Abstract
BackgroundHealth behaviors are a key determinant of health and well-being that are influenced by the nature of the social environment. This study examined associations between social relationships and health-related behaviors among a nationally representative sample of older people.MethodsWe analyzed data from three waves (1999–2004) of the US National Health and Nutrition Examination Survey (NHANES). Participants were 4,014 older Americans aged 60 and over. Log-binomial regression models estimated prevalence ratios (PR) for the associations between social relationships and each of the following health behaviors: alcohol use, smoking, physical activity and dental attendance.ResultsHealth-compromising behaviors (smoking, heavy drinking and less frequent dental visits) were related to marital status, while physical activity, a health-promoting behavior, was associated with the size of friendship networks. Smoking was more common among divorced/separated (PR = 2.1; 95% CI: 1.6, 2.7) and widowed (PR = 1.7; 95% CI: 1.3, 2.3) respondents than among those married or cohabiting, after adjusting for socio-demographic background. Heavy drinking was 2.6 times more common among divorced/separated and 1.7 times more common among widowed men compared to married/cohabiting men, while there was no such association among women. For women, heavy drinking was associated with being single (PR = 1.7; 95% CI: 1.0, 2.9). Being widowed was related to a lower prevalence of having visited a dentist compared to being married or living with a partner (PR = 0.92; 95% CI 0.86, 0.99). Those with a larger circle of friends were more likely to be physically active (PR = 1.17; 95% CI:1.06, 1.28 for 5–8 versus less than 5 friends).ConclusionsSocial relationships of older Americans were independently associated with different health-related behaviors, even after adjusting for demographic and socioeconomic determinants. Availability of emotional support did not however mediate these associations. More research is needed to assess if strengthening social relationships would have a significant impact on older people’s health behaviors and ultimately improve their health.
Highlights
Health behaviors are a key determinant of health and well-being that are influenced by the nature of the social environment
Heavy drinking was more prevalent among those not living with a partner, there were no clear associations with the number of close friends and availability of emotional support
This study has shown that social relationships were independently associated with a range of health behaviors in a national sample of older US adults, even after adjusting for the effect of broad demographic and socioeconomic determinants
Summary
Health behaviors are a key determinant of health and well-being that are influenced by the nature of the social environment. This study examined associations between social relationships and health-related behaviors among a nationally representative sample of older people. Most health behaviors are socially patterned in terms of their association with socioeconomic position. With adults several studies provide evidence that social relationships influence health behaviors [12]. Berkman and Breslow showed in Alameda County that greater overall involvement in formal (e.g. religious organizations) and informal (e.g. friends and family) social ties was associated with more positive health behaviors over a 10 year period [15]. Little research has focused upon the association between social relationships and health behaviors amongst older people [24]. In the UK oral health behaviors were associated with social isolation in a sample of older adults [29]
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