Abstract
BackgroundAlthough social capital has been shown to be one of the important social determinants of health, the association between social trust and the risk of cardiovascular disease (CVD) is not clear yet. We aimed to investigate the association of social trust with CVD risk using a large Korean population based data.MethodsThe data of this study was derived from the Korean National Health Insurance Service database. Community-level social trust was determined from the Korean Community Health Survey. The study population consisted of 2,156,829 participants. According to social trust index measured in the area of residence during 2011, participants were followed-up from 1 January 2012 to 31 December 2016. Multivariate Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD risk according to quintiles of social trust.ResultsCompared to participants with the lowest quintile of social trust, those within the highest quintile had lower risk for CVD (aHR 0.91, 95% CI = 0.89 to 0.93), CHD (aHR 0.92, 95% CI = 0.89 to 0.95), and stroke (aHR 0.90, 95% CI = 0.87 to 0.93). The risk-reducing association of high social trust on CVD risk was preserved after additional adjustments for lifestyle behaviors including smoking, alcohol consumption, and physical activity.ConclusionHigher social trust was associated with reduced risk of CVD even after considering lifestyle behaviors. Social trust in a community level is an important determinant of CVD and enhancing social trust may lead to reduced risk of CVD.
Highlights
Social capital has been shown to be one of the important social determinants of health, the association between social trust and the risk of cardiovascular disease (CVD) is not clear yet
Participants within the highest quintile of social trust had lower risk for CVD among those with age < 65 years and ≥ 65 years
A designed study using election participation rate and registered crime rate as index of social capital show the risk-reducing effect of high social capital [29]. These two studies were focusing on different dimension of social capital while this study focused on another dimension of social capital, they showed that high social capital seemed to be related with low risk of CVD
Summary
Social capital has been shown to be one of the important social determinants of health, the association between social trust and the risk of cardiovascular disease (CVD) is not clear yet. Beyond the individual level, previous studies have attempted to determine the risk factors of CVD in the social and community levels. Among these community factors, social capital has been raised as one of the important social determinants of health in recent years. Trust is the main component of cognitive dimension which reflects the community level of social capital [7]
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