Kawachi I, Colditz G A, Ascherio A, Rimm E B, Giovannucci E, Stampfer M J, Willett W C
Department of Health and Social Behavior, Harvard School of Public Health, Boston, MA 02115, USA.
J Epidemiol Community Health. 1996 Jun;50(3):245-51. doi: 10.1136/jech.50.3.245.
Previous studies have established a relationship between low levels of social networks and total mortality, but few have examined cause specific mortality or disease incidence. This study aimed to examine prospectively the relationships between social networks and total and cause specific mortality, as well as cardiovascular disease incidence.
This was a four year follow up study in an ongoing cohort of men, for whom information on social networks was collected at baseline. The main outcome measures were total mortality, further categorised into deaths from cardiovascular disease (stroke and coronary heart disease), total cancer, accidents/suicides, and all other causes; as well as stroke and coronary heart disease incidence.
Altogether 32,624 US male health professionals aged 42 to 77 years in 1988, who were free of coronary heart disease, stroke, and cancer at baseline.
A total of 511 deaths occurred during 122,911 person years of follow up. Compared with men with the highest level of social networks, socially isolated men (not married, fewer than six friends or relatives, no membership in church or community groups) were at increased risk for cardiovascular disease mortality (age adjusted relative risk, 1.90; 95% CI 1.07, 3.37) and deaths from accidents and suicides (age adjusted relative risk 2.22; 95% CI 0.76, 6.47). No excess risks were found for other causes of death. Socially isolated men were also at increased risk of stroke incidence (relative risk, 2.21; 95% CI, 1.12, 4.35), but not incidence of non-fatal myocardial infarction.
Social networks were associated with lower total mortality by reducing deaths from cardiovascular disease and accidents/suicides. Strong social networks were associated with reduced incidence of stroke, though not of coronary heart disease. However, social networks may assist in prolonging the survival of men with established coronary heart disease.
既往研究已证实社交网络水平较低与全因死亡率之间存在关联,但很少有研究考察特定病因死亡率或疾病发病率。本研究旨在前瞻性地考察社交网络与全因死亡率、特定病因死亡率以及心血管疾病发病率之间的关系。
这是一项对一组正在进行随访的男性队列进行的为期四年的随访研究,在基线时收集了他们的社交网络信息。主要结局指标为全因死亡率,进一步分为心血管疾病(中风和冠心病)死亡、癌症死亡、事故/自杀死亡以及所有其他原因死亡;以及中风和冠心病发病率。
1988年共有32624名年龄在42至77岁之间的美国男性健康专业人员,他们在基线时无冠心病、中风和癌症。
在122911人年的随访期间共发生511例死亡。与社交网络水平最高的男性相比,社交孤立的男性(未婚、朋友或亲戚少于六人、未加入教会或社区团体)心血管疾病死亡率(年龄调整相对风险为1.90;95%可信区间为1.07,3.37)以及事故和自杀死亡风险增加(年龄调整相对风险为2.22;95%可信区间为0.76,6.47)。未发现其他死因存在额外风险。社交孤立的男性中风发病率也增加(相对风险为2.21;95%可信区间为1.12,4.35),但非致命性心肌梗死发病率未增加。
社交网络通过降低心血管疾病和事故/自杀死亡人数与较低的全因死亡率相关。强大的社交网络与中风发病率降低相关,而非冠心病发病率。然而,社交网络可能有助于延长已患冠心病男性的生存期。