Trust and all-cause mortality: a multilevel study of US General Social Survey data (1978–2010)

Abstract

BackgroundWithin public health research, generalised trust has been considered an independent predictor of morbidity and mortality for over two decades. However, there are no population-based studies that have scrutinised both contextual-level and individual-level effects of generalised trust on all-cause mortality. We, therefore, aim to investigate such associations by using pooled nationally representative US General Social Survey (GSS) data linked to the National Death Register (NDI).MethodsThe combined GSS–NDI data from the USA have 90 contextual units. Our sample consisted of 25 270 respondents from 1972 to 2010, with 6424 recorded deaths by 2014. We used multilevel parametric Weibull survival models reporting HRs and 95% CI (credible intervals for Bayesian analysis). Individual-level and contextual-level generalised trust were the exposures of interest; covariates included age, race, gender, marital status, education and household income.ResultsWe found a robust, significant impact of individual-level and contextual-level trust on mortality (HR=0.92, 95% CI 0.88 to 0.97; and HR=0.96, 95% CI 0.93 to 0.98, respectively). There were no discernible gender differences. Neither did we observe any significant cross-level interactions.ConclusionHigh levels of individual and contextual generalised trust protect against mortality, even after considering numerous individual and aggregated socioeconomic conditions. Its robustness at both levels hints at the importance of psychosocial mechanisms, as well as a trustworthy environment. Declining trust levels across the USA should be of concern; decision makers should consider direct and indirect effects of policy on trust with the view to halting this decline.

Association between social trust and the risk of cardiovascular disease in Korean adults aged 50 years or older: a nationwide retrospective cohort study

“…The mechanism of the association of social trust with health have been proposed usually by three casual pathways (16). First, by increasing social stress and anxiety, low social trust may stimulate the hypothalamic-pituitary-adrenal axis, resulting in high levels of blood cortisol, of which chronic exposure could be a risk factor for CVD (7,17). In this psychosocial pathway, high social trust may contribute to reduce CVD risk by decreasing social stress and/or anxiety.…”

Association between social trust and the risk of cardiovascular disease in Korean elderly adults: a nationwide retrospective cohort study

“…The mechanism of the association of social trust with health have been proposed usually by three casual pathways (23). First, by increasing social stress and anxiety, low social trust may stimulate the hypothalamic-pituitary-adrenal axis, resulting in high levels of blood cortisol, of which chronic exposure could be a risk factor for CVD (13,24). In this psychosocial pathway, high social trust may contribute to reduce CVD risk by decreasing social stress and/or anxiety.…”

Should Trust Be Stressed? General Trust and Proactive Coping as Buffers to Perceived Stress

“…In understanding what may drive or alleviate psychological stress, individual factors such as personality and coping strategies are important (Carver and Connor-Smith, 2010). Recently, the health benefits of trust have attracted attention not only in psychology but also in the fields of medicine and public health (Kawachi et al, 2008;Giordano and Lindström, 2016;Giordano et al, 2019). As health-promoting factors, the efficacy and relevance of related contextual effects and similar constructs to general trust also need to be evaluated (Shiell et al, 2020).…”

“…Such general trust (sometimes referred to as social capital) is generally considered important for society at large. It has been reported to be associated with general well-being (Carl and Billari, 2014), well-functioning democracies (Uslaner, 2002), economic growth (Guiso et al, 2004), cooperation (King-Casas et al, 2005), intelligence (Hooghe et al, 2012), and health (Kawachi et al, 2008;Giordano and Lindström, 2016;Giordano et al, 2019). Trust is thus associated with several beneficial outcomes that may function as buffers to adverse stressors.…”