Cited by 159Health disparities and outcomesCardiac Health and Mental HealthLipoproteins and Cardiovascular Health

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Social isolation, C-reactive protein, and coronary heart disease mortality among community-dwelling adults

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Heffner, Kathi L., Waring, Molly E., Roberts, Mary B., Eaton, Charles B., Gramling, Robert·2011·Social Science & Medicine

DOI 10.1016/j.socscimed.2011.03.016PMC PMC3090468

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Abstract

Social isolation confers increased risk for coronary heart disease (CHD) events and mortality. In two recent studies, low levels of social integration among older adults were related to higher levels of C-reactive protein (CRP), a marker of inflammation, suggesting a possible biological link between social isolation and CHD. The current study examined relationships among social isolation, CRP, and 15-year CHD death in a community sample of US adults aged 40 years and older without a prior history of myocardial infarction. A nested case-cohort study was conducted from a parent cohort of community-dwelling adults from the southeastern New England region of the United States (N = 2321) who were interviewed in 1989 and 1990. CRP levels were measured from stored sera provided by the nested case-cohort (n = 370), which included all cases of CHD death observed through 2005 (n = 48), and a random sample of non-cases. We found that the most socially isolated individuals had two-and-a-half times the odds of elevated CRP levels compared to the most socially integrated. In separate logistic regression models, both social isolation and CRP predicted later CHD death. The most socially isolated continued to have more than twice the odds of CHD death compared to the most socially integrated in a model adjusting for CRP and more traditional CHD risk factors. The current findings support social isolation as an independent risk factor of both high levels of CRP and CHD death in middle-aged adults without a prior history of myocardial infarction. Prospective study of inflammatory pathways related to social isolation and mortality are needed to fully delineate whether and how CRP or other inflammatory markers contribute to mechanisms linking social isolation to CVD health.

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“As in prior studies (Eng et al., 2002; House et al., 1982; Kaplan et al., 1988; Kawachi et al., 1996; Orth-Gomer et al., 1993), the least socially integrated were also more likely to die from CHD over a 15-year period than individuals at the highest levels of social integration.”
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Authors: Heffner, K. L., Waring, M. E., Roberts, M. B., Eaton, C. B., & Gramling, R.
Affiliations: University of Rochester Medicine (US)
University of Massachusetts Chan Medical School (US)
Brown University (US)
Corresponding author: Heffner, Kathi L.
ORCID: Heffner, Kathi L.
Waring, Molly E.
Roberts, Mary B.
Eaton, Charles B.
Gramling, Robert
Venue: Social Science & Medicine
Publisher: Elsevier BV
Published: 2011-05
Volume: 72
Issue: 9
Pages: 1482-1488
ISSN: 0277-9536 (ISSN-L)
DOI: 10.1016/j.socscimed.2011.03.016
PMC: PMC3090468
OpenAlex: W2081320959
Cited by: 159
References: 39
Citations by year: 2026: 5 · 2025: 9 · 2024: 8 · 2023: 15 · 2022: 26 · 2021: 19 · 2020: 19 · 2019: 11 · 2018: 10 · 2017: 8 · 2016: 5 · 2015: 6 · 2014: 6 · 2013: 6 · 2012: 5
FWCI: 5.59
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Social Science & Medicine (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
RePEc: Research Papers in Economics (submittedVersion)
Funders: Brown University
National Institutes of Health (7r03hg004158-03, 7r03nr010409-02)
National Institute on Aging (R24AG031089)
National Human Genome Research Institute (R03 HG004158, 1R03HG004158)
National Institute of Nursing Research (R03 NR010409, 1R03NR010409)
National Center for Research Resources (UL1RR031982)
Topics: Social Sciences › Health › Health disparities and outcomes
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
Keywords: social isolation, C-reactive protein, coronary heart disease mortality, social integration, inflammation, middle-aged adults, cardiovascular risk factors, community-dwelling adults, social determinants of health
MeSH terms: Adult, Aged, C-Reactive Protein, Coronary Disease, Female, Health Surveys, Humans, Male, Middle Aged, New England, Social Isolation, Cohort Studies, Case-Control Studies

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Social isolation, C-reactive protein, and coronary heart disease mortality among community-dwelling adults

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