Black females experience diminished cardiovascular health (CVH) earlier than other females in the U.S. Young adulthood is a pivotal period for developing and maintaining positive health behaviors and social relationships. Social isolation is a risk factor for cardiovascular disease morbidity and mortality, and that risk may begin early in life. Research with middle-aged adults suggests race and sex moderate the association between social isolation and CVH, underscoring the need to further elucidate this relationship in young Black females.
Hypothesis:
We assessed the hypothesis that (a) there are distinct latent classes of social networks for young Black females; (b) latent social network classes are associated with CVH; and (c) perceived stress and depression mediate this relationship.
Methods:
Data are from 517 Black females, age 24-32, who participated in the National Longitudinal Adolescent to Adult Health Study, a population cohort study. Social network included three components of the Berkman Syme Index (number of close friends, religious participation, volunteer/community service activities) and perceived isolation. The primary outcome was the AHA Ideal CVH score, a composite measure that includes diet, physical activity, BMI, smoking, cholesterol, blood pressure, and glucose. Proposed mediators were perceived stress and depression. A latent class analysis was conducted to identify distinct social network subgroups. General and generalized linear models were used to test for subgroup differences in ideal CVH and mediator effects.
Results:
The best fit latent class analysis identified a three-class model: (1) strong, diverse, social network, 31.5%; (2) moderate social network with no perceived social isolation, 42.6%; and limited social network with perceived social isolation, 25.9%. All subsequent analyses covaried for income because these subgroups differed on income (p=0.0003) and low income was associated with lower ideal CVH scores (p<0.001). Social network was associated with ideal CVH (p=0.004), with the strong, diverse network subgroup having better CVH scores compared to the other subgroups (p<0.005), which did not differ. Black women with a strong, diverse or a moderate network with no perceived isolation had lower probability of perceived stress and depression compared to those with a limited network and perceived isolation (p<0.018). Perceived stress and depression, however, were not associated with CVH scores and did not mediate the social network-CVH relationship.
Conclusion:
In young Black women, social networks may influence health behaviors and overall cardiovascular health, independent of mental health status. Future research should explore mediators of this relationship to effectively tailor lifestyle interventions to establish and maintain CVH and reduce health disparities.
The association between use of online social networks sites and perceived social isolation among individuals in the second half of life: results based on a nationally representative sample in Germany
