Social cohesion and mortality: A survival analysis of older adults in Japan

Sachiko Inoue, Takashi Yorifuji, Soshi Takao, Hiroyuki Doi, Ichiro Kawachi

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objectives. We examined the association between social cohesion and mortality in a sample of older adults in Japan. Methods. Data were derived from a cohort study of elderly individuals (65-84 years) in Shizuoka Prefecture; 14 001 participants were enrolled at baseline (1999) and followed up in 2002, 2006, and 2009. Among the 11 092 participants for whom we had complete data, 1427 had died during follow-up. We examined the association between social cohesion (assessed at both the community and individual levels) and subsequent mortality after control for baseline and timevarying covariates. We used clustered proportional hazard regression models to estimate hazard ratios (HRs) and confidence intervals (CIs). Results. After control for individual characteristics, individual perceptions of community cohesion were associated with a reduced risk of all-cause mortality (HR = 0.78; 95% CI = 0.73, 0.84) as well as mortality from cardiovascular disease (HR = 0.75; 95% CI = 0.67, 0.84), pulmonary disease (HR = 0.66; 95% CI = 0.58, 0.75), and all other causes (HR = 0.76; 95% CI = 0.66, 0.89). However, no statistically significant relationship was found between community cohesion and mortality risk. Conclusions. Among the elderly in Japan, more positive individual perceptions of community cohesion are associated with reduced risks of all-cause and cause-specific mortality.

Original languageEnglish
JournalAmerican Journal of Public Health
Volume103
Issue number12
DOIs
Publication statusPublished - Dec 2013

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Survival Analysis
Japan
Confidence Intervals
Mortality
Proportional Hazards Models
Lung Diseases
Cohort Studies
Cardiovascular Diseases

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Medicine(all)

Cite this

Social cohesion and mortality : A survival analysis of older adults in Japan. / Inoue, Sachiko; Yorifuji, Takashi; Takao, Soshi; Doi, Hiroyuki; Kawachi, Ichiro.

In: American Journal of Public Health, Vol. 103, No. 12, 12.2013.

Research output: Contribution to journalArticle

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abstract = "Objectives. We examined the association between social cohesion and mortality in a sample of older adults in Japan. Methods. Data were derived from a cohort study of elderly individuals (65-84 years) in Shizuoka Prefecture; 14 001 participants were enrolled at baseline (1999) and followed up in 2002, 2006, and 2009. Among the 11 092 participants for whom we had complete data, 1427 had died during follow-up. We examined the association between social cohesion (assessed at both the community and individual levels) and subsequent mortality after control for baseline and timevarying covariates. We used clustered proportional hazard regression models to estimate hazard ratios (HRs) and confidence intervals (CIs). Results. After control for individual characteristics, individual perceptions of community cohesion were associated with a reduced risk of all-cause mortality (HR = 0.78; 95{\%} CI = 0.73, 0.84) as well as mortality from cardiovascular disease (HR = 0.75; 95{\%} CI = 0.67, 0.84), pulmonary disease (HR = 0.66; 95{\%} CI = 0.58, 0.75), and all other causes (HR = 0.76; 95{\%} CI = 0.66, 0.89). However, no statistically significant relationship was found between community cohesion and mortality risk. Conclusions. Among the elderly in Japan, more positive individual perceptions of community cohesion are associated with reduced risks of all-cause and cause-specific mortality.",
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