老年人感知的邻里社会凝聚力与后续的健康和幸福感：一种全结局纵向研究方法。
Perceived neighborhood social cohesion and subsequent health and well-being in older adults: An outcome-wide longitudinal approach.
机构信息
Department of Psychology, University of British Columbia, Vancouver, Canada; Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA.
Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
出版信息
Health Place. 2020 Nov;66:102420. doi: 10.1016/j.healthplace.2020.102420. Epub 2020 Sep 6.
BACKGROUND
Growing research documents associations between neighborhood social cohesion with better health and well-being. However, other work has identified social cohesion's "dark side" and its ability to promote negative outcomes. It remains unclear if such diverging findings are attributable to differences in study design, or other reasons. To better capture its potential heterogeneous effects, we took an outcome-wide analytic approach to examine perceived neighborhood social cohesion in relation to a range of health and well-being outcomes.
METHODS
Data were from 12,998 participants in the Health and Retirement Study-a large, diverse, prospective, and nationally representative cohort of U.S. adults age >50. Multiple regression models evaluated if social cohesion was associated with physical health, health behavior, psychological well-being, psychological distress, and social well-being outcomes. All models adjusted for sociodemographics, personality, and numerous baseline health and well-being characteristics. To evaluate the effects of change in cohesion, we adjusted for prior social cohesion. Bonferroni correction was used to account for multiple testing.
RESULTS
Perceived neighborhood social cohesion was not associated with most physical health outcomes (except for reduced risk of physical functioning limitations and better self-rated health) nor health behavior outcomes (except for more binge drinking). However, it was associated with numerous subsequent psychosocial well-being (i.e., higher: positive affect, life satisfaction, optimism, purpose in life, mastery, health mastery, financial mastery; reduced likelihood of infrequent contact with friends) and psychological distress outcomes (i.e., lower depression, hopelessness, negative affect, loneliness) over the 4-year follow-up period.
CONCLUSIONS
With further research, these results suggest that perceived neighborhood social cohesion might be a valuable target for innovative policies aimed at improving well-being.
背景
越来越多的研究文献证明了邻里社会凝聚力与更好的健康和幸福感之间存在关联。然而，其他研究也发现了社会凝聚力的“阴暗面”及其促进负面结果的能力。目前还不清楚这些相互矛盾的发现是由于研究设计的差异，还是其他原因。为了更好地捕捉其潜在的异质效应，我们采用了一种全结果分析方法，研究了感知邻里社会凝聚力与一系列健康和幸福感结果之间的关系。
方法
数据来自于 12998 名参加健康与退休研究的参与者，这是一项针对美国 50 岁以上成年人的大型、多样化、前瞻性和全国代表性队列研究。多元回归模型评估了社会凝聚力是否与身体健康、健康行为、心理幸福感、心理困扰和社会幸福感结果相关。所有模型都调整了社会人口统计学、个性和许多基线健康和幸福感特征。为了评估凝聚力变化的影响，我们调整了先前的社会凝聚力。采用 Bonferroni 校正来考虑多次测试。
结果
感知邻里社会凝聚力与大多数身体健康结果（除了降低身体功能障碍的风险和更好的自我报告健康状况）以及健康行为结果（除了更多的狂饮行为）无关。然而，它与随后的许多心理社会幸福感（即更高的积极情绪、生活满意度、乐观、生活目标、掌握感、健康掌握感、财务掌握感；降低与朋友不常联系的可能性）和心理困扰结果（即更低的抑郁、绝望、消极情绪、孤独感）相关，在 4 年的随访期间。
结论
随着进一步的研究，这些结果表明，感知邻里社会凝聚力可能是改善幸福感的创新政策的一个有价值的目标。
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