prevent disability for older adults. But research to date is limited to a single lifestyle behavior and ignore sex difference in the lifestyle-disability association. This study aimed at identifying sex-specific latent classes of lifestyle and their relationship with disability among older Chinese adults.

Methods

Data were obtained from adults aged 65 years or above in the 2018 Chinese Longitudinal Healthy Longevity Survey, a nationally representative sample of older adults in China. We used latent class analysis to categorize participants into subgroups based on three dimensions of lifestyle factors: health behaviors, psychological wellbeing, and social engagement. Disability was assessed by the activities of daily living (ADL). Multivariable logistic regression was used to evaluate the associations between the latent lifestyle classes and disability.

Results

A total of 15,771 older adults were included in this analysis, of whom 56% were women and 66% aged 80 years or above. We identified four latent lifestyle classes among older women: “Health Promoting” (28%), “Isolated and Health Harming” (34%), “Restless and Dismal” (21%), and “Restless” (17%). A different set of four lifestyle classes were identified in older men: “Health Promoting” (21%), “Isolated and Health Harming” (26%), “Restless and Dismal” (20%), and “Discordant” (33%). Compared with the “Health Promoting” class, the “Isolated and Health Harming” class (OR = 1.88, 95% CI: 1.46–2.43) and the “Restless and Dismal” class (OR = 1.67, 95% CI: 1.27–2.20) had higher risk of disability in women. The “Discordant” class had lower risk of disability in men (OR = 0.52, 95% CI: 0.37–0.72).

Conclusions

Our analyses revealed different lifestyle patterns for older women and men in China. Sex differences in the associations between lifestyle and disability need to be considered when formulating interventions to prevent disability.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02087-z.

Social capital and cost-related medication nonadherence (CRN): A retrospective longitudinal cohort study using the Health and Retirement Study data, 2006-2016

Prescription drug spending and other financial factors (e.g., out-of-pocket costs) partially explain variation in cost-related medication nonadherence (CRN). Indicators of social capital such as neighborhood factors and social support may influence the health and well-being of older adults as they may rely on community resources and support from family and peers to manage conditions. Previous research on the relationship of social capital and CRN has limited evidence and contradictory findings. Hence, our objective is to assess the relationship of social capital indicators (neighborhood social cohesion, neighborhood physical disorder, positive social support, and negative social support) and CRN using a longitudinal design, 2006 to 2016, in a nationally representative sample of older adults in the United States (US). The Health and Retirement Study is a prospective panel study of US adults aged ≥ 50 years evaluated every two years. Data was pooled to create three waves and fitted using Generalized Estimating Equation modelling adjusting for both baseline and timevarying covariates (age, sex, education, race, total household income, and perceived health status). The three waves consisted of 11,791, 12,336, and 9,491 participants. Higher levels of neighborhood social cohesion and positive social support were related with lower CRN (OR 0.92, 95% CI 0.88-0.95 and OR 0.77, 95% CI 0.70-0.84, p<0.01). In contrast, higher levels of neighborhood physical disorder and negative social support were related to higher CRN (OR 1.07, 95% CI 1.03-1.11 and OR 1.46, 95% CI 1.32-1.62, p<0.01). Interventions targeting social capital are needed, reinforcing positive social support and neighborhood social cohesion and diminishing neighborhood physical disorder and negative social support for older adults.

Socioeconomic status, social capital, health risk behaviors, and health-related quality of life among Chinese older adults

Background

There is limited knowledge on the mediating role of different health risk behavior on the relationship between social capital, socioeconomic status (SES), and health-related quality of life (HRQoL) in Chinese older adults. We conducted this study to (a) investigate the condition of health risk behaviors of the Chinese elderly, and (b) assess the relationship between SES, social capital, health risk behaviors, and HRQoL.

Methods

A sample of 4868 adults aged 60 years and older were included in this study, from the China’s Health-related Quality of Life Survey for Older Adults 2018. Participants’ demographic characteristics, SES (education level, family income), health risk behaviors (smoking, alcohol consumption, physical inactivity, unhealthy dietary behavior, unhealthy weight, and sleep disorder) were collected. Social capital and HRQoL were assessed by the 16-item Personal Social Capital Scale (PSCS-16) and WHOQOL-Old, respectively. Structural equation modeling (SEM) was applied to examine the associations between variables.

Results

The proportion of smoking, alcohol consumption, physical inactivity, unhealthy dietary behavior, unhealthy weight, and sleep disorder were 32.1, 36.3, 62.5, 45.7, 31.8, and 45.5%, respectively. Significant differences were observed in education level, family income, and social capital between elderly individuals with and without each of the six health risk behavior (all p-values < 0.05). Elderly individuals who reported smoking, physical inactivity, unhealthy dietary behavior, and sleep disorder had significantly lower HRQoL than those without these unhealthy behaviors (all p-values < 0.05). SEM analysis showed that SES and social capital positively associated with alcohol consumption. Social capital negatively associated with smoking, physical inactivity, unhealthy dietary behavior, and sleep disorder. SES negatively associated with smoking, physical inactivity, unhealthy dietary behavior, unhealthy weight, and sleep disorder. Smoking, physical inactivity, unhealthy dietary behavior, and sleep disorder correlated with poorer HRQoL.

Conclusions

Chinese older adults demonstrated a high incidence of health risk behaviors, especially for physical inactivity (62.5%) and unhealthy dietary behavior (45.7%). Social capital and SES were correlated with the elderly’s HRQoL, as well as with the health risk behaviors. Health risk behaviors played potential mediating role on the relationship between social capital, SES, and HRQoL in Chinese older adults.

Individual-level Associations Between Indicators of Social Capital and Alcohol Use Disorders Identification Test Scores in Communities With High Mortality in Korea

OBJECTIVES

This study examined associations among social capital indicators (social participation and generalized trust) at the individual level and alcohol use, which was quantified using Alcohol Use Disorders Identification Test (AUDIT) scores.

METHODS

In total, there were 8800 participants in community health interviews, including 220 adults sampled systematically from a resident registration database of each of 40 sub-municipal administrative units of local (city or county) governments. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated using polychotomous logistic regression.

RESULTS

The aORs for abstainers versus people with AUDIT scores of 0-7, based on 3 questions on generalized trust, in comparison to those with no positive responses, were 1.15 (95% CI, 0.99 to 1.34) for 1 positive response, 1.16 (95% CI, 0.98 to 1.37) for 2 positive responses; and 1.39 (95% CI, 1.20 to 1.61) for 3 positive responses. The aORs for abstainers versus people with AUDIT scores of 0-7, in comparison to participation in no organizations, were 0.61 (95% CI, 0.54 to 0.69) for participation only in informal organizations; 2.16 (95% CI, 1.57 to 2.99) for participation only in religious organizations; 2.41 (95% CI, 1.10 to 5.29) for participation only in volunteer organizations; and 0.65 (95% CI, 0.57 to 0.74) for participation in formal organizations. Participants in formal social organizations, regardless of their participation in informal organizations, were more likely to have AUDIT scores of 8-15 (aOR, 1.29; 95% CI, 1.04 to 1.60) or ≥16 (aOR, 1.65; 95% CI, 1.22 to 2.23) than to have scores of 0-7.

CONCLUSIONS

Our findings may have implications for health policy to reduce alcohol problems.

Do changes in neighborhood social context mediate the effects of the moving to opportunity experiment on adolescent mental health?

This study investigated whether changes in neighborhood context induced by neighborhood relocation mediated the impact of the Moving to Opportunity (MTO) housing voucher experiment on adolescent mental health. Mediators included participant-reported neighborhood safety, social control, disorder, and externally-collected neighborhood collective efficacy. For treatment group members, improvement in neighborhood disorder and drug activity partially explained MTO's beneficial effects on girls' distress. Improvement in neighborhood disorder, violent victimization, and informal social control helped counteract MTO's adverse effects on boys' behavioral problems, but not distress. Housing mobility policy targeting neighborhood improvements may improve mental health for adolescent girls, and mitigate harmful effects for boys.

Social capital and utilization of immunization service: A multilevel analysis in rural Uttar Pradesh, India

The National Health Policy (2017) of India advocates Universal Health Coverage through inclusive growth, decentralization, and rebuilding a cohesive community through a participatory process. To achieve this goal, understanding social organization, and community relationships - defined as social capital - is critical. This study aimed to explore the influence of individual and community-level social capital on a critical health system performance indicator, three-doses of diphtheria-pertussis-tetanus (DPT3) immunization among 12-59 month children, in rural Uttar Pradesh (UP), India. The analysis is based on a cross-sectional survey from two districts of UP, which included 2239 children 12-59 months of age (level 1) from 1749 households (level 2) nested within 346 communities (level 3). We used multilevel confirmatory factor analysis to generate standardized factor scores of social capital constructs (Organizational Participation, Social Support, Trust and Social Cohesion) of the household heads and mothers both at individual and community level, which were then used in the multilevel logistic regressions to explore the independent and contextual effect of social capital on a child's DPT3 immunization status. The result showed only community-level Social Cohesion of the mothers was associated with a child's DPT3 immunization status (Adjusted odds ratio = 1.25, 95% confidence interval = 1.12-1.54; p = 0.04). Beyond its independent effect on utilization of immunization service, the collective Social Cohesion of the mothers significantly modified the relationship of child age, mother's knowledge of immunization, community wealth, and communities' contact with frontline workers with immunization status of the child. With a strong theoretical underpinning, the result substantially contributes to understanding the individual and contextual predictors of immunization service utilization and further advancing the literature of social capital in India. This study can serve as a starting point to catalyze social capital within the health interventions for achieving wellbeing and the collective development of society.

Gender Difference in Social Capital, Common Mental Disorders and Depression: ELSA-Brasil Study

Association studies between social capital and health point out that a high level of social capital can act as a protector for mental health. The growing interest in social risk factors for mental health coincides with the development of social capital research. Higher levels of social capital available through social networks can act as a protector for mental health. This study investigates gender differences in the association between social capital and common mental disorders (CMD) and depression. We analyzed 15,052 participants in the baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). CMD and depression were assessed by Clinical Interview Schedule-Revised (CIS-R) and social capital by the Resource Generator scale. We used Logistic regression models stratified by sex. Women with lower social capital in the social support dimension had a greater chance of presenting CMD (OR = 1.36; CI 95%: 1.16–1.60) and depression (OR = 2.07; CI 95%: 1.57–2.72) when compared to women with higher social capital. No association was identified among men, or among women in the “prestige and education” dimension. The differences found between the dimensions of social capital support its multidimensionality, as well as the differences found between sexes, confirm the need to approach gender in its association with mental health.

Social engagement pattern, health behaviors and subjective well-being of older adults: an international perspective using WHO-SAGE survey data

BACKGROUND

Social engagement forms the basis of social relationships by providing a sense of belonging, social identity, and fulfillment. Previous research demonstrates that social engagement was associated with positive health behaviors among older adults. However, the results have been different across health-related behaviors, and mostly based on data from high-income countries. For example, studies from the US and UK showed that social engagement was protective against smoking, while others found social engagement encouraged more smoking in many Asian cultures. In this study, we aim to examine the association between social engagement and a range of health-related behaviors and subjective well-being among older adults in six low- to middle-income countries.

METHODS

Data from the WHO Study on Global Ageing and Adult Health (SAGE Wave 1) were used. A total of 33,338 individuals aged 50 and older in China, Russia, India, Ghana, South Africa, and Mexico were included. Social engagement, tobacco use, alcohol consumption, fruit and vegetable intake, physical activity, sedentary behavior, sleep duration, depression symptoms, self-rated health status, and quality of life were assessed using established self-reported measures. Multiple logistic regression models were used to examine the relationship between social engagement and nine outcome variables, adjusting for socio-demographic characteristics.

RESULTS

Lower levels of social engagement were positively related to physical inactivity, prolonged sitting time, unhealthy sleep duration, perceived depression, poor self-rated health, and low quality of life. However, the associations between social engagement and tobacco use, excessive drinking, and insufficient fruit and vegetable intake were mixed across countries.

CONCLUSION

This international study found high social engagement as a potential health-promoting factor in some low- to middle-income countries. Although the impacts of social engagement on tobacco and alcohol use and diet were complicated and culture-specific, interventions at both individual and community levels should encourage healthy lifestyles through positive social engagement.

Cardiovascular outcomes of vildagliptin in patients with type 2 diabetes mellitus after acute coronary syndrome or acute ischemic stroke

AIMS/INTRODUCTION

The cardiovascular (CV) outcomes of vildagliptin - a dipeptidyl peptidase-4 inhibitor - in patients with type 2 diabetes mellitus after acute coronary syndrome or acute ischemic stroke are unclear.

MATERIALS AND METHODS

We analyzed data from the Taiwan National Health Insurance Research Database on 3,750 type 2 diabetes mellitus patients with acute coronary syndrome or acute ischemic stroke within 3 months between 1 August 2011 and 31 December 2013. Clinical outcomes were evaluated by comparing 1,250 participants receiving vildagliptin with 2,500 propensity score-matched participants. The primary composite outcome included CV death, non-fatal myocardial infarction and non-fatal stroke.

RESULTS

The primary composite outcome occurred in 122 patients (9.8%) in the vildagliptin group and 263 patients (10.5%) in the control group (hazard ratio [HR] 0.90, 95% confidence interval [CI] 0.72-1.11) with a mean follow-up period of 9.9 months. No significant between-group differences were observed for CV death (HR 0.93, 95% CI 0.56-1.52), non-fatal myocardial infarction (HR 0.79, 95% CI 0.46-1.36) and non-fatal stroke (HR 0.96, 95% CI 0.74-1.24). The vildagliptin group was at similar risks of hospitalization for heart failure (HF) or coronary intervention to the control group (P = 0.312 and 0.430, respectively). For patients with HF at baseline, the risk of hospitalization for HF was similar between the vildagliptin and control groups (HR 1.04, 95% CI 0.57-1.88).

CONCLUSIONS

Among patients with type 2 diabetes mellitus after a recent acute coronary syndrome or acute ischemic stroke, treatment with vildagliptin was not associated with increased risks of CV death, non-fatal myocardial infarction, non-fatal stroke and hospitalization for HF.

Residential Socioeconomic Environments and Areca Nut Use in Taiwan: A Comparison with Alcohol and Tobacco Use in Multilevel Analysis

While the association between residential socioeconomic environments and the use of globally common substances such as alcohol and tobacco has been well documented in Western countries, it remains little known about regionally important substances, such as areca nut in Asia. Objective: This study was aimed to develop residential environmental indicators in the context of Taiwan and examine their associations with areca nut use, in comparison to alcohol and tobacco use. Methods: Data were drawn from 13,392 adults across 168 townships in the 2014 National Survey on Substance Use in Taiwan. Residential socioeconomic environment variables were derived from the census and analyzed using factor analysis. Multilevel logistic regression models were used to examine the association of individual- and residential-level factors with the use of areca nut (use/nonuse), alcohol (harmful use, low-risk use, or nonuse), and tobacco (nicotine dependence, regular active use, or nonuse). Results: A three-factor structure of socioeconomic environments derived from 16 residential-level variables consisted of Rural Disadvantage, Affluence, and Family Fragmentation. Multilevel analyses showed that areca nut use was associated with both individual-level (male sex, age group 35-44 years, being divorced/widowed/separated, low educational attainment, and the occupational group of labors) and residential-level (Rural Disadvantaged and Family Fragmented) variables; such a profile was most similar to that of nicotine dependence. Conclusions: A three-factor structure could be derived for the residential-level socioeconomic environments in the Taiwanese context. Rural Disadvantaged and Family Fragmented were associated with areca nut use, which have implications for interventions targeted at the community level.

Exploration of Factor Structure and Measurement Invariance by Gender for a Modified Shortened Adapted Social Capital Assessment Tool in India

Social capital is defined as the nature of the social relationship between individuals or groups and the embedded resources available through their social network. It is considered as a critical determinant of health and well-being. Thus, it is essential to assess the performance of any tool when meaningfully comparing social capital between specific groups. Using measurement invariance (MI) analysis, this paper explored the factor structure of the social capital of men and women measured by a modified Shortened Adapted Social Capital Assessment Tool (SASCAT-I) in rural Uttar Pradesh (UP), India. The study sample comprised 5,287 men (18-101 years) and 7,186 women (15-45 years) from 6,218 randomly selected households who responded to SASCAT-I during a community-level cross-sectional survey. Social capital factor structure was examined by both exploratory and confirmatory factor analysis (CFA), and MI across genders was investigated using multigroup CFA. While disregarding gender, four unique factors (Organizational Participation, Social Support, Trust, and Social Cohesion) represented the structure of social capital. The MI analysis presented a partial metric-invariance indicating factor loadings for Organizational Participation and Social Support were the same across genders. The gender-stratified analysis demonstrated that a four-factor solution was best fitted for both men and women. Men and women of rural UP interpreted social capital differently as the perception of Trust and Social Cohesion varied across genders. For any future applications of SASCAT-I, we recommend gender-stratified factor analysis to quantify social capital's measure, acknowledging its multidimensionality.

Social capital, trust in health information, and acceptance of Measles-Rubella vaccination campaign in Tamil Nadu: A case-control study

Background

Parents' decision about vaccination of children is influenced by social relationships and sources of information. The aim of this study was to assess the influence of social capital and trust in health information on the status of Measles-Rubella (MR) vaccination campaign in Tamil Nadu.

Materials and Methods

This was a case-control study carried out in Kancheepuram district in Tamil Nadu where the MR vaccination campaign offered by Government of Tamil Nadu had poor acceptance. Cases were parents of children who had refused the MR vaccine and controls were parents having children in the same age group who had accepted the vaccine. Data on social capital and trust in health information were collected by using social capital scale developed by the researchers and trust in the source of information was measured by using simple questions on the level of trust in the information source.

Results

Nonadministration of MR vaccine was high among young parents and parents of younger children. Vaccine acceptance was higher when it was offered at school (P < 0.000) and also among parents who trusted school teachers (P < 0.003) and other school children (P < 0.014) as source of information. MR vaccine acceptance was less among parents who trusted social media and WhatsApp information. Greater levels of health-related physical social capital led to greater vaccine hesitancy. Multivariate analysis revealed that greater the age of the child, better parental attitudes toward vaccination, poorer health-related physical social capital, and greater trust in health information provided by school teachers led to overall greater acceptance of the MR vaccine.

Conclusion

Strong homogeneous bonding social capital had a negative influence on MR vaccine acceptance. Schools and school teachers played a vital role in influencing parental decision to vaccinate.

Socioeconomic Differences in Access to Neighborhood and Network Social Capital and Associations With Body Mass Index Among Black Americans

PURPOSE

To examine associations between socioeconomic status and two forms of social capital, namely, neighborhood and network measures, and how these distinct forms of capital are associated with body mass index (BMI) among Black residents of low-income communities.

DESIGN

Respondent-driven sampling was used to engage residents in a household survey to collect data on the respondents' personal network, perceptions about their neighborhood environment, and health.

SETTING

Eight special emphasis neighborhoods in Greenville, South Carolina.

PARTICIPANTS

N = 337 black/African American older adults, nearly half of whom have a household income of less than $15 000 and a high school education, were included.

MEASURES

Neighborhood capital was assessed via three scales on social cohesion, collective efficacy, and social support from neighbors. Network capital was calculated via a position generator, common in egocentric network surveys. Body mass index was calculated with self-reported height and weight.

ANALYSIS

Multilevel linear regression models were used to examine the association between neighborhood and network capital and obesity among respondents within sampling chains.

RESULTS

Higher household income was associated with greater neighborhood capital, whereas higher educational attainment was associated with greater network capital. Social cohesion was negatively associated with BMI (b = -1.25, 95% confidence interval [CI]: -2.39 to -0.11); network diversity was positively associated with BMI (b = 0.31, 95% CI: 0.08 to 0.55).

CONCLUSION

The findings shed light on how social capital may be patterned by socioeconomic status and, further, how distinct forms of capital may be differentially associated with health among black Americans.

Relationship between Individual Social Capital and Cognitive Function among Older Adults by Gender: A Cross-Sectional Study

As it is not easy to modify lifestyle, it is important to examine the effect of social capital (SC), which does not require behavior modifications, on dementia prevention. This study aimed to clarify gender differences in the relationship between cognitive function and individual SC among people living in a rural area in Japan. We used the Shimane Center for Community-based Healthcare Research and Education (CoHRE) study data from 2011 to conduct a cross-sectional analysis. The analysis included 491 participants, aged 40 years or older, who had undergone medical examinations in two rural towns in Japan. Both cognitive SC and structural SC were measured. Multivariate logistic regression analysis was conducted to estimate the odds ratios (OR) and 95% confidence interval (CI) for cognitive function levels as binary outcomes. We found a significant association between cognitive function and individual cognitive SC in men (OR: 3.11, 95% CI: 1.43–6.78), and found that cognitive function was associated with structural SC in women (OR: 1.89, 95% CI: 1.08–3.31). This study showed that the relationship between cognitive function and individual SC differed by gender. These results suggest that it is important to approach dementia prevention differently in men and women.

Social Capital and Tobacco Retail Outlet Density: An Empirical Test of the Relationship

PURPOSE

To examine the relationship between tobacco outlet density and social capital.

PARTICIPANTS

Parents of at least one teen (N = 2734) in a representative sample of US households with teens (ages 13-16).

DESIGN

Population-based, cross-sectional survey of a web panel of adolescent-parent pairs matched with spatial data for address to characterize household neighborhoods.

SETTING

US households identified by latitude and longitude with a 50-ft random shift.

MEASURES

Perceived social capital (trust and informal social control as reported by parents), tobacco outlet density (retailers per land area in 1/2-mile buffer around each household), neighborhood demographics (derived from American Community Survey), and parent demographics.

ANALYSIS

Multivariable regression examined the relationship between tobacco outlet density and social capital controlling for household buffer and individual-level covariates, including correlates of social capital.

RESULTS

Tobacco outlet density was inversely correlated with perceived trust in neighbors (B = -1.12, P = .0004), but not social control (B = 0.11, P = .731).

CONCLUSION

This study is the first we are aware of to find that social capital is related to tobacco outlet density. The results imply that individuals with low social capital may benefit from policies regulating tobacco outlet density and may benefit from policies that address neighborhood inequality by increasing social capital and reducing poverty.

Clinical outcomes of second-generation limus-eluting stents compared to paclitaxel-eluting stents for acute myocardial infarction with cardiogenic shock

Objective

Whether the cardiovascular (CV) outcomes of second-generation limus-eluting stents (LESs) differ from those of paclitaxel-eluting stents (PESs) in patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) is still unclear.

Methods

We used the Taiwan National Health Insurance Research Database to analyse data of 516 patients with AMI and CS diagnosed from January 2007 to December 2011. We used propensity score matching to adjust for the imbalance in covariate baseline values between these two groups. We evaluated clinical outcomes by comparing 197 subjects who used second-generation LESs to 319 matched subjects who used PESs.

Results

The risk of the primary composite outcomes (i.e., myocardial infarction, coronary revascularisation or CV death) was significantly lower in the second-generation LES group than in the PES group [37.3% vs. 51.8%; hazard ratio (HR), 0.73; 95% CI: 0.56–0.95] at the 12-month follow-up. The patients who received second-generation LESs had a lower risk of coronary revascularisation (HR 0.62; 95% CI: 0.41–0.93) than those who used PESs. However, the risks of myocardial infarction (HR 0.56; 95% CI: 0.26–1.24), ischemic stroke (HR 0.73; 95% CI: 0.23–2.35), or CV death (HR 0.90; 95% CI: 0.63–1.28) were not significantly different between the two groups.

Conclusions

Among patients with CS-complicating AMI, second-generation LES implantation significantly reduced the risk of coronary revascularisation and composite CV events compared to PES implantation at the 12-month follow-up.

Religious Affiliation, Informal Participation, and Network Support Associated With Substance Use: Differences Across Age Groups

Background. Associations between religious involvement and substance use are well established. However, limited research examines the effects of religious affiliation, informal participation, and network support on substance use among two distinct age cohorts. Objectives. This study aims to examine whether religious affiliation, informal participation, and network support are associated with alcohol, tobacco, and marijuana use among young and late middle-age adults. Method. The UC Berkeley Social Networks Study (Wave 1, 2015) offers novel cohort data on young (21-30 years old, n = 483) and late middle-age (50-70 years old, n = 673) adults. Poisson regression models were used to predict alcohol use, while logistic regression models were used to predict odds of smoking and marijuana use. Results. Among young adults, membership in a religious organization was associated with less alcohol, tobacco, and marijuana use. Conversely, participating in informal organizations was associated with more alcohol and marijuana use. Desiring more people to talk to and get together with were associated with more smoking and drinking, respectively. However, wishing more people to ask for help was associated with less substance use altogether. In a similar pattern, among older adults, religious involvement was associated with less alcohol and marijuana use. Desiring more people to ask for help was also related to less marijuana use. Conclusion. Younger adult participation in informal groups serves to encourage social substance use. In contrast, older people are more involved in religious groups, which support social behaviors that do not include substance use.

Network-based and cohesion-based social capital and variations in depressive symptoms among Taiwanese adults

BACKGROUND

Network- and cohesion-based social capital may play an important role in improving mental health. However, there is limited understanding about these relationships among adults in Taiwan.

AIM

The aim of this study was to examine the association between individual-level network and cohesion-based social capital and depressive symptoms among a population-based sample of Taiwanese adults.

METHODS

Data were obtained from the 1997 Taiwan Social Change Survey (n = 2,598). The 20-item Center for Epidemiological Studies Depression Scale was used to measure depressive symptom scores; ⩾16 represented high depressive symptoms. Network-based social capital was measured using a position generator. Two dimensions of cohesion-based social capital were assessed: cognitive (perceived neighborhood trust and reciprocity) and structural (local community participation and organizational participation). Multivariable log-binomial regression models, weighted to account for the complex sampling design and adjusted for confounders, estimated prevalence ratios and 95% confidence intervals (CIs) to examine the association between each social capital measure and depressive symptoms.

RESULTS

In this study, 29.6% of respondents were classified as having high depressive symptom scores. Higher scores of composite cognitive social capital (adjusted Prevalence Ratios (aPR)  = 0.92, 95% CI = [0.90, 0.95]) and structural social capital (aPR = 0.80, 95% CI = [0.65, 0.99]) were associated with a lower likelihood of high depressive symptom scores after controlling for confounders. However, there was no association between network social capital and depressive symptoms.

CONCLUSION

The findings suggest that the relationship between social capital and depressive symptoms in Taiwan differs according to the specific dimension of social capital assessed. Differentiating between network- and cohesion-based social capital merits greater attention to inform our understanding of building social capital to promote and improve mental health outcomes.

Gender differences in cigarette smoking and alcohol drinking among adolescents and young adults in Hanoi, Shanghai, and Taipei

Objective

This study aimed to examine gender differences in smoking and alcohol drinking behaviors in three Asian cities of Hanoi, Shanghai, and Taipei, and to assess the magnitude of gender differences across the three cities.

Methods

A total of 17,016 adolescents (age: 15–19 years) and young adults (age: 20–24 years) were selected using multi-stage sampling methods and surveyed in face-to-face interviews. A total of 16,554 unmarried respondents were included in this analysis.

Results

Gender differences were significant for smoking only, drinking only, and both behaviors in each city. Male respondents were 30.66 times more likely to report smoking only than female respondents in Hanoi, followed by Shanghai and Taipei. This pattern was similar for drinking only and both smoking and drinking behaviors.

Conclusions

The magnitude of gender differences in smoking only, drinking only, and both behaviors widely varies across the three cities. Further research can examine how these differences may be used to prevent and reduce smoking and drinking in the adolescent and young adult population.

The "Dark Side" Effects of Social Capital on Harmful Drinking among Chinese Community Residents: A Multilevel Study

Background: To determine the effects of social capital on harmful drinking (HD) among Chinese community residents using a multilevel study. Methods: A cross-sectional study conducted from 2017⁻2018. In total, 13,610 participants were randomly interviewed from 29 districts of 3 cities in China with a multi-stage sampling procedure. Social capital, including social cohesion, membership in social organizations, and frequency of social participation, were assessed using validated scales. HD was assessed using the CAGE four-item questionnaire. Multilevel models were developed to determine whether social capital was related to HD when socioeconomic and demographic covariates were controlled. Results: In general, the prevalence of HD was 8.18%, and more specifically, 13.77% for men and 2.74% for women. After controlling for covariates and stratifying by gender, compared to residents in the low individual-level membership of social organizations, we found that the odds ratio (OR) for HD was 1.30 with a 95% confidence interval (CI) of 1.07⁻1.56 among men and 1.95 (95% CI: 1.29⁻2.97) among women. Compared to residents in the low individual-level frequency of social participation groups, the odds ratio of HD among women was 1.58 (95% CI: 1.10⁻2.26). There was no association between district-level social capital and HD. Conclusions: A high level of social capital may promote HD among the residents of Chinese neighborhoods. Intervention to modify social capital under the Chinese drinking culture may help reduce HD.

Effect of characteristics and life in cities in China on residents' smoking behaviour

Objective

This study aimed to identify the relationship between city-level economic development and smoking behaviour.

Methods

Using multilevel mixed-effects logistic methods, we examined the relationship between smoking/passive smoking and respondents’ lifestyles in the city.

Results

We found that respondents living in cities with higher per capita gross domestic product (GDP) were less likely to smoke than those living in cities with lower per capita GDP (odds ratio [OR] = 0.977, 95% confidence interval [CI]: 0.958–0.997). Further, respondents with higher levels of life satisfaction and subjective social status were less likely to smoke than those with lower levels of these variables (OR = 0.942, 95% CI: 0.893–0.994; OR = 0.955, 95% CI: 0.928–0.983, respectively). In terms of passive smoking, respondents with higher levels of subjective social status in their cities were less likely to smoke than those with lower levels (OR = 0.972, 95% CI: 0.948–0.996). Smoking and exposure to second-hand smoke were more common among those with lower socioeconomic status.

Conclusions

Smoking is one of the most serious public health hazards in China. People’s smoking behaviour is significantly related to characteristics of their cities and their socioeconomic status. Improved smoking-prevention measures are urgently required in China.

Exploring how structural and cognitive social capital influence preventive health behavior

Purpose

People living on poverty-level incomes in developing nations face unique health challenges as compared to those in developed nations. New insights emerge from a bottom of the pyramid context (India) where culture-based health notions, preventive orientation and health resources differ from developed western health orientations and resources. The purpose of this paper is to explore how structural and cognitive social capital indirectly influence preventive health behavior (PHB) through perceived health value.

Design/methodology/approach

The participants for this study include rural people from Tamil Nadu, a state of India who are classified as those living below poverty level based on a per capita/per day consumption expenditure of Rupees 22.50 (an equivalent of US$0.40 a per capita/per day) (Planning Commission, Government of India, 2012). The study included a total number of 635 participants (312 males and 323 females). Relatively a high response rate (79 percent) was achieved through personal contacts and telephone solicitation, cash incentive and multiple follow-ups. Participants completed a questionnaire assessing structural and cognitive social capital, preventative health behavior, perceived health value, and health locus of control (HLC).

Findings

The results show that perceived health value mediates the relationship between cognitive social capital and PHB. Specifically, cognitive social capital influences BoP people’s assessment of benefits of engaging in PHB, that, in turn, influences PHB. In addition, the findings showed that HLC moderates the effect of social capital on PHB. Social capital positively related to enhanced PHB only among those who believe that health outcomes are controllable.

Originality/value

The authors findings indicate that cognitive social capital has enormous potential in promoting health intervention and the health of poor communities, a sentiment shared by prior researchers (Glenane-Antoniadis et al., 2003; Fisher et al., 2004; Martin et al., 2004; Weitzman and Kawachi, 2000). Overall, from a theoretical, empirical and methodological perspective, the current study offers a unique contribution to the social capital and PHB literature. First, drawing from the HBM and HLC, the findings provide a more nuanced explanation of how distinct aspects of social capital predict PHB. Specifically, the relationship between social capital and PHB is qualified by the extent one perceives personal control over her health. In addition, the cognitive component of social capital influences PHB through perceptions of health value.

Do Internet Users Lead a Healthier Lifestyle?

Internet use has spread rapidly worldwide in recent years, but the proportion of older people who use it remains low in Taiwan. Meanwhile, due to population aging in the country, chronic diseases have become more prevalent among older people. This study explores the link between exposure to the Internet and adoption of a healthy lifestyle among the middle-aged and elderly people. Data are drawn from the Topic on Health of the 2011 Taiwan Social Change Survey. We use the logistic regression as the baseline model and apply the propensity-score weighting method to identify the effect of Internet use on exercising, vegetable and fruit eating, betel nut chewing, smoking, and heavy drinking. Our results show that people aged 40 years and older who use the Internet regularly are more likely to adopt an overall healthy lifestyle. The findings suggest that the Internet is a good channel to enhance people's health investment.

Influence of the time interval from diagnosis to treatment on survival for early-stage liver cancer

Objectives

Liver cancer is the fifth most common cancer in men and the ninth most common cancer in women, and the WHO expects that there will be 1,341,344 cases in 2034 worldwide. Liver cancer also has the second-highest cancer death rate, accounting for 7% of all cancers. The study is going to explore the relationship between time interval from diagnosis to treatment and survival status of early-stage liver cancer patients.

Materials and methods

This is a retrospective cohort study using the national database from Taiwan. The datasets include the Taiwan Cancer Registry Database (TCR), the National Health Insurance Research Database (NHIRD), and the National Registry of Deaths. The target population for the study was patients newly diagnosed with stage I and stage II liver cancer between the years 2004 and 2010. Total of 26,038 cases were included in the study. Except descriptive analysis, the relationship between patient characteristics and the time interval from diagnosis to treatment was examined by chi-square tests. In addition, modified Cox proportional hazard models were used to analyze the hazard ratio of patient death with various treatment delay durations.

Results

There were 20,430 patients (78.46%) who received treatment less than 30 days after diagnosis, while 2,674 patients (10.27%) received treatment between 31 and 60 days after diagnosis, and 2,068 patients (7.94%) received treatment between 61 and 180 days after diagnosis, and 866 patients (3.33%) who received treatment 181 days after diagnosis. Those treated more than 181 days and 61–180 days after diagnosis had a 1.68-fold increased risk of death (95% confidence interval: 1.50–1.88) and a 1.39-fold increased risk of death (95% confidence interval: 1.31–1.17), respectively. Being male, being elderly, having a higher CCI level, and being treated in a hospital with a low service volume were factors associated with a poorer prognosis.

Conclusion

Overall, this study utilized a national cohort to conclude that for early-stage liver cancer patients, a longer the time interval from diagnosis to treatment results in a lower survival rate.

Cognitive Social Capital and Formal Volunteering Among Older Adults in Urban China: Does Gender Matter?

This study examined the moderating effect of gender on the relationship between cognitive social capital and formal volunteering among older adults in urban China. Cognitive social capital refers to individuals' perceptions of their social relationships in local communities. We used quota sampling to recruit 456 older adults aged 60 years and older from 16 communities of Gusu district, Suzhou city, in late 2015. Multiple group analysis was used to examine the proposed model. Gender had a moderating effect on the relationship between cognitive social capital and volunteering. The associations between cognitive social capital and volunteering were higher among older men than older women. The findings highlight the important role of cognitive social capital in influencing formal volunteering among older adults in urban Chinese contexts. The findings are particularly important for enhancing volunteering among older adults across different social and economic backgrounds. Policy and intervention implications are discussed.

Social capital and frequent attenders in general practice: a register-based cohort study

Background

Frequent attendance to primary care constitutes a large use of resources for the health care system. The association between frequent attendance and illness-related factors has been examined in several studies, but little is known about the association between frequent attendance and individual social capital. The aim of this study is to explore this association.

Methods

The analysis is conducted on responders to the North Denmark Region Health Profile 2010 (n = 23,384), individually linked with information from administrative registers. Social capital is operationalized at the individual level, and includes cognitive (interpersonal trust and norms of reciprocity) as well as structural (social network and civic engagement) dimensions. Frequent attendance is defined as the upper-quartile of the total number of measured consultations with a general practitioner over a period of 148 weeks.

Results

Using multiple logistic regression, we found that frequent attendance was associated with a lower score in interpersonal trust [OR 0.86 (0.79–0.94)] and social network [OR 0.88 (0.79–0.98)] for women, when adjusted for age, education, income and SF12 health scores. Norms of reciprocity and civic engagement were not significantly associated with frequent attendance for women [OR 1.05 (0.99–1.11) and OR 1.01 (0.92–1.11) respectively]. None of the associations were statistically significant for men.

Conclusion

This study suggests that for women, some aspects of social capital are associated with frequent attendance in general practice, and the statistically significant dimensions belonged to both cognitive and structural aspects of social capital. This association was not seen for men. This indicates a multifaceted and heterogeneous relationship between social capital and frequent attendance among genders.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5230-2) contains supplementary material, which is available to authorized users.

Does Gender Moderate the Relationship Between Social Capital and Life Satisfaction? Evidence From Urban China

The present study aimed to test the moderating effect of gender on the relationship between social capital and life satisfaction among older adults in urban China. A quota sampling method was used to select 456 older adults aged 60 and older from 16 local communities in Suzhou city in 2015. Hierarchical multiple regression was employed to test the proposed models. The associations between family social capital and life satisfaction were higher among older men than women. Trust and helping others were stronger predictors of older women's life satisfaction than their male counterparts. Citizenship activities affected life satisfaction among older men only. The findings highlight the important role of social capital in sustaining and/or improving life satisfaction among both older women and men. Policy and intervention implications are discussed.

Risk of Second Primary Cancer in People with Non-melanoma Skin Cancer: A Nationwide Cohort Study

PURPOSE

Previous western studies have found Caucasians with skin cancer, either melanoma or nonmelanoma skin cancer (NMSC), have an elevated risk of second primary cancer. Our objective was to assess the risk of second primary cancer in Taiwanese with NMSC.

MATERIALS AND METHODS

By using data from Taiwan's National Health Insurance Research Database, we conducted a population-based cohort study to assess the risk of incident second primary cancer in Taiwanese affected by NMSC.

RESULTS

We identified 505 subjects with NMSC and 2,020 matched controls. After adjustment for potential confounders including age, sex, urbanization, and Charlson Comorbidity Index, people who had NMSC had a 1.43-fold (95% confidence interval [CI], 1.05 to 1.96) risk for the development of second primary cancer as comparedwith control group. Menwith NMSC had a 2.99-fold (95% CI, 1.00 to 9.10) risk for second primary cancer involving the lip, oral cavity, and pharynx and a 3.51-fold (95% CI, 1.21 to 10.17) risk for second primary cancer involving the genitourinary organs when compared to the control group. By contrast, women with NMSC did not have an increased risk of second primary cancer.

CONCLUSION

This study revealed Asians with NMSC have an increased risk of second primary cancer. Our findings can be a useful reference for health care for people diagnosed with NMSC.

Social interactions, trust and risky alcohol consumption

BACKGROUND

The association of social capital and alcohol consumption is one of the most robust empirical findings in health economics of the past decade. However, the direction of the relationship between the two is heavily dependent on which dimension of social capital is studied and which alcohol measure is used. In this paper, we examine the effect of social interactions and generalised trust on drinking in the general Danish population survey.

METHODS

Participants (n = 2569) were recruited as part of a larger study. The double-hurdle model for the volume of alcohol consumption and the multivariate logistic model for heavy episodic drinking were estimated.

RESULTS

We found evidence that social networking with male friends, membership in voluntary organisations, and generalised trust were significantly associated with the mean volume of alcohol consumption and heavy drinking. We also observed that social support at the community level had a buffering effect against heavy episodic drinking.

CONCLUSIONS

The findings support previous findings in which social interactions and generalised trust were found to predict individuals' volume of drinking and heavy episodic drinking. However, the results varied across the indicators.

Air pollution exposure increases the risk of rheumatoid arthritis: A longitudinal and nationwide study

OBJECTIVE

Rheumatoid arthritis (RA) has been associated with inhaled pollutants in several studies, and it is a disease of chronic inflammation. The association between air pollution and the risk of RA remains unclear. Therefore, we conducted this nationwide, retrospective, sex-stratification study to evaluate this association.

METHODS

We collected data from the Longitudinal Health Insurance Database (LHID), maintained by the Taiwan Bureau of National Health Insurance, and the Taiwan Air Quality-Monitoring Database (TAQMD), released by the Taiwan Environmental Protection Agency. The TAQMD provides the daily concentrations of particulate matter with the aerodynamic diameter <2.5μm (PM2.5) and nitrogen dioxide (NO2) from 74 ambient air quality-monitoring stations distributed all over Taiwan during 1998-2010. The LHID and TAQMD were linked according to the residential areas of insurants and the areas where the air quality-monitoring stations were located. A residential area was defined according to the location of the clinic and hospital that treated acute upper respiratory tract infections. The yearly average air pollutant concentrations were categorized into 4 levels based on quartiles. We evaluated the risk of RA in residents exposed to 4 levels of PM2.5 and NO2 concentrations.

RESULTS

We detected an increased risk of RA in participants exposed to PM2.5 and NO2. Among four quartiles of NO2 concentration, namely Q1, Q2, Q3, and Q4, the adjusted hazard ratios (aHRs) in Q2, Q3, and Q4 compared with that in Q1 were 1.07 (95% confidence interval [CI]=0.76-1.50), 1.63 (95% CI=1.16-2.31),and 1.49 (95% CI=1.05-2.12), respectively. Regarding the PM2.5 concentrations, the aHRs after exposure to the Q2, Q3, and Q4 levels were 1.22 (95% CI=0.85-1.74), 1.15 (95% CI=0.82-1.62), and 0.79 (95% CI=0.53-1.16), respectively.

CONCLUSION

The results of this nationwide study suggest an increased risk of RA in residents exposed to NO2.

Relationships of Community and Individual Level Social Capital with Activities of Daily Living and Death by Gender

This study determined whether there is an association between social capital and a composite outcome of decline in Activities of Daily Living (ADL) and death by gender. A prospective 3.5 year cohort study was conducted in a rural town in Japan. The study participants were 984 individuals aged 65 years and older with not impaired on ADL at 2010 baseline survey. Social participation and generalized trust were measured as social capital. The individual level responses were dichotomized and aggregated into the community level (eight areas). Multilevel logistic regression adjusting for covariates revealed that social participation at the individual level was significantly associated with higher odds of composite outcome (OR of “not participate” = 1.97, 95% CI = 1.38–2.81). Regarding generalized trust, only in men, there was an inverse association at the community level (OR of “low” = 0.55, 95% CI = 0.32–0.96), and a positive association at the individual level (OR of “tend to be careful” = 2.22, 95% CI = 1.27–3.90). These results suggest that social capital were associated with a decline in ADL and death and that the association may differ by gender.

How are social capital and sense of coherence associated with hazardous alcohol use? Findings from a large population-based Swedish sample of adults

AIMS

This study examined whether social capital and a sense of coherence are associated with hazardous alcohol use in a large population-based Swedish sample. In particular, the objectives were (a) to examine which of five subdimensions of social capital is associated with hazardous alcohol use, (b) to investigate the moderating role of sense of coherence and (c) to examine possible sex differences.

METHODS

A postal survey was distributed to a sample of respondents (aged 18-84 years) from five Swedish counties that was stratified by sex, age and city; 40,674 (59.2%) participants responded, of which 45.5% were men and 54.5% were women with a mean±SD age of 53.8±17.9 years.

RESULTS

Structural dimensions of social capital were associated with an increased probability of hazardous alcohol use among both men and women, whereas the increased probability associated with cognitive dimensions occurred mostly among women. Sense of coherence was robustly associated with a decreased probability of hazardous alcohol use among both men and women. There were few moderating effects of sense of coherence and sex differences emerged mainly for the cognitive dimension of social capital. CONCLUSIONS ASSOCIATIONS BETWEEN SOCIAL CAPITAL DIMENSIONS AND HAZARDOUS ALCOHOL USE WERE PARTLY SEX-SPECIFIC, WHEREAS THE BENEFITS OF A SENSE OF COHERENCE ACCRUED TO BOTH SEXES SOCIAL CAPITAL DIMENSIONS AND SENSE OF COHERENCE WERE GENERALLY UNRELATED TO EACH OTHER ONLY ASSOCIATIONS BETWEEN THE COGNITIVE DIMENSIONS OF SOCIAL CAPITAL AND HAZARDOUS ALCOHOL USE DIFFERED BY SEX.