title: Social participation and coronary heart disease risk in a large prospective study of UK women.
abstract: Participation in social activities is thought to prevent heart disease, but evidence is inconclusive.
  
  
  
  We assessed whether participating in social activities reduces the risk of coronary heart disease (CHD) in a large prospective study of 735,159 middle-aged UK women.
  
  
  
  Women reported their participation in eight social activities (religious group, voluntary work, adult education, art/craft/music, dancing, sports club, yoga, bingo) and were followed for first CHD event (hospital admission or death) over the next 8.6 years. Cox regression models were used to estimate relative risks for CHD incidence by participation in each and in any of the social activities.
  
  
  
  After adjustment for age and region only, every activity except bingo was associated with a reduced risk of CHD (n = 30,756 cases in total). However, after additional adjustment for 11 factors (deprivation, education, smoking, physical activity, body mass index, alcohol, marital status, self-rated health, happiness, hypertension, diabetes), every relative risk estimate moved close to 1.0. For example, for participation in any of the activities compared with none, the relative risk adjusted for age and region only was 0.83 (99% confidence interval 0.81-0.86), but changed to 1.06 (99% confidence interval 1.02-1.09) after additional adjustment. Adjustment for education, self-rated health, smoking and physical activity attenuated the associations most strongly. Residual confounding and other unmeasured factors may well account for any small remaining associations.
  
  
  
  Associations between participation in various social activities and CHD risk appear to be largely or wholly due to confounding by personal characteristics of the participants.
authors.affiliation: Nuffield Department of Population Health, University of Oxford, UK sarah.floud@ceu.ox.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Floud
authors.affiliation: Nuffield Department of Population Health, University of Oxford, UK.
authors.forename: Angela
authors.initials: A
authors.lastname: Balkwill
authors.affiliation: Nuffield Department of Population Health, University of Oxford, UK.
authors.forename: Dexter
authors.initials: D
authors.lastname: Canoy
authors.affiliation: Nuffield Department of Population Health, University of Oxford, UK.
authors.forename: Gillian K
authors.initials: GK
authors.lastname: Reeves
authors.affiliation: Nuffield Department of Population Health, University of Oxford, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Green
authors.affiliation: Nuffield Department of Population Health, University of Oxford, UK.
authors.forename: Valerie
authors.initials: V
authors.lastname: Beral
authors.affiliation: Nuffield Department of Population Health, University of Oxford, UK.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Cairns
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D016017:Odds Ratio; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D058992:Social Participation; D012959:Socioeconomic Factors; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D016387:Women's Health
keywords: Coronary heart disease; incidence; social participation; women