BMC Public Health | |
Social relationships and health related behaviors among older US adults | |
Georgios Tsakos5  Ichiro Kawachi2  Michael Marmot5  Aubrey Sheiham5  Jun Aida3  Tarani Chandola1  Tim Newton4  Wael Sabbah4  Anja Heilmann5  Richard G Watt5  | |
[1] School of Social Sciences, University of Manchester, Manchester, UK;Department of Society, Human Development and Health, Harvard School of Public Health, Boston, USA;Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai, Japan;Dental Institute, Kings College London, London, UK;Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK | |
关键词: Aging; Health behaviors; Social relationships; | |
Others : 1130014 DOI : 10.1186/1471-2458-14-533 |
|
received in 2014-04-04, accepted in 2014-05-23, 发布年份 2014 | |
【 摘 要 】
Background
Health behaviors are a key determinant of health and well-being that are influenced by the nature of the social environment. This study examined associations between social relationships and health-related behaviors among a nationally representative sample of older people.
Methods
We analyzed data from three waves (1999–2004) of the US National Health and Nutrition Examination Survey (NHANES). Participants were 4,014 older Americans aged 60 and over. Log-binomial regression models estimated prevalence ratios (PR) for the associations between social relationships and each of the following health behaviors: alcohol use, smoking, physical activity and dental attendance.
Results
Health-compromising behaviors (smoking, heavy drinking and less frequent dental visits) were related to marital status, while physical activity, a health-promoting behavior, was associated with the size of friendship networks. Smoking was more common among divorced/separated (PR = 2.1; 95% CI: 1.6, 2.7) and widowed (PR = 1.7; 95% CI: 1.3, 2.3) respondents than among those married or cohabiting, after adjusting for socio-demographic background. Heavy drinking was 2.6 times more common among divorced/separated and 1.7 times more common among widowed men compared to married/cohabiting men, while there was no such association among women. For women, heavy drinking was associated with being single (PR = 1.7; 95% CI: 1.0, 2.9). Being widowed was related to a lower prevalence of having visited a dentist compared to being married or living with a partner (PR = 0.92; 95% CI 0.86, 0.99). Those with a larger circle of friends were more likely to be physically active (PR = 1.17; 95% CI:1.06, 1.28 for 5–8 versus less than 5 friends).
Conclusions
Social relationships of older Americans were independently associated with different health-related behaviors, even after adjusting for demographic and socioeconomic determinants. Availability of emotional support did not however mediate these associations. More research is needed to assess if strengthening social relationships would have a significant impact on older people’s health behaviors and ultimately improve their health.
【 授权许可】
2014 Watt et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150226150304977.pdf | 209KB | download |
【 参考文献 】
- [1]World Health Organisation: Global Health Risks. Mortality and Burden of Disease Attributable to Selected Major Risks. Geneva: World Health Organisation; 2009.
- [2]LaCroix AZ, Gurainik JM, Berkman LF, Wallace RB, Satterfield S: Maintaining mobility in later life: II Smoking, alcohol consumption, physical activity and body mass index. Am J Epidemiol 1993, 137:858-869.
- [3]Feart C, Peres K, Samieri C, Letenneur L, Dartigues JF, Barberger-Gateau P: Adherence to a Mediterranean diet and onset of disability in older persons. Eur J Epidemiol 2011, 26:747-756.
- [4]Chakravarty EF, Hubert HB, Krishnan E, Bruce BB, Lingala VB, Fries JF: Lifestyle risk factors predict disability and death in healthy aging adults. Am J Med 2012, 125:190-197.
- [5]Tsubota-Utsugi M, Ito-Sato R, Ohkubo T, Kikuya M, Asayama K, Metoki H, Fukushima N, Kurimoto A, Tsubono Y, Imai Y: Health behaviors as predictors for declines in higher level functional capacity in older adults: the Ohasama Study. J Am Geriatr Soc 2011, 57:1993-2000.
- [6]Maraldi C, Harris TB, Newman AB, Kritchevsky SB, Pahor M, Koster A, Satterfield S, Ayonayon HN, Fellin R, Volpato S, Health ABC study: Moderate alcohol intake and risk of functional decline: the Health, Aging and Body Composition study. J Am Geriatr Soc 2009, 57:1767-1775.
- [7]Artaud F, Dugravot A, Sabia S, Singh-Manoux A, Tzourio C, Elbaz A: Unhealthy behaviours and disability in older adults: Three-City Dijon cohort study. BMJ 2013, 347:4240.
- [8]Sabia S, Singh-Manoux A, Hagger-Johnson G, Cambois E, Brunner EJ, Kivimaki M: Influence of individual and combined healthy behaviours on successful aging. CMAJ 2012, 184:1985-1992.
- [9]Emmons EM: Health behaviors in a social context. In Social Epidemiology. Edited by Berkman LF, Kawachi I. Oxford: Oxford University Press; 2000:242-266.
- [10]Jarvis M, Wardle J: Social patterning of individual health behaviours: the case of cigarette smoking. In Social Determinants of Health. Edited by Marmot M, Wilkinson R. Oxford: Oxford University Press; 1999.
- [11]Berkman LF, Glass T: Social integration, social networks, social support and health. In Social Epidemiology. Edited by Berkman LF, Kawachi I. Oxford: Oxford University Press; 2000:137-173.
- [12]Umberson D, Crosnoe R, Reczek C: Social relationships and health behavior across the life course. Annu Rev Sociol 2010, 36:139-157.
- [13]Laursen B, Bukowski WM: A developmental guide to the organisation of close relationships. Int J Behav Dev 1997, 21:747-770.
- [14]Jessor R: Critical issues in research on adolescents’ health promotion. In Promoting Adolescent Health. A Dialogue on Research and Practice. Edited by Coates TJ, Petersen AC, Perry L. York: Academic Press; 1982:447-465.
- [15]Berkman LF, Breslow L: Health and Ways of Living: The Alameda County Study. New York: Oxford University Press; 1983.
- [16]Waite LJ: Does marriage matter? Demography 1995, 32:483-508.
- [17]Denney JT: Family and household formations and suicide in the United States. J Marriage Fam 2010, 72:202-213.
- [18]Musick MA, House JS, Williams DR: Attendance at religious services and mortality in a national sample. J Health Soc Behav 2004, 45:198-213.
- [19]Seeman M, Seeman A, Budros A: Powerlessness, work and community: a longitudinal study of alienation and alcohol use. J Health Soc Behav 1988, 29:185-198.
- [20]Lindstrom M, Isacsson SO, Elmstahl S, The Malmö Shoulder-Neck Study Group: Impact of different aspects of social participation and social capital on smoking cessation among daily smoker: a longitudinal study. Tob Control 2003, 12:274-281.
- [21]Lindstrom M: Social capital, economic conditions, martial status and daily smoking: a population-based study. Public Health 2010, 124:71-77.
- [22]Kim D, Subramanian SV, Gortmaker SL, Kawachi I: US state and county level social capital in relation to obesity and physical inactivity: a multilevel, multivariable analysis. Soc Sci Med 2003, 63:1045-1059.
- [23]Weyers S, Dragano N, Mobus S, Beck EM, Stang A, Möhlenkamp S, Jöckel KH, Erbel R, Siegrist J: Poor social relations and adverse health behavior: stronger associations in low socioeconomic groups? Int J Public Health 2010, 55:17-23.
- [24]Seeman TE, Crimmins E: Social environment effects on health and aging. Integrating epidemiologic and demographic approaches and perspectives. Ann N Y Acad Sci 2001, 954:88-117.
- [25]Frongillo EA, Rauschenbach BS, Roe DA, Williamson DF: Characteristics related to elderly persons’ not eating for 1 or more days: implications for meal programs. Am J Public Health 1992, 82:600-602.
- [26]Kang SH, Bloom JR: Social support and cancer screening among older black Americans. J Natl Cancer Inst 1993, 85:737-742.
- [27]Burr JA, Lee HJ: Social relationships and dental care service utilization among older adults. J Aging Health 2012, 25:191-200.
- [28]Shiovitz-Ezra A, Litwin H: Social network type and health-related behaviors: evidence from an American national survey. Soc Sci Med 2012, 75:901-904.
- [29]McGrath C, Bedi R: Influences of social support on the oral health of older people in Britain. J Oral Rehabil 2002, 29:918-922.
- [30]CDC: Analytic and Reporting Guidelines: The National Health and Nutrition Examination Survey (NHANES). Hyattsville: National Center for Health Statistics, Centers for Disease Control and Prevention; 2006.
- [31]CDC: Key concepts about survey methodology. Continuous NHANES Web Tutorial. [http://www.cdc.gov/nchs/tutorials/NHANES/SurveyOrientation/DataStructureContents/intro.htm webcite] Accessed 28 May 2013
- [32]U.S. Department of Agriculture and U.S. Department of Health and Human Services: Foods and Food Components to Reduce. In Dietary Guidelines for Americans. 7th edition. Washington, DC: US Government Printing Office; 2010:30-32.
- [33]Manzoli L, Villari P, Pirone G, Boccia A: Marital status and mortality in the elderly: a systematic review and meta-analysis. Soc Sci Med 2007, 64:77-94.
- [34]Hoppmann C, Gerstorf D: Spousal interrelations in old age - a mini-review. Gerontology 2009, 55:449-459.
- [35]Mead N, Lester H, Chew-Graham C, Gask L, Bower P: Effects of befriending on depressive symptoms and distress: systematic review and meta-analysis. Br J Psychiatry 2010, 196:96-101.
- [36]Marcenes WS, Sheiham A: The relationship between marital quality and oral health status. Psychology Health 1996, 11:357-369.
- [37]Merchant AT, Pitiphat W, Ahmed B, Kawachi I, Joshipura K: A prospective study of social support, anger expression and risk of periodontitis in men. J Am Dent Assoc 2003, 134:1591-1596.
- [38]Aida J, Hanibuchi T, Nakade M, Hirai H, Osaka K, Kondo K: The different effects of vertical social capital and horizontal social capital on dental status: a multilevel analysis. Soc Sci Med 2009, 69:512-518.
- [39]Sabbah W, Tsakos G, Chandola T, Newton T, Kawachi I, Sheiham A, Marmot MG, Watt RG: The relationship between social network, social support and periodontal disease among older Americans. J Clin Periodontol 2011, 38:547-552.
- [40]Tsakos G, Sabbah W, Chandola T, Newton T, Kawachi I, Aida J, Sheiham A, Marmot MG, Watt RG: Social relationships and oral health among adults aged 60 years or older. Psychosom Med 2013, 75:178-186.
- [41]Statacorp: Stata Statistical Software: Release 12. College Station: StataCorp LP; 2011.
- [42]Barros A, Hirakata V: Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Me Res Methodol 2003, 3:1-13.
- [43]House JS, Landis KR, Umberson D: Social relationships and health. Science 1988, 241:540-545.
- [44]Holt-Lunstad J, Smith TB, Layton JB: Social relationships and mortality risk: a meta-analytic review. PLoS Medicine 2010, 7:e1000316.
- [45]Eng PM, Kawachi I, Fitzmaurice G, Rimm EB: Effects of marital transitions on changes in dietary and other health behavious in US male health professionals. J Epidemiol Community Health 2005, 59:56-62.
- [46]Lee S, Cho E, Grodstein F, Kawachi I, Hu FB, Colditz GA: Effects of marital transitions on changes in dietary and other health behaviours in US women. Int J Epid 2005, 34:69-78.
- [47]Umberson D: Gender, marital status and the social control of health behavior. Soc Sci Med 1992, 34:907-917.
- [48]National Institute on Alcohol Abuse and Alcoholism: Occupational alcoholism: a review of research. Research Monograph no 8. Washington, DC: US GPO; 1982.
- [49]Kleinke CL, Staneski RA, Meeker FB: Attributions for smoking behavior: comparing smokers with non-smokers and predicting smokers’ cigarette consumption. J Res Pers 1983, 17:242-255.
- [50]Berkman L, Syme SL: Social networks, host resistance and mortality: a nine-year follow up of Alameda county residents. Am J Epidemiol 1979, 109:186-204.
- [51]Cohen S, Wills TA: Stress, social support and the buffering hypothesis. Psychol Bull 1985, 98:310-357.
- [52]Cornwell B, Schumm LP, Laumann EO, Graber J: Social networks in the NSHAP study: rationale, measurement and preliminary findings. J Gerontol B Psychol Sci Soc Sci 2009, 64:47-55.
- [53]Kenfield SA, Stampfer MJ: Healthy behaviours yield major benefits in ageing. BMJ 2013, 347:f5156.