Social Isolation: A Predictor of Mortality Comparable to Traditional Clinical Risk Factors
Social Isolation: A Predictor of Mortality Comparable to Traditional Clinical Risk Factors
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DOI：
10.2105/ajph.2013.301261
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发表时间：
2013-11-01
影响因子：
12.7
通讯作者：
Adler, Nancy
中科院分区：
文献类型：
--
作者：
Pantell, Matthew;Rehkopf, David;Adler, Nancy
目标。我们在一个具有全国代表性的美国样本中探索了社会隔离与死亡率之间的关系，并比较了社会隔离与传统临床危险因素的预测能力。我们使用了来自第三次全国健康和营养检查调查和国家死亡指数的16849名成年人的数据。预测变量为4个社会隔离因子和1个综合指数。比较预测因素包括吸烟、肥胖、高血压和高胆固醇。使用未调整的Kaplan-Meier表和控制社会人口学特征的Cox比例风险回归模型来预测死亡率。与世隔绝的男性和女性的未经调整的生存曲线比不那么与世隔绝的人更差。考克斯模型显示，社会隔离预测两性的死亡率，吸烟和高血压也是如此。在男性中，个人社会预测因素包括未婚、不经常参加宗教活动、没有俱乐部或组织背景；在女性中，显著预测因素是未婚、不经常社交和不经常参加宗教活动。社会隔离作为死亡率预测因子的强度与有充分证据的临床风险因素相似。我们的结果表明评估患者的社会隔离水平的重要性。
Objectives. We explored the relationship between social isolation and mortality in a nationally representative US sample and compared the predictive power of social isolation with that of traditional clinical risk factors.Methods. We used data on 16 849 adults from the Third National Health and Nutrition Examination Survey and the National Death Index. Predictor variables were 4 social isolation factors and a composite index. Comparison predictors included smoking, obesity, elevated blood pressure, and high cholesterol. Unadjusted Kaplan-Meier tables and Cox proportional hazards regression models controlling for sociodemographic characteristics were used to predict mortality.Results. Socially isolated men and women had worse unadjusted survival curves than less socially isolated individuals. Cox models revealed that social isolation predicted mortality for both genders, as did smoking and high blood pressure. Among men, individual social predictors included being unmarried, participating infrequently in religious activities, and lacking club or organization affiliations; among women, significant predictors were being unmarried, infrequent social contact, and participating infrequently in religious activities.Conclusions. The strength of social isolation as a predictor of mortality is similar to that of well-documented clinical risk factors. Our results suggest the importance of assessing patients' level of social isolation.