207348 Health Disparity in Social Connection, Diabetes Mellitus and Mortality among American White and African Americans Aged 70 or Older: An Eight-year Follow-up Study

Wednesday, November 11, 2009: 11:05 AM

Longjian Liu, MD, PhD, MSc , Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA
Raymond Lum, MPhil, MS , Health Management and Policy, Drexel University School of Public Health, Philadelphia, PA
Jixiang Ma , Shandong Center for Disease Control and Prevention, Institute of Non-Cmmunicable Disease Prevention, Jinan, Shandong, China
Kate Clark, MPA , Philadelphia Corporation for Aging, Philadelphia, PA
Allen Glicksman, PhD , Research and Evaluation, Philadelphia Corporation for Aging, Philadelphia, PA
Xiaoyan Yin, MD , Division of Endocrinology, Diabetes & Metabolism, University of Pennsylvania School of Medicine, Philadelphia, PA
Objective: Social connections (SC) are behaviors that demonstrate a person has networks of friends, neighbors and family relatives. We aimed at examining associations between SC, diabetes mellitus (DM) and mortality among American White (W) and African Americans (AA).

Method: Data (n=9,246) from the Second Longitudinal Study of Aging, a nationally representative sample in adults aged>=70 at the time of participation (1994-96), are analyzed to examine SC and DM in relation to risk of mortality in 2002. SC status is assessed using weighted SC scores. A higher SC score indicates a worse SC status. Subjects with SC scores >90% of SC distribution in the total sample are defined as SC disadvantage (SCD). Propensity score, a novel biostatistical technique, is applied to adjust for baseline covariates.

Results: Mean SC scores (95%CI) were 3.08 (2.96 – 3.20) and 4.21 (3.86 – 4.55) for male W and AA (p<0.01); and 2.86 (2.78 – 2.94) and 3.69 (3.46 – 3.93) for female W and AA (p<0.01). Subjects with SCD and DM had the highest mortality followed by those with SCD only, DM only, and with none of these two conditions. Cox regression analyses indicated that SCD and DM were independent predictors of mortality in both W and AA participants. The adjusted hazard ratios of mortality were 1.17 and 1.74 for SCD in W and AA (p<0.01); and were 1.39 and 1.23 for DM in W and AA (p<0.01) respectively. Conclusion: Enhancing social connection and controlling diabetes play a crucial role in controlling and reducing health disparities in mortality.

Learning Objectives:
1. To understand whether and how social connection play a pivotal role in health and longevity. 2. To understand that there are significant health disparities in social connection and diabetes (one of major chronic diseases affects African Americans), these two conditions are strongly associated with a significantly higher mortality in the minority group. 3. To learn and discuss how to calculate social connection scores using standard biostatistical techniques. 4. To learn how to adjust for confounding variables using Propensity score, a novel biostatistical technique used for adjustment for baseline covariates in order to examine associations between predictors and outcomes appropriately.

Keywords: Aging, Networking

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: researcher and educator
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: The Epidemiology of Chronic Disease and Aging
See more of: Epidemiology