title: The relationship between five different measures of structural social capital, medical examination outcomes, and mortality.
abstract: Higher social capital is associated with improved mental and physical health and reduced risk of premature mortality. We explored the relationship between five measures of structural social capital and 1) intermediate health outcomes (elevated C-reactive protein, cholesterol, blood pressure, and serum fibrinogen) and 2) distal outcomes (cardiovascular and all cause mortality). We did so using the National Health and Nutrition Examination Survey III 1988-1994 linked to the National Death Index with mortality follow-up through 2006. We employed ordinary least squares regression for the intermediate outcomes, seemingly unrelated regression (SUR) to consider combined effects, and Cox proportionate hazards models for mortality outcomes. We then performed extensive sensitivity analyses, exploring the contribution of various variables and reverse causality. We find that our measures of social capital did not predict statistically significant changes in the laboratory biomarkers we study. Nevertheless, belonging to organizations or attending church >12 times per year were associated with reduced all cause mortality (hazard ratio [HR] = 0.81, 95% confidence interval [CI] = 0.70-0.93 and HR = 0.72, 95% CI = 0.60-0.86, respectively). In SUR analyses, however, combined laboratory values were significant for all measures of social capital we study with the exception of visits to neighbors. This suggests that some forms of structural social capital improve survival through small changes in multiple measures of biological risk factors rather than moderate or large changes in any one measure.
authors.affiliation: Columbia University, Mailman School of Public Health, 600 West 168th St., 6th Floor, New York, NY 10032, USA. pm124@columbia.edu
authors.forename: Peter
authors.initials: P
authors.lastname: Muennig
authors.forename: Alison K
authors.initials: AK
authors.lastname: Cohen
authors.forename: Aileen
authors.initials: A
authors.lastname: Palmer
authors.forename: Wenyi
authors.initials: W
authors.lastname: Zhu
mesh_terms: D000328:Adult; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005500:Follow-Up Studies; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends*; D009749:Nutrition Surveys; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
chemical_list: D005340:Fibrinogen; D002097:C-Reactive Protein; D002784:Cholesterol