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The influence of low social support and living alone on premature mortality among aging Canadians

  • Quantitative Research
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Abstract

Objectives

Among older Canadians, we examined the influence of low social support, a weak sense of belonging, and living alone to understand their role on mortality risk in Canada.

Methods

We conducted a retrospective cohort study of older Canadians surveyed in 2001 from the Canadian Community Health Survey and followed up with death events through December 31, 2011 from the Canadian Vital Statistics Database. Analyses were stratified by age: 55–64 and 65 and older. Social support was assessed using measures developed for the Medical Outcomes Study. A sense of belonging, a binary measure, measured community integration. Living alone was a binary measure. Survival analysis was applied using a Cox proportional hazards model, adjusted for age, sex, income, smoking, and frailty.

Results

Among respondents 55–64 (n = 6822), low affection (HR = 1.37; 95% CI 1.07, 1.75), low emotional/informational support (HR = 1.36; 95% CI 1.06, 1.74), and low positive social interactions (HR = 1.36; 95% CI 1.06, 1.75) were associated with mortality risk. Among respondents 65 and older (n = 8966), low affection (HR = 1.17; 95% CI 1.04, 1.31), low positive social interactions (HR = 1.20; 95% CI 1.07, 1.34), low emotional/informational support (HR = 1.19; 95% CI 1.06, 1.33), and a weak sense of belonging (HR = 1.13; 95% CI 1.05, 1.22) were associated with mortality risk.

Conclusion

Low social support and a weak sense of belonging are important risk factors among older Canadians and should be part of the dialogue in Canada about their roles in healthy aging.

Résumé

Objectifs

Chez les Canadiens âgés, nous avons examiné l’influence du faible soutien social, du faible sentiment d’appartenance et du fait de vivre seul pour en comprendre le rôle sur le risque de mortalité au Canada.

Méthode

Nous avons mené une étude de cohorte rétrospective des Canadiens âgés sondés en 2001 dans l’Enquête sur la santé dans les collectivités canadiennes et fait un suivi avec les décès survenus jusqu’au 31 décembre 2011 d’après la Base canadienne de données sur l’état civil. Nos analyses ont été stratifiées selon l’âge : 55 à 64 ans et 65 ans et plus. Le soutien social a été évalué à l’aide d’indicateurs élaborés pour l’étude Medical Outcomes Study. Le sentiment d’appartenance, un indicateur binaire, a mesuré l’intégration dans la communauté. Le fait de vivre seul était aussi un indicateur binaire. Nous avons appliqué une analyse de survie à l’aide du modèle des risques proportionnels de Cox en apportant des ajustements selon l’âge, le sexe, le revenu, le tabagisme et la fragilité.

Résultats

Chez les répondants de 55 à 64 ans (n = 6822), le peu d’affection (RC = 1,37, IC de 95% : 1,07, 1,75), le peu d’appui émotionnel/informationnel (RC = 1,36, IC de 95% : 1,06, 1,74) et le peu d’interactions sociales positives (RC = 1,36, IC de 95% : 1,06, 1,75) étaient associés au risque de mortalité. Chez les répondants de 65 ans et plus (n = 8966), le peu d’affection (RC = 1,17, IC de 95% : 1,04, 1,31), le peu d’interactions sociales positives (RC = 1,20, IC de 95% : 1,07, 1,34), le peu d’appui émotionnel/informationnel (RC = 1,19, IC de 95% : 1,06, 1,33) et le faible sentiment d’appartenance (RC = 1,13, IC de 95% : 1,05, 1,22) étaient associés au risque de mortalité.

Conclusion

Le peu de soutien social et le faible sentiment d’appartenance sont d’importants facteurs de risque chez les Canadiens âgés et devraient faire partie du dialogue au Canada sur leur rôle dans le vieillissement sain.

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Acknowledgements

Funding for this project was provided by the Canadian Institutes of Health Research, the Fonds de Recherche du Québec - Santé, and the Institute for Health and Social Policy of McGill University.

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Authors and Affiliations

  1. Department of Interdisciplinary Studies, Appalachian State University, 301 Bodenheimer Drive, Boone, NC, 28608, USA

    Kelly Ann Renwick

  2. Statistics Canada, R.H. Coats Building, Floor 24 A, 100 Tunney’s Pasture, Driveway, Ottawa, ON, K1A 0T6, Canada

    Claudia Sanmartin

  3. Centre for Outcomes Research and Evaluation (CORE), Research Institute of the MUHC, McGill University, 5252 Boulevard de Maisonneuve Ouest, Office 3E.09, Montréal, QC, H4A 3S5, Canada

    Kaberi Dasgupta

  4. Priestley International Centre for Climate, University of Leeds, Leeds, LS2 9JT, UK

    Lea Berrang-Ford

  5. Department of Geography, McGill University, Burnside Hall, Room 705, 805, Sherbrooke Street West, Montreal, QC, H3A 0B9, Canada

    Nancy Ross

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  1. Kelly Ann Renwick
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  2. Claudia Sanmartin
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Correspondence to Kelly Ann Renwick.

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Renwick, K.A., Sanmartin, C., Dasgupta, K. et al. The influence of low social support and living alone on premature mortality among aging Canadians. Can J Public Health 111, 594–605 (2020). https://doi.org/10.17269/s41997-020-00310-9

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  • DOI: https://doi.org/10.17269/s41997-020-00310-9

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