Association of group-level segregation with cardiovascular health in older adults: an analysis of data from the Korean Social Life, Health, and Aging Project
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
OBJECTIVES: The adverse health effects of individual-level social isolation (e.g., perceived loneliness) have been well documented in older adults. However, little is known about the impact of collective-level social isolation on health outcomes. We sought to examine the association of group-level segregation with cardiovascular health (CVH) in older adults. METHODS: From the prospective Korean Social Life, Health, and Aging Project database, we identified 528 community-dwelling older adults who were aged ≥60 years or were married to those aged ≥60 years. Participants who belonged to smaller social groups separate from the major social group were defined as group-level-segregated. The CVH score was calculated as the number of ideal non-dietary CVH metrics (0-6), as modified from the American Heart Association’s Life’s Simple 7. Using ordinal logistic regression models, we assessed cross-sectional and longitudinal associations between group-level segregation and CVH. RESULTS: Of the 528 participants (mean age, 71.7 years; 60.0% female), 108 (20.5%) were segregated at baseline. In the cross- sectional analysis, group-level segregation was significantly associated with lower odds of having a higher CVH score at baseline after adjusting for socio-demographic factors and cognitive function (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.43 to 0.95). Among 274 participants who completed an 8-year follow-up, group-level segregation at baseline was marginally associated with lower odds of having a higher CVH score at 8 years (OR, 0.49; 95% CI, 0.24 to 1.02). CONCLUSIONS: Group-level segregation was associated with worse CVH. These findings imply that the social network structure of a community may influence its members’ health status.
Abstract
OBJECTIVES: The adverse health effects of individual-level social isolation (e.g., perceived loneliness) have been well documented in older adults. However, little is known about the impact of collective-level social isolation on health outcomes. We sought to examine the association of group-level segregation with cardiovascular health (CVH) in older adults. METHODS: From the prospective Korean Social Life, Health, and Aging Project database, we identified 528 community-dwelling older adults who were aged ≥60 years or were married to those aged ≥60 years. Participants who belonged to smaller social groups separate from the major social group were defined as group-level-segregated. The CVH score was calculated as the number of ideal non-dietary CVH metrics (0-6), as modified from the American Heart Association’s Life’s Simple 7. Using ordinal logistic regression models, we assessed cross-sectional and longitudinal associations between group-level segregation and CVH. RESULTS: Of the 528 participants (mean age, 71.7 years; 60.0% female), 108 (20.5%) were segregated at baseline. In the cross- sectional analysis, group-level segregation was significantly associated with lower odds of having a higher CVH score at baseline after adjusting for socio-demographic factors and cognitive function (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.43 to 0.95). Among 274 participants who completed an 8-year follow-up, group-level segregation at baseline was marginally associated with lower odds of having a higher CVH score at 8 years (OR, 0.49; 95% CI, 0.24 to 1.02). CONCLUSIONS: Group-level segregation was associated with worse CVH. These findings imply that the social network structure of a community may influence its members’ health status.
참고문헌 (34)
- Holt-Lunstad J, "Loneliness and social isolation as risk factors for mortality : a meta-analytic review", Perspect Psychol Sci, 10, pp.227~237 (2015)
- Luo Y, "Loneliness, health, and mortality in old age : a national longitudinal study", Soc Sci Med, 74, pp.907~914 (2012)
- O’Súilleabháin PS, "Loneliness, living alone, and all-cause mortality : the role of emotional and social loneliness in the elderly during 19 years of follow-up", Psychosom Med, 81, pp.521~526 (2019)
- Abell JG, "Living alone and mortality : more complicated than it seems", Eur Heart J Qual Care Clin Outcomes, 5, pp.187~188 (2019)
- Jensen MT, "Living alone is associated with all-cause and cardiovascular mortality : 32 years of follow-up in the Copenhagen Male Study", Eur Heart J Qual Care Clin Outcomes, 5, pp.208~217 (2019)
- Hodgson S, "Loneliness, social isolation, cardiovascular disease and mortality : a synthesis of the literature and conceptual framework", J R Soc Med, 113, pp.185~192 (2020)
- Hakulinen C, "Social isolation and loneliness as risk factors for myocardial infarction, stroke and mortality : UK Biobank cohort study of 479 054 men and women", Heart, 104, pp.1536~1542 (2018)
- Valtorta NK, "Loneliness and social isolation as risk factors for coronary heart disease and stroke : systematic review and meta-analysis of longitudinal observational studies", Heart, 102, pp.1009~1016 (2016)
- Hawkley LC, "Loneliness matters : a theoretical and empirical review of consequences and mechanisms", Ann Behav Med, 40, pp.218~227 (2010)
- Cacioppo JT, "Lonely traits and concomitant physiological processes : the MacArthur social neuroscience studies", Int J Psychophysiol, 35, pp.143~154 (2000)
- Kramer MR, "Is segregation bad for your health?", Epidemiol Rev, 31, pp.178~194 (2009)
- Acevedo-Garcia D, "Future directions in residential segregation and health research : a multilevel approach", Am J Public Health, 93, pp.215~221 (2003)
- Youm Y, "All-cause mortality and three aspects of social relationships : an eight-year follow-up of older adults from one entire Korean village", Sci Rep, 11, pp.465~ (2021)
- 염유식, "Self-rated Health and Global Network Position: Results From the Older Adult Population of a Korean Rural Village", Annals of geriatric medicine and research, 20(3), pp.149~159 (2016), 대한노인병학회[DOI]
- Youm Y, "Social network properties and self-rated health in later life : comparisons from the Korean social life, health, and aging project and the national social life, health and aging project", BMC Geriatr, 14, pp.102~ (2014)
- Lee JM, "The Korean social life, health and aging project-health examination cohort", Epidemiol Health, 36, pp.e2014003~ (2014)
- Wasserman S, "Social network analysis: methods and applications", pp.92~166 (1994), Cambridge University Press
- Lloyd-Jones DM, "Defining and setting national goals for cardiovascular health promotion and disease reduction : the American Heart Association’s strategic Impact Goal through 2020 and beyond", Circulation, 121, pp.586~613 (2010)
- Podsiadlo D, "The Timed"Up & Go" : a test of basic functional mobility for frail elderly persons", J Am Geriatr Soc, 39, pp.142~148 (1991)
- Shumway-Cook A, "Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go test", Phys Ther, 80, pp.896~903 (2000)
- Kershaw KN, "Neighborhood-level racial", ethnic residential segregation and incident cardiovascular disease : the multi-ethnic study of atherosclerosis, 2015, pp.131, 141~148
- Kershaw KN, "Racial", ethnic residential segregation and cardiovascular disease risk, 2015, pp.9, 10~
- Kershaw KN, "Association of changes in neighborhood-level racial residential segregation with changes in blood pressure among Black adults : the CARDIA Study", JAMA Intern Med, 177, pp.996~1002 (2017)
- Kim YC, "Integrated connection to neighborhood storytelling network, education, and chronic disease knowledge among African Americans and Latinos in Los Angeles", J Health Commun, 16, pp.393~415 (2011)
- Schwarte L, "The Central California Regional Obesity Prevention Program : changing nutrition and physical activity environments in California’s heartland", Am J Public Health, 100, pp.2124~2128 (2010)
- Yanek LR, "Project Joy : faith based cardiovascular health promotion for African American women", Public Health Rep, 116(Suppl 1), pp.68~81 (2001)
- 박경순, "어떤 농촌노인이 경로당에 가지 않는가?", 사회복지정책, 42(2), pp.163~184 (2015), 한국사회복지정책학회[DOI]
- Kershaw KN, "Metropolitan-level racial residential segregation and black-white disparities in hypertension", Am J Epidemiol, 174, pp.537~545 (2011)
- Wirtz PH, "Psychological stress, inflammation, and coronary heart disease", Curr Cardiol Rep, 19, pp.111~ (2017)
- Rohleder N, "Stimulation of systemic low-grade inflammation by psychosocial stress", Psychosom Med, 76, pp.181~189 (2014)
- Holt-Lunstad J, "Why social relationships are important for physical health : a systems approach to understanding and modifying risk and protection", Annu Rev Psychol, 69, pp.437~458 (2018)
- Eisenberger NI, "In sickness and in health : the co-regulation of inflammation and social behavior", Neuropsychopharmacology, 42, pp.242~253 (2017)
- Lee SH, "Loneliness and immune gene expression in Korean adults : the moderating effect of social orientation", Health Psychol, 40, pp.686~691 (2021)
- Slavich GM, "Social safety theory : a biologically based evolutionary perspective on life stress, health, and behavior", Annu Rev Clin Psychol, 16, pp.265~295 (2020)