Berkman Lisa F, Melchior Maria, Chastang Jean-François, Niedhammer Isabelle, Leclerc Annette, Goldberg Marcel
Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02115, USA.
Am J Epidemiol. 2004 Jan 15;159(2):167-74. doi: 10.1093/aje/kwh020.
The authors investigated associations between social integration and all-cause and cause-specific mortality among French employees of Electricity of France-Gas of France. A total of 12,347 men aged 40-50 years in 1989 and 4,352 women aged 35-50 years in 1989 comprised the sample. In age-adjusted survival analyses for all causes of death, men who were least socially integrated were 4.42 times as likely to die during follow-up (1993-1999) as those with the highest level of integration (p < 0.0001). After adjustment for age, occupation, smoking, alcohol consumption, body mass index, self-reported health, depressive symptoms, and region of France, relative risks for men ranging from the least socially integrated to the most socially integrated were 2.70 (95% confidence interval (CI): 1.17, 6.23), 1.95 (95% CI: 1.25, 3.04), and 1.37 (95% CI: 0.92, 2.04) in comparison with the most integrated men. In multivariate cause-specific analyses, isolated men had elevated risks of dying from cancer (relative risk = 3.60) and from accidents and suicide (relative risk = 3.54). Among women, in multivariate analyses, the relative risk was 3.64 (95% CI: 0.72, 18.58). The small number of deaths among women (n = 29) limited statistical power and prohibited cause-specific analyses. These results suggest that in this employed cohort of middle-aged men and women, social integration is an important predictor of mortality.
作者调查了法国电力公司-法国燃气公司的法国员工中社会融合与全因死亡率及特定病因死亡率之间的关联。样本包括1989年的12347名年龄在40至50岁之间的男性和1989年的4352名年龄在35至50岁之间的女性。在对所有死因进行年龄调整的生存分析中，社会融合程度最低的男性在随访期间（1993 - 1999年）死亡的可能性是社会融合程度最高的男性的4.42倍（p < 0.0001）。在对年龄、职业、吸烟、饮酒、体重指数、自我报告的健康状况、抑郁症状和法国地区进行调整后，社会融合程度从最低到最高的男性与社会融合程度最高的男性相比，相对风险分别为2.70（95%置信区间（CI）：1.17，6.23）、1.95（95% CI：1.25，3.04）和1.37（95% CI：0.92，2.04）。在多变量特定病因分析中，独居男性死于癌症（相对风险 = 3.60）以及死于事故和自杀（相对风险 = 3.54）的风险升高。在女性中，多变量分析显示相对风险为3.64（95% CI：0.72，18.58）。女性死亡人数较少（n = 29），限制了统计效力，无法进行特定病因分析。这些结果表明，在这个中年男性和女性就业队列中，社会融合是死亡率的一个重要预测因素。
