Abstract
BackgroundWhether community level social capital is associated with mortality within an Asian population is yet unclear.MethodsThe study population was derived from the Korean National Health Insurance Service-National Sample Cohort. A total of 636,055 participants were followed-up during 2012–2013 for deaths from all causes, cardiovascular disease (CVD), cancer, and other causes. Community level social trust and reciprocity at the administrative district level were derived from the Korean Community Health Survey. Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for mortality according to levels of community level social trust and reciprocity.ResultsCompared to participants who reside in areas within the lower half of community level social trust, those who reside in areas within the upper half had lower risk of death from all causes (aHR 0.84, 95% CI 0.78–0.89), CVD (aHR 0.82, 95% CI 0.67–0.99), and cancer (aHR 0.85, 95% CI 0.73–0.98). Similarly, residing in areas in the upper half of community level social reciprocity was associated with reduced risk for all-cause mortality (aHR 0.80, 95% CI 0.75–0.86). The protective association of high community level social trust and reciprocity on mortality remained after additional adjustments for smoking, alcohol intake, and physical activity.ConclusionsResiding in areas with high community level social trust and reciprocity may be associated with better population health status.
Highlights
Whether community level social capital is associated with mortality within an Asian population is yet unclear
While some studies showed that higher social trust was associated with lower mortality risk [6, 7], others failed to show a significant relationship between social trust and mortality [8]
There was a significant difference in the proportion of age, household income, and Charlson comorbidity index between the upper and lower halves of social trust or reciprocity
Summary
Whether community level social capital is associated with mortality within an Asian population is yet unclear. Choi et al BMC Public Health (2020) 20:1793 association of community level social capital with health has built up [5], there is still a dearth of empirical evidence on the relationship between social trust and reciprocity with mortality. While some studies showed that higher social trust was associated with lower mortality risk [6, 7], others failed to show a significant relationship between social trust and mortality [8]. These studies, were limited by their cross-sectional or ecological design. It has been proposed that there may be genetic [13] and cultural [14] components that contribute to social trust, highlighting the need for studies on social trust or reciprocity with mortality among participants outside of the Western population
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