title: Socioeconomic status, structural and functional measures of social support, and mortality: The British Whitehall II Cohort Study, 1985-2009.
abstract: The authors examined the associations of social support with socioeconomic status (SES) and with mortality, as well as how SES differences in social support might account for SES differences in mortality. Analyses were based on 9,333 participants from the British Whitehall II Study cohort, a longitudinal cohort established in 1985 among London-based civil servants who were 35-55 years of age at baseline. SES was assessed using participant's employment grades at baseline. Social support was assessed 3 times in the 24.4-year period during which participants were monitored for death. In men, marital status, and to a lesser extent network score (but not low perceived support or high negative aspects of close relationships), predicted both all-cause and cardiovascular mortality. Measures of social support were not associated with cancer mortality. Men in the lowest SES category had an increased risk of death compared with those in the highest category (for all-cause mortality, hazard ratio = 1.59, 95% confidence interval: 1.21, 2.08; for cardiovascular mortality, hazard ratio = 2.48, 95% confidence interval: 1.55, 3.92). Network score and marital status combined explained 27% (95% confidence interval: 14, 43) and 29% (95% confidence interval: 17, 52) of the associations between SES and all-cause and cardiovascular mortality, respectively. In women, there was no consistent association between social support indicators and mortality. The present study suggests that in men, social isolation is not only an important risk factor for mortality but is also likely to contribute to differences in mortality by SES.
authors.affiliation: INSERM U, Centre for Research in Epidemiology and Population Health, Villejuif, France. silvia.stringhini@chuv.ch
authors.forename: Silvia
authors.initials: S
authors.lastname: Stringhini
authors.forename: Lisa
authors.initials: L
authors.lastname: Berkman
authors.forename: Aline
authors.initials: A
authors.lastname: Dugravot
authors.forename: Jane E
authors.initials: JE
authors.lastname: Ferrie
authors.forename: Michael
authors.initials: M
authors.lastname: Marmot
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimaki
authors.forename: Archana
authors.initials: A
authors.lastname: Singh-Manoux
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008131:London / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009026:Mortality; D016016:Proportional Hazards Models; D057566:Self Report; D012737:Sex Factors; D012923:Social Class; D012944:Social Support