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Association of group-level segregation with cardiovascular health in older adults: an analysis of data from the Korean Social Life, Health, and Aging Project
Sung-Ha Lee, Hyeok-Hee Lee, Kiho Sung, Yoosik Youm, Hyeon Chang Kim
Epidemiol Health. 2023;45:e2023041.   Published online April 4, 2023
DOI: https://doi.org/10.4178/epih.e2023041
  • 4,875 View
  • 187 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The adverse health effects of individual-level social isolation (e.g., perceived loneliness) have been well documented in older adults. However, little is known about the impact of collective-level social isolation on health outcomes. We sought to examine the association of group-level segregation with cardiovascular health (CVH) in older adults.
METHODS
From the prospective Korean Social Life, Health, and Aging Project database, we identified 528 community-dwelling older adults who were aged ≥60 years or were married to those aged ≥60 years. Participants who belonged to smaller social groups separate from the major social group were defined as group-level-segregated. The CVH score was calculated as the number of ideal non-dietary CVH metrics (0-6), as modified from the American Heart Association’s Life’s Simple 7. Using ordinal logistic regression models, we assessed cross-sectional and longitudinal associations between group-level segregation and CVH.
RESULTS
Of the 528 participants (mean age, 71.7 years; 60.0% female), 108 (20.5%) were segregated at baseline. In the crosssectional analysis, group-level segregation was significantly associated with lower odds of having a higher CVH score at baseline after adjusting for socio-demographic factors and cognitive function (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.43 to 0.95). Among 274 participants who completed an 8-year follow-up, group-level segregation at baseline was marginally associated with lower odds of having a higher CVH score at 8 years (OR, 0.49; 95% CI, 0.24 to 1.02).
CONCLUSIONS
Group-level segregation was associated with worse CVH. These findings imply that the social network structure of a community may influence its members’ health status.
Summary
Korean summary
본 연구는 “한국인의 사회적 삶, 건강과 노화에 대한 조사”(Korean Social Life, Health and Aging Project, KSHAP)에서 측정한 한 지역 내의 사회적 연결망 자료를 이용하여 사회적 분리와 심혈관 건강 사이의 관계를 살펴보았다. 그 결과, 사회적 분리는 비만, 고혈압, 콜레스테롤, 흡연, 음주 신체적 활동 등을 종합한 ‘라이프 심플 7’ 지표와 부정적인 관련성을 보였으며, 8년 후 추적 조사에서도 이 패턴이 유지되었다. 본 연구 결과는 사회적, 집단적 분리 현상이 신체적 건강에도 악영향을 초래할 수 있음을 시사한다.
Key Message
Using the prospective Korean Social Life, Health, and Aging Project (KSHAP) database, we discovered that group-level segregation was significantly associated with worse cardiovascular health (CVH). Also, we observed a tendency for baseline group-level segregation to be linked to worse CVH after an 8-year follow-up period. These findings emphasize the significance of group-level segregation as a potential contributing factor in the health outcomes of older adults.

Citations

Citations to this article as recorded by  
  • Association of social isolation and loneliness with the risk of hypertension in middle aged and older adults: Findings from a national representative longitudinal survey
    Shiqi Wang, Hao Zhang, Yiling Lou, Qiqi You, Qingqing Jiang, Shiyi Cao
    Journal of Affective Disorders.2024; 349: 577.     CrossRef
Gender role stereotypes, patriarchal attitudes, and cognitive function in the elderly rural Korean population: a cross-sectional study
Hye Rin Choi, Byeonggwan Ha, Ye Jin Jeon, Yoosik Youm, Hyeon Chang Kim, Sun Jae Jung
Epidemiol Health. 2021;43:e2021023.   Published online April 7, 2021
DOI: https://doi.org/10.4178/epih.e2021023
  • 11,055 View
  • 355 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We analyzed whether gender role stereotypes (GRS) and patriarchal attitudes are associated with cognitive function in an elderly community.
METHODS
We analyzed data from 580 people enrolled in the Korean Social Life, Health, and Aging Project. The degrees to which respondents held stereotypical beliefs about gender roles and had patriarchal mindsets were measured using a questionnaire. Based on participants’ responses, we divided respondents into 2 groups—those with conservative mindsets and those with open mindsets—according to the median score for each of the 2 variables. Cognitive function was assessed using the Mini-Mental State Examination, Korean version (MMSE-K). Cognitive impairment was defined as an MMSE-K score ≤21 points. Multivariable logistic regression was performed, adjusting for gender, age, socio-demographic and lifestyle factors, and social network size. Age and lifestyle factors were stratified.
RESULTS
Compared to those with open mindsets, those with conservative mindsets regarding gender roles and patriarchal norms had adjusted odds ratios of 1.88 (95% confidence interval [CI], 1.11 to 3.19) and 1.67 (95% CI, 1.00 to 2.79) for cognitive impairment, respectively. In the stratified analysis, subgroups with younger age and a good lifestyle maintained a protective association with cognitive impairment.
CONCLUSIONS
GRS and a patriarchal mindset were marginally significantly associated with cognitive impairment among women later in life.
Summary
Korean summary
농촌지역에 거주하는 노년기 인구 580명 대상으로 성 역할 고정관념 또는 가부장적 사고가 인지기능과 연관성이 있는지 로지스틱 회귀분석을 통해 알아보았다. 분석결과, 보수적인 성 역할 고정관념과 가부장적 사고를 가진 여성에서 개방적인 사고를 가진 여성보다 인지기능이 통계적으로 유의하게 저하된 결과를 얻었다.
Key Message
We investigated whether gender role stereotypes and patriarchal attitudes are associated with cognitive function in the elderly rural Korean population. Compared to women with open attitudes, those with conservative attitudes regarding gender roles and patriarchal norms had marginally significant higher odds ratios for cognitive impairment. Thus, gender role stereotypes and a patriarchal mindset were marginally significantly associated with cognitive impairment among women later in life.

Citations

Citations to this article as recorded by  
  • Examining the gender equity outlook and patriarchal beliefs of police constables in Allahabad, India: A machine learning approach
    Saumya Tripathi
    Policing: A Journal of Policy and Practice.2023;[Epub]     CrossRef
Association of social network size and composition with physical activity in Korean middle-aged adults
Moon Su Kwak, So Mi Jemma Cho, Jee-Seon Shim, Dae Jung Kim, Yoosik Youm, Hyeon Chang Kim
Epidemiol Health. 2020;42:e2020070.   Published online November 25, 2020
DOI: https://doi.org/10.4178/epih.e2020070
  • 8,353 View
  • 140 Download
  • 2 Web of Science
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Physical activity (PA) is an established protective factor for many chronic diseases. Numerous studies have established positive relationships between social networks and PA. Accordingly, this study examined the relationship between social network structures (specifically the network size and the number and proportion of same-sex alters) and self-reported PA in Korean middle-age adults, where the term “alter” refers to a respondent’s social network members.
METHODS
We analyzed 8,092 participants of the Cardiovascular and Metabolic Diseases Etiology Research Center cohort. We assessed the association between each network structure variable and PA level using a linear regression model. Then, we employed logistic regression to evaluate associations between social network structure and adherence to guideline-recommended exercise levels. Socio-demographic factors and health status measures were used as covariates.
RESULTS
In both sexes, the social network size and proportion of same-sex network members showed positive relationships with total and moderate-to-vigorous PA. Notably, female participants with a greater number of kin were more likely to satisfy the recommended amount of total PA.
CONCLUSIONS
These findings suggest that large scale, same-sex intervention programs can help to achieve recommended PA regimens.
Summary
Korean summary
이 연구는 30-64세 중년의 한국인 8,092(남자 2,805, 여자 5,207)명에서 사회연결망 특성과 신체활동량의 관련성을 평가했다. 남녀 모두에서 사회연결망의 크기가 클수록, 연결망내 동성인 사람의 비중이 높을수록 신체활동량이 많았다. 사회연결망 크기와 연결망내 동성인 사람의 비중은 권장 신체활동량을 충족률과도 양의 관련성을 보였다. 반면, 연결망내 친족의 비중이 높은 경우는 오히려 권장신체활동량을 충족할 가능성이 낮았다.
Cohort Profile
The Korean social life, health and aging project-health examination cohort
Ju-Mi Lee, Won Joon Lee, Hyeon Chang Kim, Wungrak Choi, Jina Lee, Kiho Sung, Sang Hui Chu, Yeong-Ran Park, Yoosik Youm
Epidemiol Health. 2014;36:e2014003.   Published online May 13, 2014
DOI: https://doi.org/10.4178/epih/e2014003
  • 22,635 View
  • 196 Download
  • 22 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
The Korean Social Life, Health, and Aging Project (KSHAP) is a population-based longitudinal study of health determinants among elderly Koreans. The target population of the KSHAP are people aged 60 years or older and their spouses living in a rural community of Korea. A complete enumeration survey was conducted in the first wave of the KSHAP on 94.7% (814 of 860) of the target population between December 2011 and July 2012. The KSHAP-Health Examination (KSHAP-HE) cohort consists of 698 people who completed additional health examinations at a public health center (n=533) or at their home (n=165). Face-to-face questionnaires were used to interview participants on their demographics, social network characteristics, medical history, health behaviors, cognitive function, and depression symptoms. Health center examinations included anthropometric measures, body impedance analysis, resting blood pressure measurement, radial artery tonometry, bone densitometry, the timed up-and-go test, and fasting blood analysis. However, only anthropometric measures, blood pressure measurement, and non-fasting blood analysis were available for home health examinations. Collaboration is encouraged and access to the KSHAP baseline data will be available via the website of the Korean Social Science Data Archive (http://www.kossda.or.kr).
Summary
Korean summary
한국인의 사회적 삶, 건강과 노화에 대한 조사(Korean Social Life, Health, and Aging Project, KSHAP) 연구는 노인 건강의 사회적 결정요인과 그 상호작용을 평가하는 것을 목적으로 한다. 이를 위하여 사회연결망분석(social network analysis) 기법을 도입하였다. 사회연결망분석은 개인간의 관계를 네트워크로 파악하는 개념으로, 본 연구에서는 지역사회 전체의 사회연결망 안에서 개인의 특성 및 개인간 상호작용의 특성이 신체적 정신적 건강에 미치는 영향을 연구하고자 한다. 대상인구집단은 인천광역시 강화군 일개 면 지역의 60세 이상 인구 및 그 배우자이며, 전체 860명의 모집단에서 814명(94.7%)의 건강면접조사 및 사회연결망 분석을 완료하였으며, 이 가운데 보건지소(533명) 또는 가정(165명)에서 추가 건강검진을 수행한 698명을 대상으로 KSHAP-Health Examination (KSHAP-HE) 코호트를 구축하였다.

Citations

Citations to this article as recorded by  
  • Distinct neuroanatomical correlates of interference-related verbal episodic memory test in healthy older adults
    Seyul Kwak, Hairin Kim, Jeanyung Chey
    Aging, Neuropsychology, and Cognition.2024; 31(1): 97.     CrossRef
  • A Prospective Sociocentric Study of 2 Entire Traditional Korean Villages: The Korean Social Life, Health, and Aging Project (KSHAP)
    Jiwon Baek, Ekaterina Baldina, Kiho Sung, Sung-Ha Lee, Nicholas A Christakis, Peter Bearman, Hyeon Chang Kim, Sang Hui Chu, Eun Lee, Yeong-Ran Park, Jeanyung Chey, Youn-Hee Choi, Dohoon Lee, Yoosik Youm
    American Journal of Epidemiology.2024; 193(2): 241.     CrossRef
  • The Effect of Cognitive Impairment on the Association Between Social Network Properties and Mortality Among Older Korean Adults
    Eunji Kim, Kiho Sung, Chang Oh Kim, Yoosik Youm, Hyeon Chang Kim
    Journal of Preventive Medicine and Public Health.2023; 56(1): 31.     CrossRef
  • Association of group-level segregation with cardiovascular health in older adults: an analysis of data from the Korean Social Life, Health, and Aging Project
    Sung-Ha Lee, Hyeok-Hee Lee, Kiho Sung, Yoosik Youm, Hyeon Chang Kim
    Epidemiology and Health.2023; 45: e2023041.     CrossRef
  • Neural and social correlates of attitudinal brokerage: using the complete social networks of two entire villages
    Yoosik Youm, Junsol Kim, Seyul Kwak, Jeanyung Chey
    Proceedings of the Royal Society B: Biological Sciences.2021; 288(1944): 20202866.     CrossRef
  • More Teeth and Posterior Balanced Occlusion Are a Key Determinant for Cognitive Function in the Elderly
    Taejun Park, Yun-Sook Jung, Keunbada Son, Yong-Chul Bae, Keun-Bae Song, Atsuo Amano, Youn-Hee Choi
    International Journal of Environmental Research and Public Health.2021; 18(4): 1996.     CrossRef
  • Social connectedness and hair cortisol in community-dwelling older adults
    Sung-Ha Lee, Ekaterina Baldina, Eun Lee, Yoosik Youm
    Comprehensive Psychoneuroendocrinology.2021; 6: 100053.     CrossRef
  • Distributed functional connectivity predicts neuropsychological test performance among older adults
    Seyul Kwak, Hairin Kim, Hoyoung Kim, Yoosik Youm, Jeanyung Chey
    Human Brain Mapping.2021; 42(10): 3305.     CrossRef
  • Association between masticatory function and cognitive impairment in the elderly
    Taejun Park, Hyojin Heo, Min-Jeong Cho, Hyeon Chang Kim, Yoosik Youm, Keun-Bae Song, Youn-Hee Choi
    Journal of Korean Academy of Oral Health.2021; 45(2): 57.     CrossRef
  • Gender role stereotypes, patriarchal attitudes, and cognitive function in the elderly rural Korean population: a cross-sectional study
    Hye Rin Choi, Byeonggwan Ha, Ye Jin Jeon, Yoosik Youm, Hyeon Chang Kim, Sun Jae Jung
    Epidemiology and Health.2021; 43: e2021023.     CrossRef
  • Prevalence of and factors related with abnormal fundoscopic findings among the elderly population in a rural community in South Korea
    Hye Rin Choi, Tyler Hyungtaek Rim, Jung Hyun Lee, Seung Won Lee, Jongmin Baek, Kwanghyun Kim, Yoosik Youm, Hyeon Chang Kim
    Seminars in Ophthalmology.2020; 35(1): 41.     CrossRef
  • Gender differences in social network of cognitive function among community‐dwelling older adults
    Sungwon Lee, Seungwon Lee, Eun Lee, Yoosik Youm, Hyun Sang Cho, Woo Jung Kim
    Geriatrics & Gerontology International.2020; 20(5): 467.     CrossRef
  • Social Activities and Health-Related Quality of Life in Rural Older Adults in South Korea: A 4-Year Longitudinal Analysis
    JiYeon Choi, Kyeongra Yang, Sang Hui Chu, Yoosik Youm, Hyeon Chang Kim, Yeong-Ran Park, Youn-Jung Son
    International Journal of Environmental Research and Public Health.2020; 17(15): 5553.     CrossRef
  • Similarity in functional brain connectivity at rest predicts interpersonal closeness in the social network of an entire village
    Ryan Hyon, Yoosik Youm, Junsol Kim, Jeanyung Chey, Seyul Kwak, Carolyn Parkinson
    Proceedings of the National Academy of Sciences.2020; 117(52): 33149.     CrossRef
  • Associations of systemic inflammation with frontotemporal functional network connectivity and out-degree social-network size in community-dwelling older adults
    Minji Bang, Junsol Kim, Suk Kyoon An, Yoosik Youm, Jeanyung Chey, Hyeon Chang Kim, Kyungmee Park, Kee Namkoong, Eun Lee
    Brain, Behavior, and Immunity.2019; 79: 309.     CrossRef
  • Association between estimated glomerular filtration rate (eGFR) and asymmetric dimethylarginine (ADMA) concentrations among the elderly in a rural community: a cross-sectional study
    Hye Rin Choi, Seung Won Lee, Da-Hye Jeon, Nam Wook Hur, Yoosik Youm, Hyeon Chang Kim
    BMC Geriatrics.2019;[Epub]     CrossRef
  • Cohort profile: Korean Urban Rural Elderly (KURE) study, a prospective cohort on ageing and health in Korea
    Namki Hong, Kwang-Joon Kim, Su Jin Lee, Chang Oh Kim, Hyeon Chang Kim, Yumie Rhee, Yoosik Youm, Jin-Young Choi, Hyun-Young Park
    BMJ Open.2019; 9(10): e031018.     CrossRef
  • Is the Relationship between Depression and C Reactive Protein Level Moderated by Social Support in Elderly?-Korean Social Life, Health, and Aging Project (KSHAP)
    Nam Wook Hur, Hyeon Chang Kim, Linda Waite, Yoosik Youm
    Psychiatry Investigation.2018; 15(1): 24.     CrossRef
  • Association between vitamin D status and asymmetric dimethylarginine (ADMA) concentration in the Korean elderly population
    Hye Rin Choi, Seung Won Lee, Hyungseon Yeom, Da-Hye Jeon, Hyeon Chang Kim, Yoosik Youm
    Maturitas.2017; 102: 13.     CrossRef
  • Factors Associated with Insomnia among the Elderly in a Korean Rural Community
    Woo Jung Kim, Won-tak Joo, Jiwon Baek, Sung Yun Sohn, Kee Namkoong, Yoosik Youm, Hyeon Chang Kim, Yeong-Ran Park, Sang Hui Chu, Eun Lee
    Psychiatry Investigation.2017; 14(4): 400.     CrossRef
  • Association between C reactive protein level and depressive symptoms in an elderly Korean population: Korean Social Life, Health and Aging Project
    B. M. Song, J.-M. Lee, W. Choi, Y. Youm, S. H. Chu, Y.-R. Park, H. C. Kim
    BMJ Open.2015; 5(2): e006429.     CrossRef
  • Social network properties and self-rated health in later life: comparisons from the Korean social life, health, and aging project and the national social life, health and aging project
    Yoosik Youm, Edward O Laumann, Kenneth F Ferraro, Linda J Waite, Hyeon Chang Kim, Yeong-Ran Park, Sang Hui Chu, Won-tak Joo, Jin A Lee
    BMC Geriatrics.2014;[Epub]     CrossRef

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