Social Isolation and Mortality in US Black and White Men and Women

被引:96
作者
Alcaraz, Kassandra I. [1 ]
Eddens, Katherine S. [2 ]
Blase, Jennifer L. [3 ]
Diver, W. Ryan [1 ]
Patel, Alpa V. [1 ]
Teras, Lauren R. [1 ]
Stevens, Victoria L. [1 ]
Jacobs, Eric J. [1 ]
Gapstur, Susan M. [1 ]
机构
[1] Amer Canc Soc, Behav & Epidemiol Res Grp, Atlanta, GA 30329 USA
[2] Univ Kentucky, Coll Publ Hlth, Dept Hlth Behav & Soc, Lexington, KY USA
[3] Georgia Inst Technol, Sch Comp Sci, Atlanta, GA 30332 USA
基金
美国国家卫生研究院;
关键词
cancer; Cancer Prevention Study II; cardiovascular disease; cohort studies; health disparities; mortality; race; social isolation; CARDIOVASCULAR-DISEASE; RISK-FACTORS; HEALTH; LONELINESS; CONNECTIONS; NETWORKS; SUPPORT; CANCER; OLDER; INTEGRATION;
D O I
10.1093/aje/kwy231
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Social isolation is associated with higher mortality in studies comprising mostly white adults, yet associations among black adults are unclear. In this prospective cohort study, we evaluated whether associations of social isolation with all-cause, cardiovascular disease, and cancer mortality differed by race and sex. Adults enrolled in Cancer Prevention Study II in 1982/1983 were followed for mortality through 2012 (n = 580,182). Sex- and race-specific multivariable-adjusted hazard ratios and 95% confidence intervals were estimated for associations of a 5-point social isolation score with risk of death. Social isolation was associated with all-cause mortality in all subgroups (P for trend 0.005); for the most isolated versus the least isolated, the hazard ratios were 2.34 (95% confidence interval (CI): 1.58, 3.46) and 1.60 (95% CI: 1.41, 1.82) among black men and white men, respectively (P for interaction = 0.40) and 2.13 (95% CI: 1.44, 3.15) and 1.84 (95% CI: 1.68, 2.01) among black women and white women, respectively (P for interaction = 0.89). The association did not differ between black men and black women (P for interaction = 0.33) but was slightly stronger in white women than in white men (P for interaction = 0.01). Social isolation was associated with cardiovascular disease mortality in each subgroup (P for trend < 0.03) but with cancer mortality only among whites (P for trend < 0.0001). Subgroup differences in the influence of specific social isolation components were identified. Identifying and intervening with socially isolated adults could improve health outcomes.
引用
收藏
页码:102 / 109
页数:8
相关论文
共 38 条
[1]   African American church participation and health care practices [J].
Aaron, KF ;
Levine, D ;
Burstin, HR .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2003, 18 (11) :908-913
[2]   Invited Commentary: Evolution of Social Networks, Health, and the Role of Epidemiology [J].
Aiello, Allison E. .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 2017, 185 (11) :1089-1092
[3]   The ConNECT Framework: a model for advancing behavioral medicine science and practice to foster health equity [J].
Alcaraz, Kassandra I. ;
Sly, Jamilia ;
Ashing, Kimlin ;
Fleisher, Linda ;
Gil-Rivas, Virginia ;
Ford, Sabrina ;
Yi, Jean C. ;
Lu, Qian ;
Meade, Cathy D. ;
Menon, Usha ;
Gwede, Clement K. .
JOURNAL OF BEHAVIORAL MEDICINE, 2017, 40 (01) :23-38
[4]  
[Anonymous], 1992, INT CLASS DIS
[5]  
[Anonymous], 1977, INT CLASS DIS
[6]  
Assari S, 2017, BEHAV SCI-BASEL, V7, DOI 10.3390/bs7040068
[7]   Social Integration, Social Support and Mortality in the US National Health Interview Survey [J].
Barger, Steven D. .
PSYCHOSOMATIC MEDICINE, 2013, 75 (05) :510-517
[8]   Social integration and mortality: A prospective study of French employees of electricity of France-gas of France [J].
Berkman, LF ;
Melchior, M ;
Chastang, JF ;
Niedhammer, I ;
Leclerc, A ;
Goldberg, M .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 2004, 159 (02) :167-174
[9]   SOCIAL NETWORKS, HOST-RESISTANCE, AND MORTALITY - 9-YEAR FOLLOW-UP-STUDY OF ALAMEDA COUNTY RESIDENTS [J].
BERKMAN, LF ;
SYME, SL .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1979, 109 (02) :186-204
[10]  
Brissette I., 2000, SOCIAL SUPPORT MEASU, P53