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L F Berkman

Publications and source records attributed to L F Berkman.

At least 91 records · Page 5Linked to original sources
PubMed1987

Assessing social networks and social support in epidemiologic studies.

Epidemiologists and other researchers in the biomedical field have recently recognized the potential importance of social networks and the support they provide in maintaining health and well being. However, measuring social networks and social support has not proven to be easy, measures are generally not well validated and critical dimensions or characteristics of networks have yet to be identified. The aim of this paper is to provide the reader with some background on the work being done in this area. In particular, attention is devoted to why, historically, social networks have been suspected of playing a role in disease causation, what some important characteristics of networks are likely to be, examples of measures currently in use, and what the biological pathways are that may link networks to morbidity and mortality. A description of the Alameda County Study in California is given. In this study, people who were socially isolated were found to be over twice as likely to die in a nine-year follow-up period as those with many contacts. This increased risk was found to be independent of alcohol and cigarette consumption, obesity and other health practices.

Adult↗
PubMed1986

Depressive symptoms in relation to physical health and functioning in the elderly.

The associations between depressive symptoms and functional disability and chronic conditions are examined in an elderly cohort of 2,806 noninstitutionalized men and women living in New Haven, Connecticut who were interviewed in 1982 as a part of the Yale Health and Aging Project. The aim is to explore several potential sources of invalidity in using the Center for Epidemiologic Studies-Depression scale (CES-D) to measure depressive symptoms in elderly populations. In particular, the authors are concerned with the possibility that prevalent physical illnesses and disabilities may cause the older person to report many somatic complaints, a major component of most measures of depressive symptomatology, and thereby inflate his or her CES-D score. Mean CES-D scores are 4.86 for those without any disabilities and range to 13.51 for those with major functional disabilities. However, physical disability is significantly associated with virtually every item on the CES-D scale not just those somatically-oriented items. The addition of functional disability to a multivariate model including age subfactor analysis of responses from this elderly sample produces results almost identical to those reported by earlier investigators who studied younger and middle-aged adults. The authors conclude that physical disabilities among the elderly do not appear to be a major threat to the validity of the CES-D scale and that the strong associations between physical and mental health should be rigorously investigated.

Aged↗
PubMed1985

The use of pediatric medical care: a critical review.

The problems of who uses medical services and why, are important ones for investigators interested in studying chronic diseases, particularly if they wish to avoid systematic error when assembling a study population. These issues are important when studying pediatric diseases due to the uneven use of medical services by children and the tendency of lower socioeconomic groups to use hospital facilities rather than private practitioners. In order to address these problems, we must understand why families seek medical care for young children. Utilization research shows that a number of descriptive factors such as child's age, birth order, parental education, financial resources and perceived symptoms are related to service use. Additionally, psychosocial variables, such as distress, also predict utilization. Neither the descriptive nor psychosocial variables explain much of the variance in utilization. While some of this lack of explanatory power can be attributed to problems in measurement or study design, there are also conceptual and methodological issues that are not addressed in pediatric utilization research. This paper discusses four of these issues. It is our conclusion that two of these problems, the need for a new utilization taxonomy and the ambiguity of cause and effect, can be remedied. While more difficult to address, the inadequate conceptualization of social stress, psychological distress, and social support can be improved. However, measuring health status independently of utilization represents a major methodologic problem for which we currently have no ideal solution.

Birth Order↗
PubMed1985

The impact of social stressors and social networks on pediatric medical care use.

Substantial differences in the use of pediatric medical resources reinforce the need for identifying and understanding factors that influence the use of medical services for children. This research assesses the simultaneous impact of sociodemographic characteristics, health attitudes and beliefs, psychologic distress, social stressors, and social networks on the use of pediatric acute care services during a 12-month period. Using a prospective longitudinal study design, data were obtained on 513 children and their families enrolled in a prepaid group practice. Linear modeling results showed that health attitudes and social networks were important predictors of acute care utilization in addition to child's age, birth order, baseline health status, and ethnic group. The authors were able to show significant effects for network size, dispersion, and tendency to use one's network members. Individuals with large nondispersed networks are more likely to use pediatric health services, apparently due to the transmission of the networks' pro-medical care health beliefs. Also the tendency to call on network members modifies an individual's propensity to seek care for minor pediatric medical problems and can make a difference by as much as 1.6 visits per year per child for acute care episodes.

Adolescent↗
PubMed1985

Epidemiology of disability in the oldest old: methodologic issues and preliminary findings.

Little is known about the health problems of the fastest-growing segment of the population. Three major community-based studies present prevalence information on physical and mental disabilities among the oldest old. These data also illustrate the limitations of interpretations in cross-sectional studies, and emphasize the value of prospective investigations of populations aged 85 and older. Although more costly and time-consuming, such prospective longitudinal studies are indispensable to sound policy planning.

Aged↗
PubMed1983

Mortality risk associated with sleeping patterns among adults.

The mortality risk associated with different sleeping patterns was assessed by use of the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, CA and a subsequent 9-year mortality follow-up. The analysis indicates that mortality rates from ischemic heart disease, cancer, stroke, and all causes combined were lowest for individuals sleeping 7 or 8 h per night. Men sleeping 6 h or less or 9 h or more had 1.7 times the total age-adjusted death rate of men sleeping 7 or 8 h per night. The comparable relative risk for women was 1.6. The association between sleeping patterns and all causes of mortality was found to be independent of self-reported trouble sleeping and self-reported physical health status at the time of the 1965 survey. Simultaneous adjustment for age, sex, race, socioeconomic status, physical health status, smoking history, physical inactivity, alcohol consumption, weight status, use of health services, social networks, and life satisfaction reduced the relative mortality risk associated with sleeping patterns to 1.3 (p less than or equal to 0.04).

Adult↗
PubMed1982

A multivariate analysis of health-related practices: a nine-year mortality follow-up of the Alameda County Study.

Associations between several common health-related practices and a variety of health outcomes have been reported. However, the independent associations between each of these practices and mortality from all causes have not been assessed. In the present report, a multiple logistic analysis of seven potentially health-related practices (individually and in a summary index) and mortality from all causes is conducted, using data from the Human Population Laboratory Study of a random sample of 6928 adults living in Alameda County, California in 1965 and a subsequent nine-year mortality follow-up. Many covariables such as physical health status and socioeconomic status are simultaneously analyzed. The health-related practices examined are: 1) never smoking; 2) regular physical activity; 3) low alcohol consumption; 4) average weight status; 5) sleeping seven to eight hours/night; 6) not skipping breakfast; and 7) not snacking between meals. The analysis reveals that five of the practices are associated with lower mortality from all causes. Neither eating breakfast nor not snacking have significant independent associations with lower mortality. After covariable adjustment, respondents who reported few low-risk practices have a relative risk of 2.3 (p less than 0.001) when compared with those who had many low-risk practices. Mortality risks for possible combinations of health-related practices are discussed.

Adult↗
PubMed1979

Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents.

The relationship between social and community ties and mortality was assessed using the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, California and a subsequent nine-year mortality follow-up. The findings show that people who lacked social and community ties were more likely to die in the follow-up period than those with more extensive contacts. The age-adjusted relative risks for those most isolated when compared to those with the most social contacts were 2.3 for men and 2.8 for women. The association between social ties and mortality was found to be independent of self-reported physical health status at the time of the 1965 survey, year of death, socioeconomic status, and health practices such as smoking, alcoholic beverage consumption, obesity, physical activity, and utilization of preventive health services as well as a cumulative index of health practices.

Adult↗
PubMedDate not supplied

The role of social relations in health promotion.

In considering new paradigms for the prevention and treatment of disease and disability, we need to incorporate ways to promote social support and develop family and community strengths and abilities into our interventions. There is now a substantial body of evidence that indicates that the extent to which social relationships are strong and supportive is related to the health of individuals who live within such social contexts. A review of population-based research on mortality risk over the last 20 years indicates that people who are isolated are at increased mortality risk from a number of causes. More recent studies indicate that social support is particularly related to survival postmyocardial infarction. The pathways that lead from such socioenvironmental exposures to poor health outcomes are likely to be multiple and include behavioral mechanisms and more direct physiologic pathways related to neuroendocrine or immunologic function. For social support to be health promoting, it must provide both a sense of belonging and intimacy and must help people to be more competent and self-efficacious. Acknowledging that health promotion rests on the shoulders not only of individuals but also of their families and communities means that we must commit resources over the next decade to designing, testing, and implementing interventions in this area.

Disease Susceptibility↗