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