P1-92
The quality of social relationships and allostatic load: An analysis of adults from the UK Household Longitudinal Study Patrick Rouxel, CLOSER, University College London Tarani Chandola, CMIST University of Manchester Michaela Benzeval, ISER, University of Essex
The quality of social relaAonships is related to health and mortality - Adults with good social rela2onships are 50% more likely to survive - Effect size is comparable with stopping smoking (Holt-Lundstad et al., 2010) What are the relevant bio-physiological mechanisms? Behavioural pathways Health outcomes Mortality Social Biological Allosta4c Physical func4on pathways load rela4onships Cogni4ve func4on Diseases Psychosocial resources Uchino, 2006 LimitaAons of exisAng research on social relaAonships and allostaAc load (AL): - Evidence for a rela2onship between social support and AL is equivocal - The es2mates of associa2on tend to be small in magnitude - Social resources are inconsistently conceptualized and opera2onalized - Considerable heterogeneity in the opera2onaliza2on of AL - Most studies do not consider poten2al interac2ons (e.g., with SES, employment status, sex; age) - Most of the research on social rela2onships and AL has been conducted among older adults, with almost no studies among younger adults
Research QuesAons
- Are posiAve social support and negaAve social interacAons from partner, rela2ves and friends associated with allostaAc load aPer controlling for socio-demographic, socio-economic, health, behavioural and personality factors? - Does posiAve social support from different sources buffer the associa2on of negaAve social interacAons with allostaAc load (cross buffering effects)? - Does posiAve social support buffer the associa2on of social disadvantage (and other external stressors) with allostaAc load?
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Data
UK Household Longitudinal Study: - The largest longitudinal household study - Representa2ve of adults living in UK households - Nurse health assessment at wave 2 (2010-11) - 10,175 adults provided a blood sample - Analy2cal sample in this study was 7,928 with no missing data on the allosta2c load biomarkers, social rela2onships and covariates. Analyses: nega2ve binomial regression models controlling for socioeconomic/demographic, health, behavioural and personality factors
EsAmated allostaAc load by posiAve social support and negaAve social interacAons with friends
Adults with high levels of posiAve social support and negaAve social interacAon from friends have the highest es2mated AL
EsAmated allostaAc load by posiAve social support from partners and educaAonal qualificaAon
AllostaAc load Neuroendocrine Immune Metabolic DHEA-S IGF-1
CRP Fibrinogen
Cardio
Anthropometric
SBP DBP
Waist/Height ra2o
Triglycerides Chol/HDL Crea2ne HbA1c
AllostaAc load was constructed by first dichotomizing each of the 11 biomarkers based on respondents in the highest sex-specific quarAle of risk (‘1’) versus the remaining quar2le (‘0’) - Except for DHEAS and crea2ne clearance rate for which the lowest quarAle indicated higher risk These binary measures were then summed to create the overall allosta2c load score (ranging from 0 to 10) Social relaAonships from Spouse/Partner, Rela/ves, and Friends PosiAve social support Empathy – Dependability – InAmacy NegaAve social interacAons CriAcism – Being let down – Annoyance
Men with degrees appear to benefit the most from posiAve support from their partners.
EsAmated allostaAc load by posiAve social support from partners and employment status
Results
Nega%ve Binomial regression coefficients (95% Confidence intervals): Allosta%c Load regressed on Posi%ve Social Support and Nega%ve Social Interac%ons from different sources Hypotheses Greater percep2ons of posiAve/negaAve social support are associated with lower/higher allostaAc load. NegaAve social interacAon is more strongly associated with allostaAc load compared with - For men, posiAve support from their partner is associated posiAve social support with lower AL Higher posiAve support reduces the associa2on - For women, no associa2on between partner social of negaAve social interacAons with AL (crossrela2onships and AL buffering hypothesis) - PosiAve support from rela(ves is associated with lower The effects of risk factors for allostaAc load AL (older age, female gender, low educa2on, - NegaAve interacAons from friends is associated with unemployment) are moderated among adults higher AL with posiAve social support (stress buffering hypothesis)
[email protected] Funder: ESRC GCRF Postdoctoral Research Fellowship Partner
Positive support from partner Lowest tertile Middle tertile Highest tertile Negative interactions from partner Lowest tertile Middle tertile Highest tertile Positive support from relatives Lowest tertile Middle tertile Highest tertile Negative interactions from relatives Lowest tertile Middle tertile Highest tertile Positive support from friends Lowest tertile Middle tertile Highest tertile Negative interactions from friends Lowest tertile Middle tertile Highest tertile
p-value for gender interaction
Men
Women
ref -0.08 (-0.16 ,-0.001) -0.07 (-0.14 ,-0.001)
ref -0.02 (-0.1 ,0.06) 0.04 (-0.03 ,0.11)
0.49 0.02
ref 0.01 (-0.05 ,0.07) -0.01 (-0.09 ,0.08)
ref 0.00 (-0.06 ,0.06) 0.02 (-0.06 ,0.11)
0.88 0.56
Relatives
Friends
Men and Women
Men and Women
ref -0.02 (-0.06 ,0.02) -0.05 (-0.10 ,-0.01) ref 0.03 (-0.01 ,0.06) 0.04 (-0.02 ,0.10)
ref -0.03 (-0.07 ,0.01) 0.01 (-0.03 ,0.06)
ref 0.03 (-0.02 ,0.07) 0.06 (0.01 ,0.11)
Unemployed adults with supporAve partners have lower levels of AL than unemployed adults whose partners are not supporAve.
Conclusions
- Generally weak associa2ons between social rela2onships and AL aPer controlling for covariates - Associa2ons between AL and negaAve social interacAons were not always stronger than posiAve social support - No evidence of cross-buffering role of posiAve social support - LiZle evidence that having a supporAve partner buffers the effect of no qualifica2ons on AL for men or women - Some evidence that posiAve support from partners buffers the effect of disadvantaged employment statuses (being unemployed or sick/disabled) on AL
