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Anderson AM, Sherman J, Fitzpatrick MM, Browning C, Kertes DA, Mackos A, Pickler RH, Smith L, Ford JL. Associations between adolescent perceived loneliness and hair cortisol concentration. Psychoneuroendocrinology 2024; 170:107184. [PMID: 39332136 DOI: 10.1016/j.psyneuen.2024.107184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 09/13/2024] [Accepted: 09/13/2024] [Indexed: 09/29/2024]
Abstract
INTRODUCTION Adolescents experience high levels of loneliness, which is linked to poor health in adulthood. Loneliness may contribute to poor health through chronic dysregulation of the hypothalamic-pituitary-adrenal axis. In this analysis, we examined the associations between survey- and ecological momentary assessment (EMA)-based measures of loneliness and hair cortisol concentrations (HCC) in a sample of 1102 adolescents and assessed sex differences in this relationship. METHODS Data came from wave 1 of the Adolescent Health and Development in Context study. We conducted a series of multivariable linear regression models to examine the associations between loneliness and HCC. Models were adjusted for adolescent and caregiver demographics, adolescent clinical factors, adolescent hair care practices, and adolescent lifetime mental health diagnosis and current psychotropic medication use. An interaction term between sex and loneliness was added to assess for effect moderation. RESULTS In our sample, the mean HCC was 1.35 pg/mg (SD=1.1). The mean for the unstandardized survey loneliness measure was 1.79 (SD=0.79) for the total analytic sample. The unstandardized mean for the EMA loneliness measure was - 0.02 (SD=2.1) for the total analytic sample. In model one testing the bivariate linear relationship between loneliness and HCC, higher loneliness via survey and EMA measures was associated with lower HCC (Survey: b= - 0.10, SE=0.03, p=.004; EMA: b= - 0.09, SE=0.03, p=.005). In model two, higher loneliness remained significantly associated with lower HCC (Survey: b= - 0.07, SE=0.03, p=.023; EMA: b= - 0.07, SE=0.03, p=.037), after controlling for the following covariates: sociodemographic factors, pubertal development and BMI, corticosteroid use, hair care practices, season of collection and assayed hair length. In model 3, youth lifetime mental health diagnosis and current psychotropic medication use were added into the regression model, and higher loneliness remained significantly associated with lower HCC (Survey: b= - 0.07, SE=0.03, p=.029; EMA: b= - 0.07, SE=0.03, p=.039). There was no effect modification by sex (Survey: b=0.04, SE=0.06, p=.552; EMA: b= - 0.01, SE=0.06, p=.843). CONCLUSIONS In our analysis, both survey- and EMA-reported loneliness measures were associated with lower HCC. No evidence of an interaction between sex and loneliness was observed. Future research is needed to validate these findings and investigate longitudinal relationships among adolescent loneliness, stress physiology, and downstream health sequelae.
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Affiliation(s)
| | - Jessica Sherman
- The Ohio State University College of Nursing, Columbus, OH, USA
| | | | | | - Darlene A Kertes
- University of Florida Department of Psychology, Gainesville, FL, USA
| | - Amy Mackos
- The Ohio State University College of Nursing, Columbus, OH, USA
| | - Rita H Pickler
- The Ohio State University College of Nursing, Columbus, OH, USA
| | - Lindsay Smith
- The Ohio State University College of Nursing, Columbus, OH, USA
| | - Jodi L Ford
- The Ohio State University College of Nursing, Columbus, OH, USA
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Teyton A, Nukavarapu N, Letellier N, Sears DD, Yang JA, Jankowska MM, Benmarhnia T. Simulating the impact of greenspace exposure on metabolic biomarkers in a diverse population living in San Diego, California: A g-computation application. Environ Epidemiol 2024; 8:e326. [PMID: 39118965 PMCID: PMC11309718 DOI: 10.1097/ee9.0000000000000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 07/10/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Growing evidence exists that greenspace exposure can reduce metabolic syndrome risk, a growing public health concern with well-documented inequities across population subgroups. We capitalize on the use of g-computation to simulate the influence of multiple possible interventions on residential greenspace on nine metabolic biomarkers and metabolic syndrome in adults (N = 555) from the 2014-2017 Community of Mine Study living in San Diego County, California. Methods Normalized difference vegetation index (NDVI) exposure from 2017 was averaged across a 400-m buffer around the participants' residential addresses. Participants' fasting plasma glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride concentrations, systolic and diastolic blood pressure, hemoglobin A1c (%), waist circumference, and metabolic syndrome were assessed as outcomes of interest. Using parametric g-computation, we calculated risk differences for participants being exposed to each decile of the participant NDVI distribution compared to minimum NDVI. Differential health impacts from NDVI exposure by sex, ethnicity, income, and age were examined. Results We found that a hypothetical increase in NDVI exposure led to a decrease in hemoglobin A1c (%), glucose, and high-density lipoprotein cholesterol concentrations, an increase in fasting total cholesterol, low-density lipoprotein cholesterol, and triglyceride concentrations, and minimal changes to systolic and diastolic blood pressure, waist circumference, and metabolic syndrome. The impact of NDVI changes was greater in women, Hispanic individuals, and those under 65 years old. Conclusions G-computation helps to simulate the potential health benefits of differential NDVI exposure and identifies which subpopulations can benefit most from targeted interventions aimed at minimizing health disparities.
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Affiliation(s)
- Anaïs Teyton
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, California
- School of Public Health, San Diego State University, San Diego, California
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, California
| | - Nivedita Nukavarapu
- Population Sciences, Beckman Research Institute, City of Hope, Duarte, California
| | - Noémie Letellier
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, California
- Irset Institut de Recherche en Santé, Environnement et Travail, UMR-S 1085, Inserm, University of Rennes, EHESP, Rennes, France
| | - Dorothy D. Sears
- College of Health Solutions, Arizona State University, Phoenix, Arizona
- Department of Medicine, University of California, San Diego, La Jolla, California
- Department of Family Medicine, University of California, San Diego, La Jolla, California
- Moores Cancer Center, University of California, San Diego, La Jolla, California
| | - Jiue-An Yang
- Population Sciences, Beckman Research Institute, City of Hope, Duarte, California
| | - Marta M. Jankowska
- Population Sciences, Beckman Research Institute, City of Hope, Duarte, California
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, La Jolla, California
- Irset Institut de Recherche en Santé, Environnement et Travail, UMR-S 1085, Inserm, University of Rennes, EHESP, Rennes, France
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Baek SU, Won JU, Lee YM, Yoon JH. Association between long working hours and metabolic dysfunction-associated steatotic liver disease: a nationwide population-based study in Korea. Public Health 2024; 232:188-194. [PMID: 38796916 DOI: 10.1016/j.puhe.2024.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 04/13/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVES Long working hour is a known risk factor for metabolic diseases. We explored the association between working hours and metabolic dysfunction-associated steatotic liver disease (MASLD). STUDY DESIGN Data on working hours among 22,818 workers (11,999 females) from the Korea National Health and Nutrition Examination Survey (2013-2021) were used for this study. METHODS MASLD was defined as a combination of hepatic steatosis combined with one or more of cardiometabolic risk factors (overweight/obesity, prediabetes/diabetes, raised blood pressure, hypertriglyceridemia, low high-density lipoprotein cholesterol). Hepatic steatosis was assessed using the hepatic steatosis index. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS The overall prevalence of MASLD was 30.4% in men and 18.1% in women. Among male workers, 20.2% worked ≥55 h/week, whereas among female workers, 10.1% worked ≥55 h/week. Compared with working 35-40 h/week, working ≥55 h/week was positively associated with overweight/obesity (OR: 1.21; 95% CI: 1.05-1.40), pre-diabetes mellitus (pre-DM)/DM (OR: 1.20; 95% CI: 1.04-1.38), raised blood pressure (OR: 1.17; 95% CI: 1.02-1.35), and presence of any cardiometabolic risk factors (OR: 1.56; 95% CI: 1.21-2.02). The adjusted OR (95% CI) of the association between working hours and MASLD was 1.27 (1.09-1.47) for ≥55 h/week compared with working 35-40 h/week in male workers. In female workers, long working hours were not clearly associated with cardiometabolic risk factors and MASLD. CONCLUSION Long working hours are positively associated with MASLD among Korean male workers. Policy interventions are needed to mitigate the adverse metabolic effects of prolonged working hours.
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Affiliation(s)
- S-U Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea; Graduate School, Yonsei University College of Medicine, Seoul, South Korea
| | - J-U Won
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea
| | - Y-M Lee
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea
| | - J-H Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, South Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea.
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Knauft K, Zilioli S, Tarraf W, Rorai V, Perry TE, Lichtenberg PA. Social connectedness in older Urban African-American adults during the COVID-19 pandemic: the roles of education and partnership. Aging Ment Health 2024; 28:874-881. [PMID: 37986033 PMCID: PMC11102929 DOI: 10.1080/13607863.2023.2282682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/03/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE This study examined education, partnership status, and the moderating role of the lockdown period on social connectedness during the COVID-19 pandemic in a sample of urban African-American older adults. METHODS Five hundred thirty-four African-American adults living in Detroit (91.0% female, Mage = 74.53) reported demographic information pre-pandemic and answered one social connectedness questionnaire between April and December 2020. RESULTS Participants interviewed after the lockdown (post-June 2020) reported more loneliness than those interviewed during the lockdown (April-June, 2020). Married/partnered participants reported less loneliness and social isolation. Loneliness did not differ between those with high education levels interviewed during the lockdown compared to post-lockdown. However, among individuals with low education levels, those interviewed after the lockdown reported more loneliness than those interviewed during the lockdown period. CONCLUSION Our findings suggest partnership status is associated with more social connectedness during the pandemic and education accentuates the effects of forced isolation related to loneliness among urban African-American older adults.
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Affiliation(s)
| | - Samuele Zilioli
- Department of Psychology, Wayne State University
- Department of Family Medicine and Public Health Sciences, Wayne State University
| | | | | | - Tam E. Perry
- Institute of Gerontology, Wayne State University
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Parker M, Self‐Brown SR, Rahimi A, Fang X. Longitudinal Analysis of the Relationship Between Social Isolation and Hypertension in Early Middle Adulthood. J Am Heart Assoc 2024; 13:e030403. [PMID: 38619293 PMCID: PMC11179928 DOI: 10.1161/jaha.123.030403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 03/01/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Most studies have used cross-sectional or limited follow-up data to evaluate the relationship between social isolation (SI) and hypertension in older populations. The objective of this analysis was to examine the relationship between longitudinal SI and hypertension in a younger population. METHODS AND RESULTS The present analysis used data from waves I to V of the National Longitudinal Study of Adolescent to Adult Health (1994-2018) and logistic regression models to describe the association of timing, duration, and transitional patterns of SI with hypertension in early middle adulthood. Models were adjusted for demographic variables and adolescent socioeconomic and health-related confounders. SI was higher across life stages among individuals with hypertension (adolescence: 38% versus 35%, young adulthood: 52% versus 44%, and early middle adulthood: 61% versus 52%). Individuals who were socially isolated in young adulthood or early middle adulthood had greater odds of hypertension in early middle adulthood than those who were not (odds ratio [OR], 1.30 [95% CI, 1.07-1.56]; OR, 1.42 [95% CI, 1.15-1.76], respectively). Early middle adulthood hypertension was significantly associated with persistent SI across all life stages and for those who moved into persistent SI after adolescence (OR, 1.40 [95% CI, 1.02-1.93]; OR, 1.61 [95% CI, 1.18-2.19], respectively). CONCLUSIONS SI in young or early middle adulthood significantly increased the odds of hypertension, as did moving into SI and the accumulation of SI across life stages. Our analysis provides insights regarding timing for effective interventions to reduce hypertension earlier in the life course, which may prevent future adverse cardiovascular-related events.
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Affiliation(s)
- Marie Parker
- School of Public HealthGeorgia State UniversityAtlantaGA
| | | | | | - Xiangming Fang
- School of Public HealthGeorgia State UniversityAtlantaGA
- College of Economics and ManagementChina Agricultural UniversityBeijingChina
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Abreu TC, Mackenbach JD, Heuvelman F, Schoonmade LJ, Beulens JW. Associations between dimensions of the social environment and cardiometabolic risk factors: Systematic review and meta-analysis. SSM Popul Health 2024; 25:101559. [PMID: 38148999 PMCID: PMC10749911 DOI: 10.1016/j.ssmph.2023.101559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/27/2023] [Accepted: 11/11/2023] [Indexed: 12/28/2023] Open
Abstract
Aim The social environment (SE), including social contacts, norms and support, is an understudied element of the living environment which impacts health. We aim to comprehensively summarize the evidence on the association between the SE and risk factors of cardiometabolic disease (CMD). Methods We performed a systematic review and meta-analysis based on studies published in PubMed, Scopus and Web of Science Core Collection from inception to 16 February 2021. Studies that used a risk factor of CMD, e.g., HbA1c or blood pressure, as outcome and social environmental factors such as area-level deprivation or social network size as independent variables were included. Titles and abstracts were screened in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale. Data appraisal and extraction were based on the study protocol published in PROSPERO. Data were synthesized through vote counting and meta-analyses. Results From the 7521 records screened, 168 studies reported 1050 associations were included in this review. Four meta-analyses based on 24 associations suggested that an unfavorable social environment was associated with increased risk of cardiometabolic risk factors, with three of them being statistically significant. For example, individuals that experienced more economic and social disadvantage had a higher "CVD risk scores" (OR = 1.54, 95%CI: 1.35 to 1.84). Of the 458 associations included in the vote counting, 323 (71%) pointed towards unfavorable social environments being associated with higher CMD risk. Conclusion Higher economic and social disadvantage seem to contribute to unfavorable CMD risk factor profiles, while evidence for other dimensions of the social environment is limited.
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Affiliation(s)
- Taymara C. Abreu
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
| | - Joreintje D. Mackenbach
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
| | - Fleur Heuvelman
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
| | - Linda J. Schoonmade
- University Library, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, the Netherlands
| | - Joline W.J. Beulens
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Utrecht, the Netherlands
- Amsterdam Public Health, Amsterdam Cardiovascular Sciences, Amsterdam, Noord-Holland, the Netherlands
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You E, Nicholson NR, Jacobson SA, Poghosyan H, Feinn RS, Charlotte L. Social Isolation and Population Density: Racial and Ethnic Differences Among Older Adults. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241273127. [PMID: 39229676 PMCID: PMC11375685 DOI: 10.1177/00469580241273127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/12/2024] [Accepted: 06/18/2024] [Indexed: 09/05/2024]
Abstract
This study uses secondary data analysis to assess the relationship between social isolation (SI) and population density in the US, as well as any moderating influence that race/ethnicity may have on that relationship. A recent consensus on the measure of SI is that it focuses on the objective absence of social connections, whereas loneliness refers to subjective assessments of one's social connections. Therefore, while the original study measured both objective and subjective SI may be innovative, it may also be overly ambitious. SI puts older people at risk for health problems, including an increased chance of dying. The AARP Foundation gathered the initial convenience sample, which included 8149 senior citizens. The study determined population density using self-reported zip codes, measured as persons per square mile, and divided the results into tertiles. Linear mixed models were used to investigate the moderating role of race/ethnicity between population density and SI. The findings revealed that greater population density was associated with less SI for individuals residing in zip codes with a higher percentage of the same race/ethnicity, but more SI for those in zip codes with a lower percentage of the same race/ethnicity. These results suggest that race/ethnicity should be considered in future studies or when developing policies and interventions to address SI among older adults in high-population-density areas. For example, when policymakers aim to address SI in a community, they may want to collect data based on zip codes and create targeted interventions for specific racial/ethnic groups within those zip code areas.
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Affiliation(s)
- Eunhea You
- Quinnipiac University - North Haven Campus, North Haven, CT, USA
| | | | | | | | - Richard S. Feinn
- Quinnipiac University - North Haven Campus, North Haven, CT, USA
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Delolmo-Romero S, Correa-Rodríguez M, Sánchez-Martínez MC, Gil-Gutiérrez R, Ortego-Centeno N, Rueda-Medina B. Social Health and Its Influence on Metabolic Health Among a Rural Population: A Cross-Sectional Study. Clin Nurs Res 2024; 33:9-18. [PMID: 37382362 DOI: 10.1177/10547738231184935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
The aim of this study was to estimate the prevalence of metabolic syndrome (MetS) in a Spanish rural population and assess differences in prevalence according to loneliness level, social isolation, and social support. This is a cross-sectional study of 310 patients. MetS was defined by National Cholesterol Education Program-Third Adult Treatment Panel. The UCLA (University of California, Los Angeles) Loneliness Scale, Multidimensional Scale of Social Support, and Lubben Social Network Scale were used to assess loneliness, perceived social support, and social isolation. Almost half of the participants fulfilled MetS diagnosis criteria. Subjects with MetS showed significantly higher levels of loneliness, less social support, and greater social isolation. Systolic blood pressure was significantly higher in socially isolated rural adults. Environmental factors may play a key role in the prevalence of MetS, so specific screening and prevention programs could help health professionals prevent the increasing rates of MetS in rural populations under these socially specific conditions of vulnerability.
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Affiliation(s)
- Sara Delolmo-Romero
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain
- Instituto de Investigación Biosanitaria IBS GRANADA, Spain
| | - María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain
- Instituto de Investigación Biosanitaria IBS GRANADA, Spain
| | | | - Rocío Gil-Gutiérrez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain
- Instituto de Investigación Biosanitaria IBS GRANADA, Spain
| | - Norberto Ortego-Centeno
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain
- Department of Medicine, Faculty of Medicine, University of Granada, Spain
| | - Blanca Rueda-Medina
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain
- Instituto de Investigación Biosanitaria IBS GRANADA, Spain
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Donnelly R, Lin Z, Umberson D. Parental Death Across the Life Course, Social Isolation, and Health in Later Life: Racial/Ethnic Disadvantage in the U.S. SOCIAL FORCES; A SCIENTIFIC MEDIUM OF SOCIAL STUDY AND INTERPRETATION 2023; 102:586-608. [PMID: 37840946 PMCID: PMC10569383 DOI: 10.1093/sf/soad027] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 01/13/2023] [Indexed: 10/17/2023]
Abstract
Bereavement is a risk factor for poor health, yet prior research has not considered how exposure to parental death across the life course may contribute to lasting social isolation and, in turn, poor health among older adults. Moreover, prior research often fails to consider the racial context of bereavement in the United States wherein Black and Hispanic Americans are much more likely than White Americans to experience parental death earlier in life. The present study uses longitudinal data from the Health and Retirement Study (HRS; 1998-2016) to consider linkages of parental death, social isolation, and health (self-rated health, functional limitations) for Black, Hispanic, and White older adults. Findings suggest that exposure to parental death is associated with higher levels of isolation, greater odds of fair/poor self-rated health, and greater odds of functional limitations in later life. Moreover, social isolation partially explains associations between parental bereavement and later-life health. These patterns persist net of psychological distress-an additional psychosocial response to bereavement. Racial inequities in bereavement are central to disadvantage: Black and Hispanic adults are more likely to experience a parent's death earlier in the life course, and this differential exposure to parental death in childhood or young adulthood has implications for racial and ethnic inequities in social isolation and health throughout life.
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Affiliation(s)
- Rachel Donnelly
- Vanderbilt University, Department of Sociology, 2101 W End Ave, Nashville, TN 37249, USA
| | - Zhiyong Lin
- University of Texas at San Antonio, Department of Sociology, One UTSA Circle, San Antonio, TX 78249, USA
| | - Debra Umberson
- University of Texas at Austin, Department of Sociology and Population Research Center, 110 Inner Campus Drive, Austin, TX 78705, USA
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Bapolisi AM, Maurage P, Georges CMG, Petit G, Balola M, Cikomola CJ, Rime B, Philippot P, Persu A, de Timary P. Personal and Interpersonal Factors Moderate the Relation Between Human-Made Trauma and Hypertension: A Path Analysis Approach. Psychosom Med 2023; 85:710-715. [PMID: 37363996 DOI: 10.1097/psy.0000000000001225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
BACKGROUND Although the link between trauma, posttraumatic stress disorder (PTSD), and hypertension is established, its underlying mechanisms remain underexplored. OBJECTIVE This study tested a theoretical model exploring the moderating influence of psychological (emotion regulation) and interpersonal (social support) factors on the mediation between trauma and hypertension, through PTSD. METHODS We measured these variables through self-reported questionnaire on 212 patients, recruited from internal medicine in a general hospital of Bukavu, a region affected by more than 25 years of armed conflicts. We first evaluated the PTSD mediation in the absence of moderators, before testing each moderator using moderated path analysis. RESULTS Results showed that PTSD partially mediates the relationship between human-made trauma and hypertension, whereas social support and maladaptive emotion regulation moderate the relationship between human-made trauma and PTSD. CONCLUSIONS The relationship between human-made trauma, PTSD, and hypertension might be modulated by psychological and interpersonal factors, which paves the way for new interventions targeting emotion regulation and social support to reduce PTSD and hypertension in populations exposed to human-made violence.
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Affiliation(s)
- Achille M Bapolisi
- From the Adult Psychiatry Department and Institute of Neuroscience, Cliniques Universitaires Saint-Luc(Bapolisi, Petit, de Timary), Université Catholique de Louvain, Brussels, Belgium; Université Catholique de Bukavu and Hôpital Provincial Général de Bukavu (Bapolisi, Balola, Cikomola), Bukavu, Democratic Republic of Congo; Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (Maurage, Rime, Philippot), UCLouvain, Louvain-la-Neuve; Division of Cardiology, Cliniques Universitaires Saint-Luc (Georges, Persu), Université Catholique de Louvain; and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique (Persu), Université Catholique de Louvain, Brussels, Belgium
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Umberson D, Donnelly R. Social Isolation: An Unequally Distributed Health Hazard. ANNUAL REVIEW OF SOCIOLOGY 2023; 49:379-399. [PMID: 38106980 PMCID: PMC10722883 DOI: 10.1146/annurev-soc-031021-012001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Social isolation is a potent predictor of poor health, mortality, and dementia risk. A great deal of research across national contexts provides causal evidence for these linkages and identifies key explanatory mechanisms through which isolation affects health. Research on social isolation recognizes that some people are more likely than others to be isolated, but over the past several decades, researchers have focused primarily on the consequences of isolation for health rather than a systematic assessment of the social conditions that foster isolation over the life course. In this article, we review the available evidence on inequities in social isolation and develop a conceptual framework to guide future research on structural systems that fuel social isolation over the life course. Future work in this area has the potential to identify root causes of inequality in social isolation, as well as targeted policy levers to reduce isolation in vulnerable populations.
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Affiliation(s)
- Debra Umberson
- Department of Sociology, Center on Aging & Population Sciences, and Population Research Center, University of Texas at Austin, Austin, Texas, USA
| | - Rachel Donnelly
- Department of Sociology, Vanderbilt University, Nashville, Tennessee, USA
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12
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Bala C, Rusu A, Gheorghe-Fronea OF, Benedek T, Pop C, Vijiiac AE, Stanciulescu D, Darabantiu D, Roman G, Dorobantu M. Social and Metabolic Determinants of Prevalent Hypertension in Men and Women: A Cluster Analysis from a Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1736. [PMID: 36767102 PMCID: PMC9914893 DOI: 10.3390/ijerph20031736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Essential hypertension (HTN) has a complex spectrum of pathophysiological determinants and current guidelines provide limited information on high-risk groups that should be targeted for its primary prevention. The objective of our research was to identify clusters of social and metabolic factors associated with prevalent HTN in men and women from a population-based survey in Romania. Of the 1477 participants in the main study, 798 with complete data were analyzed here. Using two-step cluster analysis, one high-risk cluster in women and two high and intermediate risk for prevalent HTN in men were identified. Older age, rural area, lower education, and higher burden of metabolic factors characterized clusters with higher risk, while intermediate risk in men was characterized by a more metabolically healthy phenotype in younger individuals. In logistic regression, men in Cluster 1 vs. those in Cluster 3 had an odds ratio (OR) of 9.6 (95%CI: 4.6; 20.0), p < 0.001 for prevalent HTN, while OR for Cluster 2 vs. Cluster 3 was 3.2 (95%CI: 1.4; 7.4), p = 0.005. In women, the OR for HTN was 10.2 (95%CI: 5.7; 18.5) if assigned to Cluster 2 vs. Cluster 1, p < 0.001. These results pointed out the subgroups and communities that the primary prevention of HTN should be prioritized in.
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Affiliation(s)
- Cornelia Bala
- Department of Diabetes and Nutrition, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Adriana Rusu
- Department of Diabetes and Nutrition, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Oana Florentina Gheorghe-Fronea
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
- Cardiology Department, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania
| | - Theodora Benedek
- Cardiology Department, County Clinical Emergency Hospital, Faculty of Medicine, “Gheorghe Emil Palade” University of Medicine, Pharmacy, Science, and Technology, 540142 Targu Mures, Romania
| | - Calin Pop
- Emergency Clinical County Hospital Baia Mare, Faculty of Medicine, “Vasile Goldiș” West University, 430130 Baia Mare, Romania
| | - Aura Elena Vijiiac
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
- Cardiology Department, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania
| | - Diana Stanciulescu
- Cardiology Department, Clinical Emergency Hospital Bucharest, 014461 Bucharest, Romania
| | - Dan Darabantiu
- Department of Cardiology, Arad Emergency Clinical County Hospital, Faculty of Medicine, “Vasile Goldiș” West University, 310025 Arad, Romania
| | - Gabriela Roman
- Department of Diabetes and Nutrition, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Maria Dorobantu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
- Romanian Academy, 010071 Bucharest, Romania
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13
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Umberson D, Lin Z, Cha H. Gender and Social Isolation across the Life Course. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2022; 63:319-335. [PMID: 35856404 PMCID: PMC10409601 DOI: 10.1177/00221465221109634] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Social isolation has robust adverse effects on health, well-being, dementia risk, and longevity. Although most studies suggest similar effects of isolation on the health of men and women, there has been much less attention to gendered patterns of social isolation over the life course-despite decades of research suggesting gender differences in social ties. We build on theoretical frames of constrained choice and gender-as-relational to argue that gender differences in isolation are apparent but depend on timing in the life course and marital/partnership history. Results indicate that boys/men are more isolated than girls/women through most of the life course, and this gender difference is much greater for the never married and those with disrupted relationship histories. Strikingly, levels of social isolation steadily increase from adolescence through later life for both men and women.
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14
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Social determinants of hypertension in high-income countries: A narrative literature review and future directions. Hypertens Res 2022; 45:1575-1581. [PMID: 35859023 PMCID: PMC9296364 DOI: 10.1038/s41440-022-00972-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/19/2022] [Accepted: 02/02/2022] [Indexed: 11/26/2022]
Abstract
Hypertension is a leading cause of cardiovascular disease and despite established strategies to lower blood pressure, the control of hypertension remains poor. This is true even in high-income countries with well-established welfare and medical systems. Among the social factors associated with hypertension (i.e., social determinants of hypertension, SDHT), individual socioeconomic status (SES), including education, income, and occupation, can be crucial for hypertension management (prevalence, awareness, treatment, and control). This article reviews the findings of recently published studies that examined the association between SES and hypertension management in high-income countries. It also discusses social prescribing, which targets social isolation and loneliness as modifiable SDHT to improve hypertension management. Conceptual framework of social determinants of hypertension![]()
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15
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Weziak-Bialowolska D, Bialowolski P, Lee MT, Chen Y, VanderWeele TJ, McNeely E. Prospective Associations Between Social Connectedness and Mental Health. Evidence From a Longitudinal Survey and Health Insurance Claims Data. Int J Public Health 2022; 67:1604710. [PMID: 35755953 PMCID: PMC9218058 DOI: 10.3389/ijph.2022.1604710] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 05/16/2022] [Indexed: 12/13/2022] Open
Abstract
Objectives: Evidence on social stimuli associated with mental health is based mostly on self-reported health measures. We aimed to examine prospective associations between social connectedness and clinical diagnosis of depression and of anxiety. Methods: Longitudinal observational data merged with health insurance data comprising medical information on diagnosis of depression and anxiety were used. 1,209 randomly sampled employees of a US employer provided data for the analysis. Robust Poisson regression models were used. Multiple imputation was conducted to handle missing data on covariates. Results: Better social connectedness was associated with lower risks of subsequently diagnosed depression and anxiety, over a one-year follow-up period. Reports of feeling lonely were associated with increased risks of depression and anxiety. Association between community-related social connectedness and subsequent diagnosis of depression, but not of anxiety, was found. The associations were independent of demographics, socioeconomic status, lifestyle, and work characteristics. They were also robust to unmeasured confounding, missing data patterns, and prior health conditions. Conclusion: Social connectedness may be an important factor for reducing risks of depression and anxiety. Loneliness should be perceived as a risk factor for depression and anxiety.
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Affiliation(s)
- Dorota Weziak-Bialowolska
- Department of Environmental Health, School of Public Health, Harvard University, Boston, MA, United States
- Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States
- Center for Evaluation and Analysis of Public Policies, Faculty of Philosophy, Jagiellonian University, Kraków, Poland
| | - Piotr Bialowolski
- Department of Environmental Health, School of Public Health, Harvard University, Boston, MA, United States
- Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States
- Department of Economics, Kozminski University, Warsaw, Poland
| | - Matthew T. Lee
- Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States
| | - Ying Chen
- Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States
- Department of Epidemiology, School of Public Health, Harvard University, Boston, MA, United States
| | - Tyler J. VanderWeele
- Institute for Quantitative Social Science, Harvard University, Cambridge, MA, United States
- Department of Epidemiology, School of Public Health, Harvard University, Boston, MA, United States
| | - Eileen McNeely
- Department of Environmental Health, School of Public Health, Harvard University, Boston, MA, United States
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16
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Shartle K, Yang YC, Richman LS, Belsky DW, Aiello AE, Harris KM. Social Relationships, Wealth, and Cardiometabolic Risk: Evidence from a National Longitudinal Study of U.S. Older Adults. J Aging Health 2022; 34:1048-1061. [PMID: 35481380 DOI: 10.1177/08982643221087807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: To investigate multiple dimensions of social relationships related to biomarkers of cardiometabolic health and how their associations vary by wealth in older adults. Methods: Growth curve models were used to investigate the longitudinal associations between measures of both positive and negative social relationships and cardiometabolic risk (CMR) over a 10-year period from 2006 to 2016 and the moderation of this association by wealth in the Health and Retirement Study (HRS). Results: Older adults with better social relationships had lower CMR on average. The protective effects of positive social relationships, however, waned at older ages, particularly for low-wealth individuals. Discussion: Our results suggest that good social relationships promote healthy aging by buffering against harmful cardiometabolic consequences of psychosocial stress, particularly among relatively wealthy individuals. Efforts to improve old age health would be more effective when focusing simultaneously on fostering social connections and boosting financial resources.
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Affiliation(s)
- Kaitlin Shartle
- Department of Sociology, 169101University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Carolina Population Center, 169101University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yang Claire Yang
- Department of Sociology, 169101University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Carolina Population Center, 169101University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Daniel W Belsky
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Allison E Aiello
- Carolina Population Center, 169101University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Epidemiology, Gillings School of Global Public Health, 41474University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kathleen Mullan Harris
- Department of Sociology, 169101University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Carolina Population Center, 169101University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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17
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Kraav SL, Awoyemi O, Junttila N, Vornanen R, Kauhanen J, Toikko T, Lehto SM, Hantunen S, Tolmunen T. The effects of loneliness and social isolation on all-cause, injury, cancer, and CVD mortality in a cohort of middle-aged Finnish men. A prospective study. Aging Ment Health 2021; 25:2219-2228. [PMID: 33939562 DOI: 10.1080/13607863.2020.1830945] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Loneliness and social isolation both increase mortality and are likely to affect health via several pathways. However, information on the potential pathways remains scarce. We investigated the associations between loneliness, social isolation, and mortality, and possible mechanisms underlying these connections. METHODS The analyzed data comprised a prospective population-based cohort of Finnish men (42-61 years at baseline, n = 2588) who were followed up for an average of 23.2 years. Mortality data were obtained from the national population register in 2012. Cox proportional hazards analysis with adjustments for possible confounding factors was used to examine the associations between loneliness and social isolation at baseline and all-cause, injury, cancer, and cardiovascular disease (CVD) mortality. Mediation analysis was conducted to investigate the mechanisms underlying the associations of loneliness and social isolation with mortality. RESULTS Loneliness predicted all-cause mortality, even after adjustments for all covariates. Loneliness predicted cancer mortality, except after adjustments for lifestyle variables or Human Population Laboratory (HPL) depression scores, and also predicted CVD mortality, except after adjustments for HPL depression scores. Social isolation predicted all-cause mortality and injury mortality. The effect of social isolation on all-cause mortality was mediated by loneliness and HPL depression scores. CONCLUSIONS Our findings suggest that both loneliness and social isolation increase the risk of all-cause mortality, while they have differing effects on different causes of death. Loneliness and depressive symptoms may mediate the effect of social isolation on increased mortality.
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Affiliation(s)
- Siiri-Liisi Kraav
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland.,Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Olutosin Awoyemi
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland.,Coventry and Warwickshire Partnership NHS Trust, Coventry, United Kingdom.,Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Niina Junttila
- Department for Teacher Education, Centre for Education and Research on Social and Health Services, University of Turku, Turku, Finland
| | - Riitta Vornanen
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Timo Toikko
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Soili M Lehto
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,R&D Department, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Sari Hantunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tommi Tolmunen
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland.,Department of Adolescent Psychiatry, Kuopio University Hospital, Kuopio, Finland
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18
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Hosseini Z, Safari A, Khan NA, Veenstra G, Conklin AI. Adiposity and the role of diverse social supports: an observational, gender-sensitive study using the baseline Canadian Longitudinal Study on Aging. Public Health Nutr 2021; 24:6103-6112. [PMID: 34462039 PMCID: PMC11148584 DOI: 10.1017/s1368980021003724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To quantify associations between four types of social support and measured adiposity among women and men. DESIGN The cross-sectional sample from the Canadian Longitudinal Study on Aging (CLSA, 2012-2015). Height, weight and waist circumference (WC) were clinically measured, and perceived availability of informational, tangible, emotional and belonging social supports was self-reported. SETTING Canada. PARTICIPANTS 28 779 adults aged 45-85 years from the CLSA. RESULTS All social support types were associated with WC and BMI among women but not among men. Women reporting the lowest informational support had significantly higher mean BMI (28·84 kg/m2 (95 % CI 28·63, 29·05)) and WC (90·81 cm (95 % CI 90·31, 91·30)) compared with women reporting maximum support (respectively, 28·09 kg/m2 (95 % CI 27·88, 28·30) and 88·92 cm (95 % CI 88·43, 89·4)). Women's abdominal obesity was associated with low levels of informational, emotional and belonging support, and women's general obesity with informational and emotional support. Notably, informational and emotional support were associated with both obesity outcomes independent of other supports among women. Only a low level of informational support was significantly independently associated with higher odds of obesity among men. CONCLUSIONS Our study provides novel insights into gender-specific associations between different types of social support and adiposity. Prospective studies are needed to further investigate potential causality of these associations between the specific social supports and future weight status, especially among women.
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Affiliation(s)
- Zeinab Hosseini
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Office 4623, Vancouver, BCV6T 1Z3, Canada
- College of Kinesiology, University of Saskatchewan, Saskatoon, Canada
| | - Abdollah Safari
- Data, Analytics, Statistics and Informatics (DASI), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Nadia A Khan
- Department of Internal Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul's Hospital, Vancouver, Canada
| | - Gerry Veenstra
- Department of Sociology, Faculty of Arts, University of British Columbia, Vancouver, Canada
| | - Annalijn I Conklin
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Office 4623, Vancouver, BCV6T 1Z3, Canada
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul's Hospital, Vancouver, Canada
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19
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Hosseini Z, Safari A, Khan NA, Veenstra G, Conklin AI. Gender Differences in the Role of Social Support for Hypertension Prevention in Canada: A Population-Based Cross-Sectional Study of the Canadian Longitudinal Study on Aging Cohort. CJC Open 2021; 3:S62-S70. [PMID: 34993435 PMCID: PMC8712674 DOI: 10.1016/j.cjco.2021.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/12/2021] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND The relationship between social support and hypertension is poorly understood in women and men. We investigated whether multiple measures of social support are linked to blood pressure levels differentially by gender. METHODS Cross-sectional study of 28,779 middle-age and older-age adults (45-85 years) in the baseline Canadian Longitudinal Study on Aging comprehensive cohort. Stratified multivariable regression models estimated the role and relative contribution of 4 types of support to blood pressure in women and men. RESULTS The highest levels of perceived availability of informational, tangible, emotional, and belonging support were significantly associated with the lowest mean level of systolic blood pressure (SBP) but not diastolic blood pressure, independent of known confounders and other support types. However, associations were small, and their directions were more consistent in women. The lowest levels of informational support, relative to the highest, were associated with higher odds of hypertension in women (odds ratio [OR] = 1.20 [95% confidence interval {CI}: 1.06, 1.36]), more so than in men (OR = 1.16 [95% CI: 1.03, 1.32]). The lowest levels of emotional support were similarly associated with the odds of hypertension (OR = 1.08 [95% CI: 1.00, 1.17] in women and OR = 1.08 [95% CI: 1.00, 1.15] in men), relative to the highest. Larger differences in mean SBP in women, compared with men, were seen for informational support (2.43 and 1.18 mm Hg, respectively) and emotional support (1.60 and 0.74 mm Hg, respectively). Findings were unaltered by sensitivity analyses. CONCLUSIONS Informational and emotional support were inversely associated with SBP, more so in women than men. Further longitudinal investigation is warranted, as results suggest that specific supports may help prevent hypertension and lower cardiovascular risk, especially in women.
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Affiliation(s)
- Zeinab Hosseini
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Abdollah Safari
- Data, Analytics, Statistics and Informatics (DASI), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nadia A. Khan
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul’s Hospital, Vancouver, British Columbia, Canada
| | - Gerry Veenstra
- Department of Sociology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Annalijn I. Conklin
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul’s Hospital, Vancouver, British Columbia, Canada
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20
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Roddick CM, Christie CD, Madden KM, Chen FS. Social integration after moving to a new city predicts lower systolic blood pressure. Psychophysiology 2021; 58:e13924. [PMID: 34423451 DOI: 10.1111/psyp.13924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/27/2021] [Accepted: 08/04/2021] [Indexed: 11/30/2022]
Abstract
Residential mobility is linked to higher incidence of cardiovascular disease (CVD) and mortality. A mechanism by which residential relocation may impact health is through the disruption of social networks. To examine whether moving to a new city is associated with increased CVD risk and whether the extent to which movers rebuild their social network after relocating predicts improved CVD risk and psychosocial well-being, recent movers (n = 26), and age- and sex-matched nonmovers (n = 20) were followed over 3 months. Blood pressure, C-reactive protein/albumin ratio (CRP/ALB), social network size, and psychosocial well-being were measured at intake (within 6 weeks of residential relocation for movers) and 3 months later. Multiple regression indicated higher systolic blood pressure (SBP) for movers (M = 107.42, SD = 11.39), compared with nonmovers (M = 102.37, SD = 10.03) at intake, though this trend was not statistically significant. As predicted, increases in movers' social network size over 3 months predicted decreases in SBP, even after controlling for age, sex, and waist-to-hip ratio, b = -2.04 mmHg, 95% CI [-3.35, -.73]. Associations between increases in movers' social ties and decreases in depressive symptoms and stress were in the predicted direction but did not meet the traditional cutoff for statistical significance. Residential relocation and movers' social network size were not associated with CRP/ALB in this healthy sample. This study provides preliminary evidence for increased SBP among recent movers; furthermore, it suggests that this elevation in CVD risk may decrease as individuals successfully rebuild their social network.
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Affiliation(s)
- Charlotte M Roddick
- Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Chelsea D Christie
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kenneth M Madden
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Frances S Chen
- Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
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21
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Jacobs M, Ellis C. Social Connectivity During the COVID-19 Pandemic: Disparities among Medicare Beneficiaries. J Prim Care Community Health 2021; 12:21501327211030135. [PMID: 34231409 PMCID: PMC8267026 DOI: 10.1177/21501327211030135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose Social connections are essential for health and well-being at all ages and may be especially important for promoting health in later life. Maintaining social connections, however, became increasingly difficult during the COVID-19 pandemic when stay-at-home orders were enacted, and social distancing became necessary. This study examines the social connectivity among Medicare beneficiaries during the COVID-19 pandemic highlighting the importance technological availability, income, and race. Methods Data from the 2020 Medicare Beneficiaries Survey COVID supplement was used to evaluate social connectedness during the spring and fall of 2020. Binomial logistic regression evaluated the relationship between feelings of social connectedness and race/ethnicity, urban status of residence, income, availability of household technologies, internet access, and chronic conditions. Results Lower social connectivity is significantly correlated with race and income. Blacks had a nearly 30% higher likelihood of feeling socially disconnected than other racial groups. Individuals with chronic conditions, particularly cancer, were significantly more likely to feel socially disconnected. Internet access and the availability of technological devices decreased the odds of feeling socially disconnected by 20% and 15% respectively. Conclusion The COVID-19 pandemic decreased the social connectedness of many vulnerable groups specifically Blacks, those living with chronic conditions, and individuals with limited access to technology. While it is outside the scope of the current study, additional research is needed to determine how to address the social and psychological impacts of the COVID-19 pandemic among elderly Americans.
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22
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Trudel-Fitzgerald C, Zevon ES, Kawachi I, Tucker-Seeley RD, Grodstein F, Kubzansky LD. The Prospective Association of Social Integration With Life Span and Exceptional Longevity in Women. J Gerontol B Psychol Sci Soc Sci 2020; 75:2132-2141. [PMID: 31495897 PMCID: PMC7664314 DOI: 10.1093/geronb/gbz116] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES Although stronger social relationships have been associated with reduced mortality risk in prior research, their associations with favorable health outcomes are understudied. We evaluated whether higher social integration levels were associated with longer life span and greater likelihood of achieving exceptional longevity. METHOD Women from the Nurses' Health Study completed the Berkman-Syme Social Network Index in 1992 (N = 72,322; average age = 58.80 years), and were followed through 2014 with biennial questionnaires. Deaths were ascertained from participants' families, postal authorities, and death registries. Accelerated failure time models adjusting for relevant covariates estimated percent changes in life span associated with social integration levels; logistic regressions evaluated likelihood of surviving to age 85 years or older among women who could reach that age during follow-up (N = 16,818). RESULTS After controlling for baseline demographics and chronic diseases, socially integrated versus isolated women had 10% (95% confidence interval [CI] = 8.80-11.42) longer life span and 41% (95% CI = 1.28-1.54) higher odds of surviving to age 85 years. All findings remained statistically significant after further adjusting for health behaviors and depression. DISCUSSION Better social integration is related to longer life span and greater likelihood of achieving exceptional longevity among midlife women. Findings suggest social integration may be an important psychosocial asset to evaluate for promoting longer, healthier lives.
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Affiliation(s)
- Claudia Trudel-Fitzgerald
- Department of Social and Behavioral Sciences and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Emily S Zevon
- Department of Social and Behavioral Sciences and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | - Francine Grodstein
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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23
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Social connections and hypertension in women and men: a population-based cross-sectional study of the Canadian Longitudinal Study on Aging. J Hypertens 2020; 39:651-660. [PMID: 33065735 DOI: 10.1097/hjh.0000000000002688] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Associations between social ties and hypertension are poorly understood in women and men. We investigated the association between marital status, living arrangement, social network size and social participation and hypertension by sex/gender. METHODS Cross-sectional analysis of 28 238 middle-age and old-age adults (45-85 years) was conducted using the baseline Canadian Longitudinal Study on Aging Comprehensive cohort data. Blood pressure (BP) was measured using the automated BpTRU device and hypertension was defined as BP more than 140/90 mmHg, or more than 130/80 mmHg in participants with diabetes, self-reported history or receiving antihypertensive therapy. RESULTS Being nonpartnered, having limited social participation (≤2 social activities per month) or a small social network size was associated with higher odds of having hypertension in women. Odds of hypertension were higher among widowed women [odds ratio 1.33 (95% confidence interval (CI): 1.16, 1.51)] compared with married women. The largest difference in adjusted mean SBP in women was between widowed [3.06 mmHg (95% CI: 2.01, 4.11)], vs. married women. For men, lone-living (vs. coliving) was linked to a lower odds of hypertension [odds ratio 0.85 (95% CI: 0.75, 0.96)] When considering two social ties simultaneously, the adverse associations between nonpartnership (mainly for singles and divorced) and BP were mitigated with increased social participation, especially among women. CONCLUSION Social ties appear to be more strongly associated with hypertension in middle and older aged women than men. Women who are nonpartnered or who engage in few social activities and men who are coliving represent at risk groups for having hypertension. Healthcare professionals may need to consider these social factors in addressing risk for hypertension and cardiovascular disease prevention.
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Kadambi S, Soto-Perez-de-Celis E, Garg T, Loh KP, Krok-Schoen JL, Battisti NML, Moffat GT, Gil-Jr LA, Mohile S, Hsu T. Social support for older adults with cancer: Young International Society of Geriatric Oncology review paper. J Geriatr Oncol 2020; 11:217-224. [PMID: 31628066 PMCID: PMC7384244 DOI: 10.1016/j.jgo.2019.09.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/04/2019] [Accepted: 09/05/2019] [Indexed: 12/20/2022]
Abstract
Older adults with cancer have increasing needs in physical, cognitive, and emotional domains, and they can experience decline in all domains with the diagnosis and treatment of cancer. Social support plays a key role in supporting these patients, mitigating negative effects of diagnosis and treatment of cancer, and improving cancer outcomes. We review the importance of social support in older adults with cancer, describe the different components of social support and how they are measured, discuss current interventions that are available to improve social support in older adults, and describe burdens on caregivers. We also highlight Dr. Arti Hurria's contributions to recognizing the integral role of social support to caring for older adults with cancer.
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Affiliation(s)
- Sindhuja Kadambi
- James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Tullika Garg
- Department of Urology, Department of Epidemiology & Health Services Research, Geisinger, Danville, PA, USA
| | - Kah Poh Loh
- James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Jessica L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA
| | | | | | - Luiz A Gil-Jr
- Division of Geriatrics, Department of Internal Medicine, Instituto do Câncer do Estado de São Paulo, University of Sao Paulo, Sao Paulo, Brazil
| | - Supriya Mohile
- James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA
| | - Tina Hsu
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON, Canada.
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de Keijzer C, Basagaña X, Tonne C, Valentín A, Alonso J, Antó JM, Nieuwenhuijsen MJ, Kivimäki M, Singh-Manoux A, Sunyer J, Dadvand P. Long-term exposure to greenspace and metabolic syndrome: A Whitehall II study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 255:113231. [PMID: 31561037 PMCID: PMC7441228 DOI: 10.1016/j.envpol.2019.113231] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 08/30/2019] [Accepted: 09/10/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND Metabolic syndrome is an important risk factor for non-communicable diseases, particularly type 2 diabetes, coronary heart disease, and stroke. Long-term exposure to greenspace could be protective of metabolic syndrome, but evidence for such an association is lacking. Accordingly, we investigated the association between long-term exposure to greenspace and risk of metabolic syndrome. METHODS The present longitudinal study was based on data from four clinical examinations between 1997 and 2013 in 6076 participants of the Whitehall II study, UK (aged 45-69 years at baseline). Long-term exposure to greenspace was assessed by satellite-based indices of greenspace including Normalized Difference Vegetation Index (NDVI) and Vegetation Continuous Field (VCF) averaged across buffers of 500 and 1000 m surrounding the participants' residential location at each follow-up. The ascertainment of metabolic syndrome was based on the World Health Organization (WHO) definition. Hazard ratios for metabolic syndrome were estimated using Cox proportional hazards regression models, controlling for age, sex, ethnicity, lifestyle factors, and socioeconomic status. RESULTS Higher residential surrounding greenspace was associated with lower risk of metabolic syndrome. An interquartile range increase in NDVI and VCF in the 500 m buffer was associated with 13% (95% confidence interval (CI): 1%, 23%) and 14% (95% CI: 5%, 22%) lower risk of metabolic syndrome, respectively. Greater exposure to greenspace was also associated with each individual component of metabolic syndrome, including a lower risk of high levels of fasting glucose, large waist circumference, high triglyceride levels, low HDL cholesterol, and hypertension. The association between residential surrounding greenspace and metabolic syndrome may have been mediated by physical activity and exposure to air pollution. CONCLUSIONS The findings of the present study suggest that middle-aged and older adults living in greener neighbourhoods are at lower risk of metabolic syndrome than those living in neighbourhoods with less greenspace.
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Affiliation(s)
- Carmen de Keijzer
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Cathryn Tonne
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Antònia Valentín
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jordi Alonso
- Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; IMIM-Parc Salut Mar, Barcelona, Catalonia, Spain
| | - Josep M Antó
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mark J Nieuwenhuijsen
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College of London, London, UK
| | - Archana Singh-Manoux
- Department of Epidemiology and Public Health, University College of London, London, UK; INSERM, U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Paris, France
| | - Jordi Sunyer
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Payam Dadvand
- ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Shiovitz-Ezra S, Parag O. Does loneliness 'get under the skin'? Associations of loneliness with subsequent change in inflammatory and metabolic markers. Aging Ment Health 2019; 23:1358-1366. [PMID: 30380911 DOI: 10.1080/13607863.2018.1488942] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objectives: To expand existing knowledge about the associations of late-life loneliness with subsequent change in inflammation as well as with metabolic dysregulation, using national representative longitudinal data. The current analysis also explores age, gender, and race differences in these pre-disease pathways. Method: The analysis is based on data from the 2005-06 and 2010-11 waves of the National Social Life, Health, and Aging Project (NSHAP)-a longitudinal survey conducted among a representative sample of community-dwelling Americans aged 57-85. Adjusted logistic regression models were used to examine associations of loneliness with changes in C-reactive protein (CRP), Glycated hemoglobin (HbA1c), Body Mass Index (BMI), Waist Circumference (WC), and metabolic burden. Results: Loneliness was found to be associated with a change for the worse in most of the metabolic bio-markers. Specifically, lonely older adults had 39%-71% higher odds of developing prospective risk levels in three out of the four metabolic bio-markers that were measured: HbA1c, BMI, and metabolic burden. Salient differences by race were found in this regard. Whereas loneliness was not significantly associated with HbA1c risk levels and BMI among the Whites, the prospective risk of high HbA1c was more than five times greater and the risk of high BMI scores was three times greater among Hispanics who experienced loneliness than among the not-lonely Hispanic group. Conclusions: The robust impact of loneliness on prospective changes for the worse in levels of various metabolic bio-markers that are closely associated with morbidity highlights the need for prevention, coping with, and reducing loneliness.
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Affiliation(s)
- Sharon Shiovitz-Ezra
- a Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem , Jerusalem , Israel
| | - Ohad Parag
- b Israel Gerontological Data Center (IGDC), The Hebrew University of Jerusalem , Jerusalem , Israel
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Henriksen RE, Nilsen RM, Strandberg RB. Loneliness as a risk factor for metabolic syndrome: results from the HUNT study. J Epidemiol Community Health 2019; 73:941-946. [DOI: 10.1136/jech-2019-212335] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/24/2019] [Accepted: 06/18/2019] [Indexed: 12/14/2022]
Abstract
ObjectiveMetabolic syndrome (MetS) includes hyperglycaemia, hypertension, central adiposity, elevated triglyceride levels and low levels of high-density lipoprotein cholesterol. All factors are identified as risk factors for cardiovascular disease and mortality. This longitudinal study examined whether loneliness, which has been shown to predict a range of negative health outcomes, increases the risk for MetS.MethodsWe used data from ‘the Nord-Trøndelag Health Study’ (HUNT) which is a large longitudinal health study based on a Mid-Norway county population (n=26 990). Self-reports, physical examinations and blood samples were analysed to evaluate the associations between loneliness and incidents of MetS after 10 years (follow-up survey conducted during 2006–2008). We also investigated the role of depression as a potential mediating factor.ResultsIndividuals who reported higher levels of loneliness had a higher odds for MetS (adjusted OR 1.09 (95% CI 1.02 to 1.16); p=0.007). This effect was mediated through depression.ConclusionsFindings suggest that loneliness may be an important factor that increases the risk for MetS. The effect of loneliness on MetS is mediated through depressive symptoms. Reducing loneliness may help prevent the incidence of MetS and related diseases.
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Abstract
Objective: This study examined genetic roots of later life social integration, and their confounding of this social factor's health linkages. Method: Data were from the 2010 wave of the Health and Retirement Study. Two dimensions of integration were examined: with one's "stakeholder" network of family and friends and with the community. Genetic measures included polygenic scores for extraversion and educational attainment. Results: Ties to one's stakeholder network had no genetic associations. The extraversion polygenic score was linked to community integration among Blacks as well as Whites. Among the latter, the same was true of one's genetic propensity for educational attainment. Although this score also influenced self-rated health, neither confounded associations of social integration with this indicator. Discussion: Later life social integration seems influenced by genetically rooted propensities for both sociability and human capital accumulation. Health linkages of integration, however, may not reflect mutual dependencies on the same genetic substrates.
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Cozier YC, Yu J, Wise LA, VanderWeele TJ, Balboni TA, Argentieri MA, Rosenberg L, Palmer JR, Shields AE. Religious and Spiritual Coping and Risk of Incident Hypertension in the Black Women's Health Study. Ann Behav Med 2018; 52:989-998. [PMID: 30418522 PMCID: PMC6230974 DOI: 10.1093/abm/kay001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background The few studies of the relationship between religion and/or spirituality (R/S) and hypertension are conflicting. We hypothesized that R/S may reduce the risk of hypertension by buffering adverse physiological effects of stress. Methods We prospectively assessed the association of R/S with hypertension within the Black Women's Health Study (BWHS), a cohort study initiated in 1995 that follows participants through biennial questionnaires. The 2005 questionnaire included four R/S questions: (i) extent to which one's R/S is involved in coping with stressful situations, (ii) self-identification as a religious/spiritual person, (iii) frequency of attending religious services, and (iv) frequency of prayer. Incidence rate ratios (IRRs) and 95% confidence intervals were calculated for each R/S variable in relation to incident hypertension using Cox proportional hazards regression models, controlling for demographics, known hypertension risk factors, psychosocial factors, and other R/S variables. Results During 2005-2013, 5,194 incident cases of hypertension were identified. High involvement of R/S in coping with stressful events compared with no involvement was associated with reduced risk of hypertension (IRR: 0.87; 95% CI: 0.75, 1.00). The association was strongest among women reporting greater levels of perceived stress (IRR: 0.77; 95% CI: 0.61, 0.98; p interaction = .01). More frequent prayer was associated with increased risk of hypertension (IRR: 1.12; 95% CI: 0.99, 1.27). No association was observed for the other R/S measures. Conclusion R/S coping was associated with decreased risk of hypertension in African American women, especially among those reporting higher levels of stress. Further research is needed to understand the mechanistic pathways through which R/S coping may affect health.
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Affiliation(s)
- Yvette C Cozier
- Slone Epidemiology Center, Boston University, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Jeffrey Yu
- Slone Epidemiology Center, Boston University, Boston, MA, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Tyler J VanderWeele
- Department of Epidemiology and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tracy A Balboni
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston MA, USA
- Department of Radiation Oncology, Harvard Medical School, Boston, MA, USA
| | - M Austin Argentieri
- National Consortium on Psychosocial Stress, Spirituality, and Health, Massachusetts General Hospital, Department of Medicine, Boston, MA, USA
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Massachusetts General Hospital, Boston, MA, USA
| | - Lynn Rosenberg
- Slone Epidemiology Center, Boston University, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Julie R Palmer
- Slone Epidemiology Center, Boston University, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
- Boston University Cancer Center, Boston University, Boston, MA, USA
| | - Alexandra E Shields
- National Consortium on Psychosocial Stress, Spirituality, and Health, Massachusetts General Hospital, Department of Medicine, Boston, MA, USA
- Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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Social Networks and Health Outcomes: Importance for Racial and Socioeconomic Disparities in Cardiovascular Outcomes. CURRENT CARDIOVASCULAR RISK REPORTS 2018; 12. [DOI: 10.1007/s12170-018-0594-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Busch EL, Whitsel EA, Kroenke CH, Yang YC. Social relationships, inflammation markers, and breast cancer incidence in the Women's Health Initiative. Breast 2018; 39:63-69. [PMID: 29614476 PMCID: PMC5936641 DOI: 10.1016/j.breast.2018.03.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 03/02/2018] [Accepted: 03/26/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Previous research has reported associations between social relationships and carcinogenesis. Inflammation is a potential mediator of these associations. To clarify these links for one tumor site, we examined associations between social relationships, circulating inflammation markers, and breast cancer incidence. MATERIALS AND METHODS Among 132,262 participants from the prospective Women's Health Initiative, we used linear and logistic regression to evaluate associations between social relationship characteristics (social support, social strain, social network size) and inflammation markers of C-reactive protein (CRP) and white blood cell count (WBC). Cox regression was used to evaluate associations between inflammation markers and breast cancer incidence, as well as associations between social relationship characteristics and breast cancer incidence with and without adjustment for inflammation markers. RESULTS Larger social networks were associated with lower continuous CRP (beta = -0.22, 95% CI -0.36, -0.08) and WBC (beta = -0.23, 95% CI -0.31, -0.16). Greater social strain was associated with higher continuous CRP (beta = 0.24, 95% CI 0.14, 0.33) and WBC (beta = 0.09, 95% CI 0.04, 0.14). When WBC was dichotomized at 10,000 cells/uL, high WBC was associated with greater hazards of in situ breast cancer (HR = 1.65, 95% CI 1.17, 2.33) but not invasive breast cancer. Social relationship characteristics were not associated with incidence of invasive or in situ breast cancer. CONCLUSION Larger social networks were associated with lower inflammation and greater social strain was associated with higher inflammation. Higher inflammation might be associated with development of in situ breast cancer, but this appeared to be due to factors other than social relationships.
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Affiliation(s)
- Evan L Busch
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, 181 Longwood Avenue, 3rd Floor, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7435, USA.
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7435, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Candyce H Kroenke
- Kaiser Permanente Northern California, Division of Research, 2000 Broadway, Oakland, CA, 94612 USA.
| | - Yang C Yang
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, 308 W. Rosemary Street, Room #219, Chapel Hill, NC 27516, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Cundiff JM, Matthews KA. Friends With Health Benefits: The Long-Term Benefits of Early Peer Social Integration for Blood Pressure and Obesity in Midlife. Psychol Sci 2018. [PMID: 29533704 DOI: 10.1177/0956797617746510] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In adults, greater social integration is associated with reduced risk of cardiovascular disease, including hypertension. Social integration earlier in life may be similarly associated with cardiovascular risk. Using a longitudinal sample of 267 Black and White men, we examined whether greater social integration with peers during childhood and adolescence, assessed by parent report, prospectively predicts lower blood pressure and body mass index two decades later in adulthood and whether these effects differ by race, given well-documented racial disparities in hypertension. Boys who were reported by their parents to be more socially integrated with peers evidenced lower blood pressure and body mass index in adulthood, and this effect was not accounted for by body mass index in childhood, childhood socioeconomic status, childhood hostility, childhood physical health, extraversion measured in adolescence, or concurrent adult self-reports of social integration. Results did not differ by race, but analyses were not powered to detect interactions of small effect size.
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Affiliation(s)
- Jenny M Cundiff
- 1 Department of Psychological Sciences, Texas Tech University
| | - Karen A Matthews
- 2 Department of Psychiatry, University of Pittsburgh.,3 Department of Psychology, University of Pittsburgh
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Boen CE, Barrow DA, Bensen JT, Farnan L, Gerstel A, Hendrix LH, Yang YC. Social Relationships, Inflammation, and Cancer Survival. Cancer Epidemiol Biomarkers Prev 2018; 27:541-549. [PMID: 29475966 DOI: 10.1158/1055-9965.epi-17-0836] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/17/2017] [Accepted: 01/29/2018] [Indexed: 12/31/2022] Open
Abstract
Background: Social stressors, such as social relationship deficits, have been increasingly linked to chronic disease outcomes, including cancer. However, critical gaps exist in our understanding of the nature and strength of such links, as well as the underlying biological mechanisms relating social relationships to cancer progression and survival.Methods: Utilizing novel questionnaire and biomarker data from the UNC Health Registry/Cancer Survivorship Cohort, this study examines the associations between diverse measures of social support and mortality risk among individuals with cancer (N = 1,004). We further assess the role of multiple serum markers of inflammation, including high-sensitivity C-reactive protein (CRP), IL6, TNFα, and VEGF, as potential mediators in the social relationship-cancer link.Results: The findings revealed that one's appraisal of their social support was associated with cancer mortality, such that individuals reporting higher levels of social support satisfaction had lower mortality risk than individuals reporting lower levels of satisfaction. The amount of support received, on the other hand, was not predictive of cancer survival. We further found evidence that inflammatory processes may undergird the link between social support satisfaction and mortality among individuals with cancer, with individuals reporting higher levels of social support satisfaction having lower levels of CRP, IL6, and TNFα.Conclusions: These results provide new knowledge of the biosocial processes producing population disparities in cancer outcomes.Impact: Our study offers new insights for intervention efforts aimed at promoting social connectedness as a means for improving cancer survival. Cancer Epidemiol Biomarkers Prev; 27(5); 541-9. ©2018 AACR.
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Affiliation(s)
- Courtney E Boen
- Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - David A Barrow
- UNC Cytokine & Biomarker Analysis Facility, School of Dentistry, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
| | - Jeannette T Bensen
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina Chapel Hill, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
| | - Laura Farnan
- Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
| | - Adrian Gerstel
- Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
| | - Laura H Hendrix
- Duke Cancer Institute/Alliance for Clinical Trials in Oncology, Durham, North Carolina
| | - Yang Claire Yang
- Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina.,Department of Sociology and Carolina Population Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina
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Yang YC, Gerken K, Schorpp K, Boen C, Harris KM. Early-Life Socioeconomic Status and Adult Physiological Functioning: A Life Course Examination of Biosocial Mechanisms. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2017; 63:87-103. [PMID: 28521624 PMCID: PMC5439296 DOI: 10.1080/19485565.2017.1279536] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
A growing literature has demonstrated a link between early-life socioeconomic conditions and adult health at a singular point in life. No research exists, however, that specifies the life course patterns of socioeconomic status (SES) in relation to the underlying biological processes that determine health. Using an innovative life course research design consisting of four nationally representative longitudinal datasets that collectively cover the human life span from early adolescence to old age (Add Health, MIDUS, NSHAP, and HRS), we address this scientific gap and assess how SES pathways from childhood into adulthood are associated with biophysiological outcomes in different adult life stages. For each dataset, we constructed standardized composite measures of early-life SES and adult SES and harmonized biophysiological measurements of immune and metabolic functioning. We found that the relative importance of early-life SES and adult SES varied across young, mid, and late adulthood, such that early-life SES sets a life course trajectory of socioeconomic well-being and operates through adult SES to influence health as adults age. We also documented evidence of the detrimental health effects of downward mobility and persistent socioeconomic disadvantage. These findings are the first to specify the life course patterns of SES that matter for underlying biophysiological functioning in different stages of adulthood. The study thus contributes new knowledge critical for improving population health by identifying the particular points in the life course at which interventions might be most effective in preventing disease and premature mortality.
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Affiliation(s)
- Yang Claire Yang
- a Department of Sociology, and Carolina Population Center , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
- b Lineberger Comprehensive Cancer Center , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Karen Gerken
- a Department of Sociology, and Carolina Population Center , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Kristen Schorpp
- a Department of Sociology, and Carolina Population Center , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Courtney Boen
- a Department of Sociology, and Carolina Population Center , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Kathleen Mullan Harris
- a Department of Sociology, and Carolina Population Center , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
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Aung MN, Moolphate S, Aung TNN, Katonyoo C, Khamchai S, Wannakrairot P. The social network index and its relation to later-life depression among the elderly aged ≥80 years in Northern Thailand. Clin Interv Aging 2016; 11:1067-74. [PMID: 27540286 PMCID: PMC4982492 DOI: 10.2147/cia.s108974] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background Having a diverse social network is considered to be beneficial to a person’s well-being. The significance, however, of social network diversity in the geriatric assessment of people aged ≥80 years has not been adequately investigated within the Southeast Asian context. This study explored the social networks belonging to the elderly aged ≥80 years and assessed the relation of social network and geriatric depression. Methods This study was a community-based cross-sectional survey conducted in Chiang Mai Province, Northern Thailand. A representative sample of 435 community residents, aged ≥80 years, were included in a multistage sample. The participants’ social network diversity was assessed by applying Cohen’s social network index (SNI). The geriatric depression scale and activities of daily living measures were carried out during home visits. Descriptive analyses revealed the distribution of SNI, while the relationship between the SNI and the geriatric depression scale was examined by ordinal logistic regression models controlling possible covariants such as age, sex, and educational attainment. Results The median age of the sample was 83 years, with females comprising of 54.94% of the sample. The participants’ children, their neighbors, and members of Buddhist temples were reported as the most frequent contacts of the study participants. Among the 435 participants, 25% were at risk of social isolation due to having a “limited” social network group (SNI 0–3), whereas 37% had a “medium” social network (SNI 4–5), and 38% had a “diverse” social network (SNI ≥6). The SNI was not different among the two sexes. Activities of daily living scores in the diverse social network group were significantly higher than those in the limited social network group. Multivariate ordinal logistic regression analysis models revealed a significant negative association between social network diversity and geriatric depression. Conclusion Regular and frequent contact with various social contacts may safeguard common geriatric depression among persons aged ≥80 years. As a result, screening those at risk of social isolation is recommended to be integrated into routine primary health care-based geriatric assessment and intervention programs.
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Affiliation(s)
- Myo Nyein Aung
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Saiyud Moolphate
- Department of Public Health, Chiang Mai Rajabhat University, Chiang Mai, Thailand
| | | | - Chitima Katonyoo
- Department of Public Health, Chiang Mai Rajabhat University, Chiang Mai, Thailand
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Boen C, Yang YC. The physiological impacts of wealth shocks in late life: Evidence from the Great Recession. Soc Sci Med 2016; 150:221-30. [PMID: 26773705 PMCID: PMC4764349 DOI: 10.1016/j.socscimed.2015.12.029] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 12/16/2015] [Accepted: 12/18/2015] [Indexed: 01/05/2023]
Abstract
Given documented links between individual socioeconomic status (SES) and health, it is likely that-in addition to its impacts on individuals' wallets and bank accounts-the Great Recession also took a toll on individuals' disease and mortality risk. Exploiting a quasi-natural experiment design, this study utilizes nationally representative, longitudinal data from the National Social Life, Health, and Aging Project (NSHAP) (2005-2011) (N = 930) and individual fixed effects models to examine how household-level wealth shocks experienced during the Great Recession relate to changes in biophysiological functioning in older adults. Results indicate that wealth shocks significantly predicted changes in physiological functioning, such that losses in net worth from the pre-to the post-Recession period were associated with increases in systolic blood pressure and C-reactive protein over the six year period. Further, while the association between wealth shocks and changes in blood pressure was unattenuated with the inclusion of other indicators of SES, psychosocial well-being, and health behaviors in analytic models, we document some evidence of mediation in the association between changes in wealth and changes in C-reactive protein, which suggests specificity in the social and biophysiological mechanisms relating wealth shocks and health at older ages. Linking macro-level conditions, meso-level household environments, and micro-level biological processes, this study provides new insights into the mechanisms through which economic inequality contributes to disease and mortality risk in late life.
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Affiliation(s)
- Courtney Boen
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, USA.
| | - Y Claire Yang
- Department of Sociology, Lineberger Comprehensive Cancer Center, and Carolina Population Center, University of North Carolina at Chapel Hill, USA
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Social relationships and physiological determinants of longevity across the human life span. Proc Natl Acad Sci U S A 2016; 113:578-83. [PMID: 26729882 DOI: 10.1073/pnas.1511085112] [Citation(s) in RCA: 327] [Impact Index Per Article: 40.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Two decades of research indicate causal associations between social relationships and mortality, but important questions remain as to how social relationships affect health, when effects emerge, and how long they last. Drawing on data from four nationally representative longitudinal samples of the US population, we implemented an innovative life course design to assess the prospective association of both structural and functional dimensions of social relationships (social integration, social support, and social strain) with objectively measured biomarkers of physical health (C-reactive protein, systolic and diastolic blood pressure, waist circumference, and body mass index) within each life stage, including adolescence and young, middle, and late adulthood, and compare such associations across life stages. We found that a higher degree of social integration was associated with lower risk of physiological dysregulation in a dose-response manner in both early and later life. Conversely, lack of social connections was associated with vastly elevated risk in specific life stages. For example, social isolation increased the risk of inflammation by the same magnitude as physical inactivity in adolescence, and the effect of social isolation on hypertension exceeded that of clinical risk factors such as diabetes in old age. Analyses of multiple dimensions of social relationships within multiple samples across the life course produced consistent and robust associations with health. Physiological impacts of structural and functional dimensions of social relationships emerge uniquely in adolescence and midlife and persist into old age.
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38
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Santini ZI, Koyanagi A, Tyrovolas S, Haro JM, Fiori KL, Uwakwa R, Thiyagarajan JA, Webber M, Prince M, Prina AM. Social network typologies and mortality risk among older people in China, India, and Latin America: A 10/66 Dementia Research Group population-based cohort study. Soc Sci Med 2015; 147:134-43. [DOI: 10.1016/j.socscimed.2015.10.061] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 10/08/2015] [Accepted: 10/27/2015] [Indexed: 11/16/2022]
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Abstract
A growing body of research demonstrates that psychosocial factors play an important role in the development of hypertension. Previous reviews have identified several key factors (i.e., occupational stress) that contribute to the onset of hypertension; however, they are now outdated. In this review, we provide an updated synthesis of the literature from 2010 to April 2014. We identified 21 articles for inclusion in the review, of which there were six categories of psychosocial stressors: occupational stress, personality, mental health, housing instability, social support/isolation, and sleep quality. Sixteen of the studies reported an association between the psychosocial stressor and blood pressure. While several findings were consistent with previous literature, new findings regarding mediating and moderating factors underlying the psychosocial-hypertension association help to untangle inconsistencies reported in the literature. Moreover, sleep quality is a novel additional factor that should undergo further exploration. Areas for future research based on these findings are discussed.
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Burr JA, Han SH, Tavares JL. Volunteering and Cardiovascular Disease Risk: Does Helping Others Get “Under the Skin?”. THE GERONTOLOGIST 2015; 56:937-47. [DOI: 10.1093/geront/gnv032] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 02/10/2015] [Indexed: 11/14/2022] Open
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