“…ENRICHD was based on evidence from a large number of longitudinal observational studies indicating that both depression and social support were related to survival post MI (13). Most of the studies indicated that both men and women who were depressed or were socially isolated had elevated mortality or reinfarction risks ranging from ∼2 to 4 (9,11,14,35,77). Results from related clinical trials were inconsistent (23,24,26).…”
Section: Interpreting the Results Of Social And Behavioral Interventimentioning
The United States ranks in the lower tiers of OECD countries in life expectancy, and recent studies indicate that socioeconomic inequalities in health have been widening in the past decades. Over this period, many rigorous longitudinal studies have identified important social, behavioral, and environmental conditions that might reduce health disparities if we could design effective interventions and make specific policy changes to modify them. Often, however, neither our policy changes nor our interventions are as effective as we hoped they would be on the basis of findings from observational studies. Reviewed here are issues related to causal inference and potential explanations for the discrepancy between observational and experimental studies. We conclude that more attention needs to be devoted to (a) identifying the correct etiologic period within a life-course perspective and (b) understanding the dynamic interplay between interventions and the social, economic, and environmental contexts in which interventions are delivered.
“…ENRICHD was based on evidence from a large number of longitudinal observational studies indicating that both depression and social support were related to survival post MI (13). Most of the studies indicated that both men and women who were depressed or were socially isolated had elevated mortality or reinfarction risks ranging from ∼2 to 4 (9,11,14,35,77). Results from related clinical trials were inconsistent (23,24,26).…”
Section: Interpreting the Results Of Social And Behavioral Interventimentioning
The United States ranks in the lower tiers of OECD countries in life expectancy, and recent studies indicate that socioeconomic inequalities in health have been widening in the past decades. Over this period, many rigorous longitudinal studies have identified important social, behavioral, and environmental conditions that might reduce health disparities if we could design effective interventions and make specific policy changes to modify them. Often, however, neither our policy changes nor our interventions are as effective as we hoped they would be on the basis of findings from observational studies. Reviewed here are issues related to causal inference and potential explanations for the discrepancy between observational and experimental studies. We conclude that more attention needs to be devoted to (a) identifying the correct etiologic period within a life-course perspective and (b) understanding the dynamic interplay between interventions and the social, economic, and environmental contexts in which interventions are delivered.
“…8,9 Large-scale studies have also suggested that marriage, one of the most central sources of support, has a salutary effect and that bereavement and divorce have a negative impact on cardiac and overall health. Married persons are at reduced risk for all-cause and post MI death, [10][11][12][13][14][15][16][17] whereas divorce is linked to increased total and cardiovascular mortality 15,18 and impaired physical and psychological health. 19 Although findings are mixed, many studies report that a greater "marriage benefit" accrues to men, 11,15,20 and that men are more adversely affected by marital disruption.…”
Section: The Authors Investigated the Relationship Between Brief Warmmentioning
The authors investigated the relationship between brief warm social and physical contact among cohabitating couples and blood pressure (BP) reactivity to stress in a sample of healthy adults (66 African American, 117 Caucasian; 74 women, 109 men
“…5,6 Lack of social support also portends a poor prognosis in patients after myocardial infarction (MI). 7,8 For example, among MI survivors, those with low to moderate levels of perceived social support had a 1-year post-CHD mortality rate about twofold higher than those with high levels of social support. 9 Furthermore, there is an interaction between depression and social support in relation to MI survival.…”
There has been mounting evidence suggesting that psychosocial factors, including anger proneness, depression and social isolation, are risk factors for coronary heart disease (CHD). 1,2 Studies have shown a positive relationship between anger proneness and CHD risk factors. The Atherosclerosis Risk in Communities (ARIC) Study found that anger proneness was an independent risk factor for CHD among normotensive, middle-aged men and women. 3 A meta-analysis reviewing several major epidemiological studies concluded that depression is an independent risk factor in the development of CHD in initially healthy people, with an overall relative risk of 1.64. 4 Other studies have also shown that depression increases short and long term mortality risk in patients with known CHD. 5,6 Lack of social support also portends a poor prognosis in patients after myocardial infarction (MI). 7,8 For example, among MI survivors, those with low to moderate levels of perceived social support had a 1-year post-CHD mortality rate about twofold higher than those with high levels of social support. 9 Furthermore, there is an interaction between depression and social support in relation to MI survival. 9 Although epidemiologic evidence is indicative, the results of psychosocial interventions after MI have
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