Relationship between selected social factors and all-cause mortality.

OBJECTIVE

Evaluate the associations between several simple-to-measure social factors and all-cause mortality to determine whether selected social factors contribute useful mortality information.

METHOD

Using the Third National Health and Nutritional Examination Survey (NHANES III) and the current NHANES III Linked Mortality File datasets, associations were evaluated among 18,460 survey participants at least 20 years of age, with 5408 deaths occurring during the 280,183 person-year follow-up. Selected social factors, including education level, current employment status, and frequency of interpersonal contact with friends/relatives, were analyzed using a Cox proportional hazard model, and the impact of the selected social factors on mortality was expressed as a hazard ratio. Associations were modeled adjusting for age and gender only and also in a multivariate regression analysis; furthermore, associations were evaluated when stratified by duration of follow up.

RESULTS

In a multivariate Cox model, independent hazard ratios for higher education, being employed, being married, frequent phone conversations with friends, frequent visits with friends or relatives, frequent church attendance, and participation in a social group ranged between 0.56 and 0.99. All corresponding 95% confidence intervals exclude 1. Many of the associations between social factors and mortality were stronger at shorter follow-up durations.

CONCLUSION

Several easy-to-measure social factors were shown to be significantly and independently associated with all-cause mortality.