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Social participation and coronary heart disease: a follow-up study of 6900 women and men in Sweden


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  • Sundquist, Kristina
  • Lindström, Martin
  • Malmström, Marianne
  • Johansson, Sven-Erik
  • Sundquist, Jan
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    Few studies have examined the relationship between social, cultural and religious participation, political empowerment and coronary heart disease (CHD). The aim of this study was to examine whether low social participation, as described in a social participation index, predicted incidence rates of CHD. This is a follow-up study, from 1990-91 to 31 December 2000, of 6861 Swedish women and men, who were interviewed about their social participation, education, housing tenure and smoking habits. A social participation index was constructed, based on 18 variables from the survey. The outcome measure was CHD morbidity and mortality. Respondents with a CHD incident from 1986 until interview were excluded from the study. Data were analysed using Cox' regression and the results are presented as hazard ratios (HR) with 95% confidence intervals (CI). In the sex- and age-adjusted model there was a gradient between the social participation index and CHD, so that persons with low social participation had the highest risk of CHD with HR=2.15; CI=1.57-2.94, followed by HR=1.67; CI=1.23-2.27 for those with middle social participation. In the full model, when education, housing tenure and smoking habits were included, the increased risk of CHD for persons with low social participation remained high, with HR=1.69, CI=1.21-2.37. We conclude that persons with low social participation in the social participation index exhibited an increased risk of CHD that remained after adjustment for education, housing tenure and smoking habits.

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 58 (2004)
    Issue (Month): 3 (February)
    Pages: 615-622

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    Handle: RePEc:eee:socmed:v:58:y:2004:i:3:p:615-622

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    Keywords: Social capital Social participation Coronary heart disease Sweden;


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    Cited by:
    1. Islam, M. Kamrul & Gerdtham, Ulf-G. & Gullberg, Bo & Lindström, Martin & Merlo, Juan, 2008. "Social capital externalities and mortality in Sweden," Economics & Human Biology, Elsevier, vol. 6(1), pages 19-42, March.
    2. Dourgnon, Paul & Grignon, Michel & Jusot, Florence, 2007. "Psychosocial resources and social health inequalities in France : Exploratory findings from a general population survey," Economics Papers from University Paris Dauphine 123456789/7007, Paris Dauphine University.
    3. Sabel, C.E. & Kihal, W. & Bard, D. & Weber, C., 2013. "Creation of synthetic homogeneous neighbourhoods using zone design algorithms to explore relationships between asthma and deprivation in Strasbourg, France," Social Science & Medicine, Elsevier, vol. 91(C), pages 110-121.
    4. Neena Chappell & Laura Funk, 2010. "Social Capital: Does it Add to the Health Inequalities Debate?," Social Indicators Research, Springer, vol. 99(3), pages 357-373, December.
    5. Florence Jusot & Michel Grignon & Paul Dourgnon, 2007. "Psychosocial resources and social health inequalities in France: Exploratory findings from a general population survey," Working Papers DT6, IRDES institut for research and information in health economics, revised Nov 2007.
    6. Ahnquist, Johanna & Wamala, Sarah P. & Lindstrom, Martin, 2012. "Social determinants of health – A question of social or economic capital? Interaction effects of socioeconomic factors on health outcomes," Social Science & Medicine, Elsevier, vol. 74(6), pages 930-939.


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