Social support and self-reported health status of older adults in the United States.

OBJECTIVES: We determined whether a representative national probability sample of US community-dwelling older adults who reported less social support also reported poorer general health status, which is a robust predictor of prospective mortality among elders. METHODS: We analyzed 2 subsamples generated via random sampling with replacement from the full analytic sample of adults aged 60 years and older in the 1999-2002 National Health and Nutrition Examination Survey (n = 3476). We built multinomial logit models with the first analytic subsample (n = 1732). Then we tested the final models on the second subsample (n = 1744) to assess the differences in odds of reporting poor, fair, or good versus very good or excellent health. We fit the cross-validated final models to the full analytic sample. RESULTS: After we controlled for age, race, gender, and educational attainment, older persons across all analytic samples who reported that they needed more support also reported having poorer health compared with better health 2 times more often than did older persons who were satisfied with the support available to them (odds ratio [OR] = 2.4; 95% confidence interval [CI] = 1.7, 3.4; P < .001). CONCLUSIONS: In the United States, older persons' satisfaction with the emotional support available to them is associated with better self-reported health status.

Prevalence of multiple chronic disease risk factors. 2001 National Health Interview Survey.

BACKGROUND: Four common factors--cigarette smoking, risky drinking of alcoholic beverages, physical inactivity, and overweight--contribute substantially to chronic disease prevalence. METHODS: We used data from the 2001 National Health Interview Survey to provide an up-to-date picture of multiple risk factor prevalence and clustering in the U.S. population. We conducted a multinomial logit analysis to examine the independent association between each covariate and the dependent ordinal risk factor variable with three levels (none or one risk factor, two risk factors, and three or four risk factors). RESULTS: Seventeen percent of the sample of 29,183 subjects had three or more risk factors. For the entire sample, the mean number of risk factors was 1.68 (95% confidence interval [CI]=1.66-1.70). Many demographic and health factors were significantly associated with the mean number of risk factors including gender, age, ethnic/racial categories, education, martial status, presence of chronic diseases, level of mental distress, country of birth, and presence and type of health insurance. Using the risk factor score as the ordinal dependent variable, adjusted odds for having a risk score of three or four versus zero or one were as follows: men aged <65, 2.49 (95% CI=2.29-2.72); education attainment of high school graduate or less, 3.24 (95% CI=2.86-3.67); and individuals with high levels of mental distress, 2.06 (95% CI=1.65-2.58). CONCLUSIONS: Our analyses confirm earlier reports of the high prevalence of multiple, clustered behavioral risk factors and underline the challenge this presents for primary care and public health systems.