American Journal of Epidemiology Vol. 128, No. 2: 370-380
Copyright © 1988 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
SOCIAL CONNECTIONS AND MORTALITY FROM ALL CAUSES AND FROM CARDIOVASCULAR DISEASE: PROSPECTIVE EVIDENCE FROM EASTERN FINLAND
1Human Population Laboratory, California Department of Health Services 2151 Berkeley Way, Annex 2, Berkeley, CA 94704
2Department of Community Health, University of Kuopio Kuopio, Finland
3Human Population Laboratory, California Public Health Foundation Berkeley, CA
4Program in Epidemiology, School of Public Health, University of California Berkeley, CA
5Department of Epidemiology, National Public Health Laboratory Helsinki, Finland
Reprint requests to Dr. George A. Kaplan
The association between an a priori measure of social connections and five-year mortality from all causes, cardiovascular diseases (International Classification of Diseases, Eighth Revision (ICD-8) codes 390–458), and ischemic heart disease (ICD-8 codes 410–414) was studied in 13,301 men and women from eastern Finland who were first interviewed in 1972 or 1977. For men, there was a graded association between extent of social connections and mortality. In multivariate models with adjustment for age, smoking, serum cholesterol, mean weighted blood pressure, measures of prevalent illness, and other possible confounders, men who were in the two lowest quintiles of the social connections scale were at increased risk compared with those in the highest quintile (odds ratio (OR)all cause = 1.54, 95% confidence interval (Cl) = 1.21–1.95; ORcardio-vascular disease = 1.54, 95% Cl = 1.11–2.13; ORlischemic heart disease = 1.34, 95% Cl = 0.94–1.90). No strong or consistent association was found for women. The association for men was modified by levels of blood pressure with the effect of low social connections greater at higher levels of blood pressure. In three separate analyses, there was no evidence for confounding or effect modification due to prevalent illness at baseline.
cardiovascular diseases; mortality; prospective studies; social isolation
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