School of Political Science and Public Administration, East China University of Political Science and Law, Shanghai 201620, China.
Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China.
Int J Environ Res Public Health. 2019 Apr 27;16(9):1498. doi: 10.3390/ijerph16091498.
Social relationships are associated with all-cause mortality. Substantial uncertainties remain, however, for the associations of social relationships with mortality from subtypes of cardiovascular disease (CVD) and major non-vascular diseases. This prospective cohort study estimated mortality risks according to social support and social integration utilizing a nationally representative sample of 29,179 adults ages 18 years and older. Cox proportional hazards regression models were employed. Social integration, but not social support was associated with all-cause mortality risk. For CVD mortality, social integration predicted a 33% lower risk (HR = 0.67, 95% CI = 0.53-0.86). The results were similar in magnitude for heart disease mortality. Participants with the highest social integration level had a 53%, 30%, and 47% decreased mortality risk of diabetes, Alzheimer's disease, and chronic lower respiratory diseases (CLRD) than those with the lowest level. These social integration associations were linear and consistent across baseline age, sex and socioeconomic status. We did not observe an association of social integration with the risk of cancer mortality. Our findings support the linear association of social integration but not social support with mortality from a range of major chronic diseases in the US adult population, independent of socioeconomic status (SES), behavioral risk factors, and health status.
社会关系与全因死亡率有关。然而，社会关系与心血管疾病（CVD）和主要非血管疾病死亡率的关联仍存在很大的不确定性。本前瞻性队列研究利用全国代表性的 29179 名 18 岁及以上成年人样本，根据社会支持和社会融合来估计死亡率风险。采用 Cox 比例风险回归模型。社会融合，而不是社会支持与全因死亡率风险相关。对于 CVD 死亡率，社会融合预测风险降低 33%（HR=0.67，95%CI=0.53-0.86）。心脏病死亡率的结果也相似。社会融合程度最高的参与者患糖尿病、阿尔茨海默病和慢性下呼吸道疾病（CLRD）的死亡率比最低水平的参与者分别降低了 53%、30%和 47%。这些社会融合关联是线性的，且在基线年龄、性别和社会经济地位方面具有一致性。我们没有观察到社会融合与癌症死亡率风险之间的关联。我们的研究结果支持社会融合与美国成年人一系列主要慢性疾病死亡率之间的线性关联，而与社会经济地位（SES）、行为风险因素和健康状况无关。
