Social integration and risk of mortality among African-Americans: the Jackson heart study.
Social integration and risk of mortality among African-Americans: the Jackson heart study.
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DOI：
10.1007/s00127-023-02485-1
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发表时间：
2023-09
影响因子：
4.4
通讯作者：
Kubzansky, Laura D.
中科院分区：
文献类型：
--
作者：
Lee, Harold H.;Okuzono, Sakurako S.;Trudel-Fitzgerald, Claudia;James, Peter;Koga, Hayami K.;Sims, Mario;Grodstein, Francine;Kubzansky, Laura D.
关键词：
有证据表明，社会融合程度越高，死亡率越低。然而，非裔美国人的研究是有限的。我们研究了来自杰克逊心脏研究的5306名非洲裔美国人的较高的社会融合是否与较低的死亡率有关，这些人在2000-2004年完成了伯克曼-赛姆社会网络指数，并被跟踪到2018年。我们使用Cox比例风险模型按社会网络指数类别（即高度社会隔离、中度社会隔离[参照组]、中度社会整合、高度社会整合）估计死亡率的风险比（HR）。协变量包括基线社会人口统计学、抑郁症状、健康状况和健康行为。与中度隔离相比，中度整合与死亡率降低11%相关（HR = 0.89, 95%可信区间[CI] 0.77, 1.03），高度整合与死亡率降低25%相关（HR = 0.75, 95%可信区间[CI] 0.64, 0.87），控制了社会人口统计学和抑郁症状；与中等隔离相比，高隔离的死亡率高出34% （HR = 1.34, 95% CI 1.00, 1.79）。进一步调整潜在的中介因素（健康状况和健康行为）只会略微减弱hr（例如，HRmoderate整合= 0.90,95% CI 0.78, 1.05； HRhigh整合= 0.77,95% CI 0.66, 0.89）。社会融合可能是一项社会心理健康资产，未来需要开展工作，以确定观察到的与非裔美国人死亡率相关的生物行为过程。在线版本包含补充材料，下载地址为10.1007/s00127-023-02485-1。
Evidence suggests that greater social integration is related to lower mortality rates. However, studies among African-Americans are limited. We examined whether higher social integration was associated with lower mortality in 5306 African-Americans from the Jackson Heart Study, who completed the Berkman-Syme Social Network Index in 2000–2004 and were followed until 2018. We estimated hazard ratios (HR) of mortality by categories of the Social Network Index (i.e., high social isolation, moderate social isolation [reference group], moderate social integration, high social integration) using Cox proportional hazard models. Covariates included baseline sociodemographics, depressive symptoms, health conditions, and health behaviors. Compared with moderate isolation, moderate integration was associated with an 11% lower mortality rate (HR = 0.89, 95% confidence interval [CI] 0.77, 1.03), and high integration was associated with a 25% lower mortality rate (HR = 0.75, 95% CI 0.64, 0.87), controlling for sociodemographics and depressive symptoms; compared with moderate isolation, high isolation was related to a 34% higher mortality rate (HR = 1.34, 95% CI 1.00, 1.79). Further adjustment of potential mediators (health conditions and health behaviors) only slightly attenuated HRs (e.g., HRmoderate integration = 0.90, 95% CI 0.78, 1.05; HRhigh integration = 0.77, 95% CI 0.66, 0.89). Social integration may be a psychosocial health asset with future work needed to identify biobehavioral processes underlying observed associations with mortality among African-Americans. The online version contains supplementary material available at 10.1007/s00127-023-02485-1.
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