Group of Health Economics and Health Service Management, Department of Economics, The University of Cantabria-IDIVAL, Santander, CP, Spain.
PLoS One. 2018 Oct 24;13(10):e0205062. doi: 10.1371/journal.pone.0205062. eCollection 2018.
Different studies have found that socioeconomic determinants influence the prevalence of chronic diseases in older people. However, there has been relatively little research on the incidence of how social isolation may affect them. We suggest that social isolation is a serious concern for people living with chronic illnesses.
In this paper, we examine whether there is an increase in the propensity of being diagnosed with chronic illnesses because of a decrease in social relations for elderly Europeans. We have used a panel data for Waves 1-6 (2004-2015) of Survey on Health, Ageing and Retirement in Europe (SHARE) and logistic regressions. Besides, we have studied three geographic macro-areas (Nordic, Continental and Southern). Being diagnosed with three or more chronic diseases is considered as a dependent variable, and as social control variables we have used three isolation proxies (living alone, providing help to family, friends or neighbours and participation-club activities). Other socio-demographic variables are included (gender, age, educational level, job situation, area of location and quality of life).
Our results for the full sample indicate that people who participate in social activities have fewer probability of suffering from chronic diseases (OR = 0.70, 95% CI 0.54, 0.92). For people who live alone the reverse effect is observed (OR = 1.20, 95% CI 1.04, 1.39). Differences are shown by macro-areas, e.g. providing help (OR = 0.58, 95% CI 0.34, 0.97) isolation proxy is significant for the Nordic macro-area. Club-participation activities and living alone are significant for Continental and Southern macro-areas, respectively (OR = 0.65, 95% CI 0.55, 0.82; OR = 1.46, 95% CI 1.21, 1.77).
Social isolation increases the risk of being diagnosed with chronic illnesses. That is, people with greater social participation have lower risk of suffering from multiple chronic diseases. This risk linked to isolation, together with the traditional one associated with lifestyles, should be considered in the development of new public policies.
不同的研究发现,社会经济决定因素会影响老年人慢性病的患病率。然而,关于社会隔离如何影响慢性病发病率的研究相对较少。我们认为,社会隔离是慢性病患者面临的一个严重问题。
在本文中,我们考察了由于老年人社会关系减少,是否会增加他们患慢性病的倾向。我们使用了欧洲健康、老龄化和退休调查(SHARE)的第 1-6 波(2004-2015 年)面板数据和逻辑回归。此外,我们研究了三个地理大区(北欧、大陆和南欧)。被诊断患有三种或更多种慢性病被视为因变量,而社会隔离的三个代理变量(独居、为家人、朋友或邻居提供帮助以及参与俱乐部活动)被用作社会控制变量。还包括其他社会人口统计学变量(性别、年龄、教育水平、工作状况、地理位置和生活质量)。
我们对全样本的结果表明,参与社会活动的人患慢性病的概率较低(OR=0.70,95%CI 0.54-0.92)。对于独居的人,相反的效果是观察到的(OR=1.20,95%CI 1.04-1.39)。不同的大区显示出差异,例如,提供帮助(OR=0.58,95%CI 0.34-0.97)隔离代理对北欧大区是显著的。俱乐部活动和独居分别对大陆和南欧大区具有显著影响(OR=0.65,95%CI 0.55-0.82;OR=1.46,95%CI 1.21-1.77)。
社会隔离会增加患慢性病的风险。也就是说,社会参与度较高的人患多种慢性病的风险较低。这种与隔离相关的风险,加上与生活方式相关的传统风险,应在新公共政策的制定中加以考虑。