Zunzunegui M V, Koné A, Johri M, Béland F, Wolfson C, Bergman H
SOLIDAGE, Université de Montréal, McGill University, Canada.
Soc Sci Med. 2004 May;58(10):2069-81. doi: 10.1016/j.socscimed.2003.08.005.
The objective was to evaluate the associations between older persons' health status and their social integration and social networks (family, children, friends and community), in two French-speaking, Canadian community dwelling populations aged 65 years and over, using the conceptual framework proposed by Berkman and Thomas. Data were taken from two 1995 surveys conducted in the city of Moncton (n = 1518) and the Montreal neighbourhood of Hochelaga-Maisonneuve (n = 1500). Social engagement (a cumulative index of social activities), networks consisting of friends, family and children and social support were measured using validated scales. Multiple logistic regressions based on structured inclusion of potentially mediating variables were fitted to estimate the associations between health status and social networks. Self-rated health was better for those with a high level of social integration and a strong network of friends in both locations. In addition, in Hochelaga-Maisonneuve family and children networks were positively associated with good health, though the effect of friend networks was attenuated in the presence of disability, good social support from children was associated with good health. Age, sex and education were included as antecedent variables; smoking, alcohol consumption, exercise, locus of control and depressive symptoms were considered intermediary variables between social networks and health. In conclusion, social networks, integration and support demonstrated unique positive associations with health. The nature of these associations may vary between populations and cultures.
目的是利用伯克曼和托马斯提出的概念框架,在加拿大两个讲法语、居住在社区的65岁及以上人群中,评估老年人的健康状况与其社会融合及社会网络(家庭、子女、朋友和社区)之间的关联。数据取自1995年在蒙克顿市(n = 1518)和蒙特利尔市霍谢拉 - 梅松纳夫街区(n = 1500)进行的两项调查。使用经过验证的量表测量社会参与度(社会活动的累积指数)、由朋友、家庭和子女组成的网络以及社会支持。基于对潜在中介变量的结构化纳入进行多元逻辑回归,以估计健康状况与社会网络之间的关联。在两个地点,社会融合程度高且有强大朋友网络的人自我评估的健康状况更好。此外,在霍谢拉 - 梅松纳夫,家庭和子女网络与良好健康呈正相关,不过在存在残疾的情况下朋友网络的影响减弱,来自子女的良好社会支持与良好健康相关。年龄、性别和教育作为先行变量纳入;吸烟、饮酒、锻炼、控制点和抑郁症状被视为社会网络与健康之间的中介变量。总之,社会网络、融合和支持与健康呈现出独特的正相关。这些关联的性质可能因人群和文化而异。