Life sustaining irritations? Relationship quality and mortality in the context of chronic illness.

Institute for Social Research, Ann Arbor, MI, United States.
Social Science [?] Medicine (Impact Factor: 2.56). 11/2008; 67(8):1291-9. DOI: 10.1016/j.socscimed.2008.06.029
Source: PubMed

ABSTRACT The social integration and mortality link are well documented but not well understood. To address this issue, the present study examined the context within which relationship quality affects mortality over a 19-year period. Participants were 40 years and older from Waves 1 (1986) and 2 (1989) of the nationally representative Americans' Changing Lives Study (N=2098). Interviews included questions about health and positive and negative relationship qualities with spouse, children, and friends/relatives. A total of 39% (N=827) of participants were deceased by 2005. In support of the main effect model, Cox proportional hazard regressions revealed that consistently low levels of positive support and an increase in negativity from spouse or child from 1986 to 1989 were associated with increased mortality. In support of the buffering effect, among people with chronic illnesses, negative relations at baseline were associated with decreased mortality. We conclude that the social relations-mortality link is more complex than previously understood and is influenced by the context.

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    ABSTRACT: Objective Analyses test the hypothesis that aspects of social relationships (quantity of ties, social support and social strain) are associated with differences in levels of biological risk across multiple major physiological regulatory systems and consequently overall multi-systems risk (i.e., allostatic load [AL]). Methods Data are from the Coronary Artery Risk Development in Young Adults (CARDIA) study - a bi-ethnic, prospective, multi-center epidemiological study, initiated in 1985-86 to track the development of cardiovascular risk in young adulthood (N = 5,115). At the year 15 follow-up when participants were between 32-45 years of age, additional social and biological data were collected; biological data used to assess AL were collected at the Oakland, CA and Chicago, IL sites (N = 844). Results Social strains were most strongly and positively related to overall AL (Cohen's d = .79 for highest vs. lowest quartile), and to each of its component biological subsystems, independent of social ties and support as well as sociodemographics and health behaviors. Social ties and emotional support were also negatively related to AL (Cohen's d = .33 and d = .44 for lowest vs. highest quartiles of ties and support, respectively) though controls for social strains reduced these associations to non-significance. Social support and social strain were more strongly related to overall AL than to any of its component subscales while social ties were less strongly related to AL and to its component subscales. There was no evidence that effects differed by sex, age or ethnicity. Conclusions Findings focus attention on the particularly strong relationship between social strains and profiles of biological risk and support the cumulative impact of social factors on biological risks, showing larger effects for cumulative AL than for any of the individual biological systems.
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