Department of Family Medicine, Seoul National University- Seoul Metropolitan Government Boramae Medical Center, Seoul, South Korea.
Department of Medicine, Seoul National University Graduate School, Seoul, South Korea.
BMC Public Health. 2020 Dec 1;20(1):1844. doi: 10.1186/s12889-020-09964-z.
Although social capital has been shown to be one of the important social determinants of health, the association between social trust and the risk of cardiovascular disease (CVD) is not clear yet. We aimed to investigate the association of social trust with CVD risk using a large Korean population based data.
The data of this study was derived from the Korean National Health Insurance Service database. Community-level social trust was determined from the Korean Community Health Survey. The study population consisted of 2,156,829 participants. According to social trust index measured in the area of residence during 2011, participants were followed-up from 1 January 2012 to 31 December 2016. Multivariate Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD risk according to quintiles of social trust.
Compared to participants with the lowest quintile of social trust, those within the highest quintile had lower risk for CVD (aHR 0.91, 95% CI = 0.89 to 0.93), CHD (aHR 0.92, 95% CI = 0.89 to 0.95), and stroke (aHR 0.90, 95% CI = 0.87 to 0.93). The risk-reducing association of high social trust on CVD risk was preserved after additional adjustments for lifestyle behaviors including smoking, alcohol consumption, and physical activity.
Higher social trust was associated with reduced risk of CVD even after considering lifestyle behaviors. Social trust in a community level is an important determinant of CVD and enhancing social trust may lead to reduced risk of CVD.
尽管社会资本已被证明是健康的重要社会决定因素之一，但社会信任与心血管疾病 (CVD) 风险之间的关联尚不清楚。我们旨在使用大型韩国人群数据研究社会信任与 CVD 风险之间的关系。
本研究的数据来自韩国国家健康保险服务数据库。社区层面的社会信任是根据韩国社区健康调查确定的。研究人群由 2156829 名参与者组成。根据 2011 年居住地区测量的社会信任指数，从 2012 年 1 月 1 日至 2016 年 12 月 31 日对参与者进行随访。使用多变量 Cox 比例风险回归来确定根据社会信任五分位数的 CVD 风险的调整后危险比 (aHR) 和 95%置信区间 (CI)。
与社会信任最低五分位的参与者相比，处于最高五分位的参与者 CVD 风险较低 (aHR 0.91, 95%CI=0.89 至 0.93)、冠心病 (aHR 0.92, 95%CI=0.89 至 0.95) 和中风 (aHR 0.90, 95%CI=0.87 至 0.93)。在进一步调整包括吸烟、饮酒和体育活动在内的生活方式行为后，高社会信任对 CVD 风险的降低风险仍然存在。
即使考虑到生活方式行为，较高的社会信任与 CVD 风险降低相关。社区层面的社会信任是 CVD 的一个重要决定因素，增强社会信任可能会降低 CVD 的风险。
