P2-291 Structural and functional measures of social support, socioeconomic position and mortality. The British Whitehall II Study
Introduction Social relationships are associated with socioeconomic position (SEP) and with mortality, but it is unclear to what extent the socioeconomic gradient in mortality is attributable to differences in social relations between socioeconomic groups. In this study, we examine the contribution of different measures of social support to the socioeconomic gradient in all-cause and cause-specific mortality.
Methods Analyses are based on 9333 participants from the British Whitehall II study, aged 35–55 years at baseline (1985). SEP was civil service employment grade at baseline and social support was assessed 3 times over a follow-up for mortality of 24.4 years.
Results Measures of social support were socially patterned, but the pattern differed by gender. In men, social isolation and marital status were predictors of all-cause (HR=1.27, 95% CI 1.07 to 1.52 for low network score and HR=1.77; 95% CI 1.45 to 2.16 for not being married) and cardiovascular mortality (HR=1.85; 95% CI 1.36 to 2.51 for low network score and HR=2.69; 95% CI 1.95 to 3.71 for not being married). These associations were partially attenuated after adjustment for self-rated health. Men in the lowest SEP had an higher mortality risk than those in the highest (HR=1.59; 95% CI=1.21 to 2.08 for all-cause and HR=2.48; 95% CI 1.55 to 3.92 for cardiovascular mortality). Network score and marital status attenuated these associations by 27% (95% CI 14% to 43%) and 29% (95% CI 17% to 52%), respectively. In women, there was no consistent association between social support and mortality.
Conclusions The associations of social support with SEP and with mortality differ by gender. In men, social isolation and in particular not being married are important risk factors for mortality and are also likely to contribute to social inequalities in health.