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PubMed2003

Do psychosocial work factors and social relations exert independent effects on sickness absence? A six year prospective study of the GAZEL cohort.

STUDY OBJECTIVES: The objective of this prospective cohort study was to determine whether psychosocial work characteristics and social relations exert independent effects on the incidence of sickness absence in a population of middle aged French employees over six years of follow up. DESIGN: This study included 9631 men and 3595 women participating in the French GAZEL cohort. Social relations (social networks, personal social support, and social relations satisfaction) were measured in 1994 by self report. Psychosocial work characteristics (decision latitude, psychological demands, and social support at work) were ascertained in 1995. Sickness absence data were collected independently. The authors studied the incidence of short (>7 days), intermediate (7-21 days), and long (>21 days) spells of absence from 1995 to 31 December 2001. Rate ratios associated with psychosocial exposures, adjusted on sociodemographic characteristics, and health behaviours, were calculated by means of log-linear Poisson regression. SETTING: A cohort of 20000 employees of France's national gas and electricity company (the GAZEL study). MAIN RESULTS: Among men and women, levels of decision latitude and personal social support below the median predicted 17% to 24% increases in absence rates. Low satisfaction with social relations and low social support at work lead to a 10% to 26% excess in sick leaves among men. No interactive effects were found between the variables under study. CONCLUSIONS: The quality of the work environment and of social relations affect sickness absence over an extended period of follow up. This study supports the hypothesis of independent, not interactive effects.

Adult↗
PubMedDate not supplied

Behavioral antecedents of coronary heart disease and atherosclerosis.

Over 50 epidemiologic, clinical, and experimental studies of behavioral influences on atherosclerosis and CHD have been reviewed; of these investigations, no more than five were published prior to 1975. Despite some inconsistencies and occasional conceptual and methodologic problems in the studies comprising this relatively young literature, the preponderance of available evidence indicates that psychosocial variables play a significant role in coronary disease. To summarize briefly, the Type A behavior pattern has been found predictive of new CHD in nearly all prospective studies of initially healthy individuals, and therapeutic modification of Type A has been shown to reduce risk of recurrent nonfatal MI. Among most prospective studies of post-MI patients and of persons at heightened risk for CHD due to elevations in traditional risk factors, however, Type A has not been found to predict, respectively, recurrence of MI or initial clinical events. Additionally, Type A individuals have shown more extensive coronary artery atherosclerosis on angiographic examination than Type Bs in a minority of studies, and, generally, only where Type A behavior has been measured by the SI. It is noted that many of these clinical studies may be faulted, though, for their use of small and heterogeneous patient samples and for possible biases in the selection and recruitment of subjects. In contrast to the globally defined Type A pattern, a high potential for hostility and an inability or unwillingness to express anger (anger-in) have emerged as significant predictors or correlates of coronary disease in all epidemiologic and clinical studies in which these variables have been examined. These consistent results suggest that a predisposition to hostility and anger, and the inhibited expression of such feelings, represent a "toxic" component of the Type A pattern. Several recent prospective investigations indicate also that high levels of life stress and possession of poor or inadequate social resources are predictive of CHD. The concepts of life stress, social network, and social support, as well as relationships among these variables, are not well-understood, however, and much additional work is needed to identify specific pathogenic and protective attributes of the social environment. In addition to studies of the psychosocial antecedents of CHD in human beings, there now are several published studies of behavioral influences on the development of coronary lesions in animal models.(ABSTRACT TRUNCATED AT 400 WORDS)

Arteriosclerosis↗
PubMed2006

Design of a health-promoting neighborhood intervention.

Design and implementation of health-promoting community interventions can advance public health and community well-being; however, realization of such programs is often challenging. Even more challenging is the implementation of ecologic interventions to revitalize built urban environments. A structured intervention entitled ;Intersection Repair; was devised in Portland, Oregon, by a non-profit organization, to implement urban gathering places in the public right of way; specific steps included situation analysis, community outreach, asset mapping, design workshops, construction permitting, building workshops, and process evaluation. The community created human-scale urban landscapes with interactive art installations to encourage social interactions. Such aesthetic improvements, which included painted street murals, information kiosks, hanging gardens, water fountains, benches, and so on, were intended to strengthen social networks and social capital by providing places for residents to engage in conversation. Community engagement in neighborhood design benefits the public at multiple levels, by promoting a healthier lifestyle, over and above urban landscape improvements.

Adolescent↗
PubMed2006

Social and demographic predictors of no transport prior to premature cardiac death: United States 1999-2000.

BACKGROUND: In the United States, over one-third of premature cardiac deaths occur outside of a hospital, without any transport prior to death. Transport prior to death is a strong, valid indicator of help-seeking behavior. We used national vital statistics data to examine social and demographic predictors of risk of no transport prior to cardiac death. We hypothesized that persons of lower social class, immigrants, non-metropolitan residents, racial/ethnic minorities, men, and younger decedents would be more likely to die prior to transport. METHODS: Our study population consisted of adult residents of the United States, aged 25 to 64 years, who died from heart disease during 1999-2000 (n = 242,406). We obtained transport status from the place of death variable on the death certificate. The independent effects of social and demographic predictor variables on the risk of a cardiac victim dying prior to transport vs. the risk of dying during or after transport to hospital were modeled using logistic regression. RESULTS: Results contradicted most of our a priori hypotheses. Persons of lower social class, immigrants, most non-metropolitan residents, and racial/ethnic minorities were all at lower risk of dying prior to transport. The greatest protective effect was found for racial/ethnic minority decedents compared with whites. The strongest adverse effect was found for marital status: the risk of dying with no transport was more than twice as high for those who were single (OR 2.35; 95% CI 2.29-2.40) or divorced (OR 2.29; 95% CI 2.24-2.34), compared with married decedents. Geographically, residents of the Western United States were at a 47% increased risk of dying prior to transport compared with residents of the metropolitan South. CONCLUSION: Our results suggest that marital status, a broad marker of household structure, social networks, and social support, is more important than social class or race/ethnicity as a predictor of access to emergency medical services for persons who suffer an acute cardiac event. Future research should focus on ascertaining "event histories" for all acute cardiac events that occur in a community, with the goal of identifying the residents most susceptible to cardiac fatalities prior to medical intervention and transport.

Adult↗
PubMed1988

Towards a network of social health services: redefining discharge planning and expanding the social work domain.

Hospitalization for most people occurs episodically in an individual's lifetime, when the patient, someone with a past and future, is acutely ill. Particularly in the present health care climate "discharge planning" in hospitals will need to be redefined to address the real needs of people at health transitions. Programmatic initiatives by hospital social work departments are suggested as a strategy of moving toward the new concept of "social health care management." This paper discusses the background and a model of expanding social work domain in providing such a viable network of social health services.

Community-Institutional Relations↗
PubMedDate not supplied

Social determinants and inequalities in urban health.

Social and environmental factors are health determinants, in association with behavior, biological factors, and health services. Whereas socioeconomic characteristics (age, gender, ethnicity, social status) describe individuals, social determinants work through broader policies that are influenced by governments. The relation between health and four social areas is discussed. Social capital, measured as social networks and social support, appears to be protective in developing some heart disease and mental illnesses; job control at work is also found to protect against heart disease; early life experiences affect both biological and social development; and the degree of income inequality within societies correlates with health status. The Independent Report on Inequalities in Health, published in the United Kingdom in 1998, is also reviewed. The report (a) briefly describes inequalities in health by social class, sex, and ethnicity; (b) reviews the literature on policy areas that affect health; (c) includes a section indicating relatively little inequality of access or provision in the National Health Service; and (d) makes 132 recommendations. Social determinants is a new area of research having the potential to link epidemiology and environmental sciences at small area level.

Epidemiology↗
PubMed2000

[Characteristics of the elderly transferees in a resort area from metropolitan areas: comparison to the elderly in a rural non-resort area and in a metropolitan area].

PURPOSES: This study examines characteristics of elderly transferees in a resort area who moved from metropolitan areas, comparing them to two groups: elderly living in a rural non-resort area and elderly living in a metropolitan area. METHODS: Both the resort area and the non-resort area were located in Ito, Shizuoka Prefecture. The metropolitan area was in Nerima ward, Tokyo. From each area, 400, 400 and 600 random samples aged 65 and over were selected for face-to-face interview surveys separately. The number of the effective samples in each of the three groups was 176 (excluding transferees from rural area), 267, and 423, respectively. Characteristics were measured from five aspects; demographic aspects, health status, health habits, social networks, and social support. RESULTS: Almost indicators of health status did not show significant differences between respondents living in the resort area and each of the remaining two groups. Respondents living in the resort area were significantly less likely to attend community groups than those living in non-resort rural areas, and they also were less likely to have a home physician or persons who provided care. CONCLUSIONS: Transferees living in a resort area who moved from metropolitan areas may have extra health and welfare needs, compared to the elderly living in non-resort rural areas or the elderly living in metropolitan areas. Possible reasons for these extra needs may be relate to their urbanized life style, lower amount of medical resources in a rural area, or lower level of informal support possessed within a household.

Aged↗
PubMedDate not supplied

[Social support of chronically mentally ill patients].

AIM: Assessment of the social support system of mentally ill persons covered by a local rehabilitation programme situated in Targówek, Warsaw. METHOD: The sample consists of 92 participants with serious mental illness. Bizoń's Social Support Inventory and Social Support Map were used. RESULTS: Patients' social networks were small (9 persons in average) but had a broad scope of functions. Therapists from community rehabilitation services constitute the biggest group of persons included in the individual network of social support. Lack of emotional support is observed. CONCLUSION: Participation in a local system of rehabilitation improves the quantity and quality of individual systems of social support.

Adult↗
PubMed2006

Suicide in farmers in Scotland.

INTRODUCTION: Farmers and farm workers have higher than expected rates of suicide and undetermined deaths in UK studies, and some rural areas of Scotland have higher than average male suicide rates. Firearm access seems to be an influencing factor in England and Wales. Type of farming, and farming social networks may also be important. This article describes suicide and undetermined deaths in male farmers and farm workers in Scotland from 1981-1999 using anonymised, routine data. METHOD: Deaths of men aged 15-74 years from suicide or undetermined cause were identified from anonymised Scottish death records. Farmers and farm workers were identified using occupation codes. Methods of suicide used by farmers were compared with those of the general male population of the same age. A multiple linear regression was used to examine the influence of farm type, and the proportion of farmers in the working population of an area. RESULTS: 307 male farmers or farm workers died by suicide or undetermined cause in the time period. The overall rate was 31.4/100,000 per year (95% CI 28.1-35.1). Deaths using firearms were over-represented (29% of farming deaths compared with 3.6% in the general male population). There was no significant association between the male suicide rate in an area, and the farming suicide rate. Areas with lower proportions of farmers tended to have higher rates of farming suicide and undetermined deaths. This one factor described 85% of the variance among areas. CONCLUSION: Deaths were substantially more likely to involve firearms than suicide and undetermined deaths in the general male population. Less use of other methods did not completely compensate for this, indicating that method availability is likely to contribute to farming suicide rates. Farmers in areas where farming is less common were more likely to die by suicide, and this described most of the differences among areas. Networks and social supports may be important protective factors for farmers.

Accidental Falls↗
PubMed1991

Mental health, social relations, and social selection: a longitudinal analysis.

A wide body of literature documents the effect of social networks and social supports on mental health. Fewer studies, however, have examined the reciprocal effect of mental health on social relationships. This problem is examined using data from a national panel survey of adults aged 20-64. For the sample as a whole, support was found for a social selection process, since psychological distress predicted decreases in primary, but not secondary, social relationships. The extent of primary relationships also were found to be associated with subsequent distress, providing evidence that the relationship between mental health and social environment may be transactional. When examined separately by gender, males but not females were found to be vulnerable to the process of social selection, supporting the hypothesis that the expression of distress is less role-appropriate for men and therefore more likely to invite social sanctions. Social causation effects also were observed only among males.

Adult↗
PubMed1999

The medial extended amygdala in male reproductive behavior. A node in the mammalian social behavior network.

Hormonal and chemosensory signals regulate social behaviors in a wide variety of mammals. In the male Syrian hamster, these signals are integrated in nuclei of the medial extended amygdala, where olfactory and vomeronasal system transmission is modulated by populations of androgen- and estrogen-sensitive neurons. Evidence from behavioral changes following lesions and from immediate early gene expression supports the hypothesis that the medial extended amygdala and medial preoptic area belong to a circuit that functions selectively in male sexual behavior. However, accumulated behavioral, neuroanatomical, and neuroendocrine data in hamsters, other rodents, and other mammals indicate that this circuit is embedded in a larger integrated network that controls not only male mating behavior, but female sexual behavior, parental behavior, and various forms of aggression. In this context, perhaps an individual animal's social responses can be more easily understood as a repertoire of closely interrelated, hormone-regulated behaviors, shaped by development and experience and modulated acutely by the environmental signals and the hormonal milieu of the brain.

Aggression↗
PubMed2005

Loneliness as a predictor of quality of life among older caregivers.

AIM: This paper reports a study investigating quality of life in relation to loneliness, caregiving, social network, gender, age and economic status among caregiving men and women in a population-based sample aged 75 years or older. BACKGROUND: Because of demographic changes, in the future more care for older people will be given by informal caregivers who are themselves older. Being old and caring for another older person may affect various aspects of life, such as physical and emotional health and decreased time for respite, which may affect social life and quality of life. METHOD: A postal questionnaire including the Short Form Health Survey was used. The sample consisted of 4278 people, aged 75 years and over, living in Sweden. Of these, 783 (18%) were caregivers. FINDINGS: Caregivers had a larger social network and reported feelings of loneliness less often than non-caregivers. Forty per cent of caregivers helped every day. There were gender differences in experiences of loneliness during the last year, with the frequency of intense feelings of loneliness being higher among women. Loneliness and a small or non-existent network were significantly associated with low quality of life among caregivers, as well as in the total sample. The results showed significant association between loneliness, weak social network and low mental quality of life. CONCLUSIONS: The fact that loneliness was the most important factor predicting low quality of life among caregivers, as well as older people in general, indicates that it is crucial in the care of older people. From a nursing perspective, the findings indicate the advantage of helping older people to keep up and develop their social networks. Nursing care should involve steps to maintain the social network before an older person becomes too weak, since decreased health status makes social contacts more difficult.

Aged↗
PubMed2005

Translation and adaptation of the Social Support Network Inventory in Brazil.

PURPOSE: To describe the translation and adaptation of the Social Support Network Inventory (SSNI) to Brazilian Portuguese. METHODS: The SSNI is a widely used, reliable, and valid instrument, designed to measure social support among English-speaking people. The questionnaire was translated and adapted to the Brazilian-Portuguese language by the back-translation method. The translated version was evaluated in a sample of 120 Brazilian women in treatment for breast cancer. FINDINGS AND CONCLUSIONS: Internal consistency and construct validity were examined, and the psychometric properties of the translated instrument were good. The translated SSNI was easily understood by the respondents and did not present difficulty during the interviews. The Portuguese version of the SSNI is a valid instrument to assess social support among Portuguese-speaking patients.

Adult↗
PubMed2005

[An investigation of social support networks for working mothers].

The purpose of our study was to investigate the social support network for working mothers, including physical, emotional and informational sources, and to discuss strategies to reduce stress caused by their multiple role strain. We asked 18 participants to fill in a questionnaire and conducted semi-constructed interviews. The results of this study showed that more than half of the working mothers want to continue their career because of self growth and the rewards from their job. Many mothers responded that a sympathetic understanding by their husbands, families and people at workplaces is essential to create a balance between their career and housework. As a result, their husbands mainly provide physical support in housekeeping and child caring, whereas their mothers provide physical and emotional support from knowledge based upon their own experience. Almost all working mothers complained of a shortage of nurseries and child caring facilities as well as limited availability of flexible services. In conclusion, the results of our study suggested that the identity of the traditional gender role needs to be changed to a contemporary one, like a husband fully participating in his child's rearing activities by reconsidering his working hours. Moreover, community services to support working mothers should be increased.

Adult↗
PubMed2000

Social support networks of lesbian, gay, and bisexual adults 60 years of age and older.

The social support networks of 416 lesbian, gay, and bisexual adults aged 60 to 91 years were examined. Participants averaged 6 people in their support networks, most of whom were close friends. The gender composition of support networks was greatly influenced by the gender of the respondent. Most support network members knew about respondents' sexual orientation. The most common type of support provided by close friends and social acquaintances was socializing support, and the most common support provided by partners, siblings, and other relatives was emotional support. The sexual orientation, gender, and age of network members did not influence respondents' satisfaction with the support received. Participants were more satisfied with support from those who knew of their sexual orientation. The more satisfied respondents felt with the support they received, the less lonely they felt. Those living with domestic partners were less lonely and rated their physical and mental health more positively than those who lived alone.

Aged↗
PubMed1984

The impact of social support networks on adult health.

Knowledge of the determinants of adult health offers important implications for planning policy that may affect the overall level of health and thus the costs of health care. One potentially important factor that has not been incorporated in previous research is the amount of information individuals have concerning health care or methods of preventive care. This study uses the number of social support networks and the degree of contact individuals have with them as an alternative measure of information. This measure of information is incorporated into an economic model based partly on Becker's Human Capital framework. Social support networks are found to have virtually no impact in explaining health outcomes for illnesses over which the individual has little control. However, when a broader range of illnesses is considered, social support networks do play a role in producing better health.

Educational Status↗
PubMed2003

[Childbirth and changes of women's social support network and mental health].

A questionnaire surveys of women was conducted, 58 persons at one month, 73 at four month, and 42 at one year after childbirth, in order to investigate the relationship between social support and mental health. Main results concerning stress-buffering effects of social support were as follows. At one month after childbirth, marital intimacy showed stress-buffering effect. At four months, beneficial factors were; informational and emotional support and social companionship from family members other than husband or mother, and informational and emotional support from a friend who was the second closest. At one year were; instrumental, informational, and emotional support and social companionship from other person who was not among those already mentioned, and informational and emotional support and social companionship from still another who was the second important. These results suggested that social support network of women underwent successive changes after childbirth. In addition, a model of changing social support network was presented, and it suggested that changing support network so that one could obtain appropriate support was effective on stress buffer.

Adult↗
PubMed2000

Peer networks among heavy, regular and infrequent drinkers prior to marriage.

OBJECTIVE: Research has consistently demonstrated that, among adolescents, the characteristics of one's peers are important predictors of substance abuse. The impact of the peer network on adult drinking, however, has received considerably less attention. The purpose of the present study was to examine social network characteristics that are associated with heavy drinking in adulthood prior to marriage. METHOD: Couples were recruited at the time of their first marriage. Husbands and wives were each given identical questionnaire packets to complete at home, independently, as well as a postage-paid envelope for packet return. A broad range of constructs was assessed; included were personality characteristics, relationship functioning, drinking behavior and social network characteristics. Complete data were obtained from 471 husbands and 471 wives. RESULTS: The social networks of heavy-drinking men, compared to men drinking regularly or infrequently, were younger, more likely to be male and unmarried and consisted of friends rather than family or others. For both men and women, "drinking buddies" accounted for nearly 75% of the heavy drinkers' peer networks. The overall ratings of support and conflict created by peers did not differ according to drinking group, for either men or women. CONCLUSIONS: Prior to marriage, the social networks of heavy drinkers differ considerably from the networks of regular or infrequent drinkers with regard to the drinking patterns of their peers. An important finding was that heavy drinkers appear to experience a similar level of emotional, financial and practical support from their peer network compared to regular or infrequent drinkers.

Adult↗