Social
Prospective associations between the quality and quantity of social relations and self-rated health in the National Social Life, Health, and Aging Project (NSHAP) Taymara Abreu* Taymara Abreu Joreintje Mackenbach Joline Beulens Ilonca Vaartjes Ichiro Kawachi
Background: Little is known about the joint effects of quality and quantity of social relations on health and few studies differentiate between positive and negative social support.
Aim: We prospectively examined the association between quality and quantity of social relations and self-rated health (SRH).
Methods: Community-residing older U.S. adults aged 57–85 years at baseline were prospectively followed over 10 years in the population-based National Social Life, Health, and Aging Project (NSHAP). Social relation measures were obtained through the baseline survey and reported about friends, family and partner. Large social network, high positive social support and high negative social support were defined as their highest quartile. These three binary measures were combined into a multicategorical exposure variable generating eight distinct categories. SRH was measured on a 5-point Likert scale and dichotomised. Odds ratios (OR) for poor SRH (lower than “fair”) were estimated with covariate-adjusted logistic regression.
Results: In total, 1,592 participants were included. Based on the combined multicategorical exposure variable as well as independent exposure variables, only higher levels of negative social support were prospectively associated with increased likelihood of poor SRH (aOR=0.65; 95%CI 0.44-0.98). From the different social ties, only family-related negative social support was associated with SRH (aOR=0.59; 95%CI 0.39-0.90). This association was similar between genders, but only statistically significant among women. Sensitivity analysis with depressive symptoms as outcome (aOR=0.65; 95%CI 0.48-0.90) supported the hypothesis that the findings for SRH may be partially driven by mental health.
Conclusion: Negative social support particularly from family is prospectively associated with poor SRH. Our findings may offer insights for possible public policies, such as policies to alleviate the burden of informal care on families.