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社区层面的社会资本与日本老年人的后续健康和幸福感:一种结果广泛的纵向研究方法。

Community-level social capital and subsequent health and well-being among older adults in Japan: An outcome-wide longitudinal approach.

机构信息

Health and Counseling Center, Osaka University, Osaka, Japan.

Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.

出版信息

Health Place. 2024 Sep;89:103336. doi: 10.1016/j.healthplace.2024.103336. Epub 2024 Aug 9.

Abstract

There is inconsistent evidence on the association between community-level social capital and the health or well-being of older adults. This study examined the association between community-level social capital and multidimensional health and well-being outcomes using an outcome-wide approach. We used data from the Japan Gerontological Evaluation Study, a nationwide cohort study of Japanese older adults (analytic samples: 47,227 for outcomes obtained from the long-term care insurance registry and 34,183 for other outcomes). We assessed three aspects of school-district-level community social capital in 2016 (civic participation, social cohesion, and reciprocity) and 41 subsequent health and well-being outcomes through 2019. We performed either a modified multilevel Poisson regression or a multilevel logistic regression analysis. We adjusted for pre-baseline characteristics, prior outcome values, and individual-level social capital from the 2013 wave. Even after Bonferroni correction, we found that community-level social capital was associated with some subsequent social well-being and physical/cognitive health. For example, community-level reciprocity was associated with a higher prevalence of taking a social role (Prevalence ratio [PR] = 1.03, 95% confidence interval [CI] = 1.02, 1.04) and undergoing health screening (PR = 1.03, 95% CI: 1.01, 1.04). There was modest evidence that community-level civic participation was associated with a higher competency of intellectual activity (PR = 1.01, 95% CI: 1.01, 1.02) and community-level social cohesion was associated with a reduced onset of functional disability (PR = 0.94, 95% CI: 0.90, 0.98). Community-level social capital may promote social well-being and some physical/cognitive health outcomes.

摘要

关于社区层面社会资本与老年人健康或福祉之间的关系,现有证据并不一致。本研究采用全结局分析方法,考察了社区层面社会资本与多维健康和福祉结局之间的关系。我们使用了来自日本老年人综合评估研究(一项针对日本老年人的全国性队列研究)的数据,分析样本包括:来自长期护理保险登记的结局(47227 例)和其他结局(34183 例)。我们于 2016 年评估了学区层面社区社会资本的三个方面(公民参与、社会凝聚力和互惠),并于 2019 年之前评估了 41 项后续健康和福祉结局。我们分别采用校正后多层次泊松回归或多层次逻辑回归分析。我们调整了基线前特征、前期结局值和 2013 年波次的个体层面社会资本。即使在 Bonferroni 校正后,我们发现社区层面社会资本与一些后续的社会福祉和身体/认知健康有关。例如,社区层面的互惠与更高的社会角色参与率(优势比 [PR] = 1.03,95%置信区间 [CI] = 1.02,1.04)和健康筛查(PR = 1.03,95%CI:1.01,1.04)有关。有适度的证据表明,社区层面的公民参与与更高的智力活动能力(PR = 1.01,95%CI:1.01,1.02)有关,社区层面的社会凝聚力与降低功能障碍的发生有关(PR = 0.94,95%CI:0.90,0.98)。社区层面的社会资本可能会促进社会福祉和一些身体/认知健康结局。

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