Association Of Social Trust With Subsequent Stroke And Cardiovascular Disease Risk

Introduction: Although social capital has been shown to be one of the important social determinants of health, the association between social trust and the risk of stroke and cardiovascular disease (CVD) is not clear yet. We aimed to investigate the association of social trust with stroke and CVD risk using a large Asian population. Methods: The study data was derived from the Korean National Health Insurance Service database. Community-level social trust was determined from the Koran Community Health Survey. The study population consisted of 2,156,829 participations. According to social trust index measured in the area of residence during 2011, participants were followed-up from 1 January 2012 to 31 December 2016. Multivariate Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for stroke and CVD risk according to quintiles of social trust. Results: Compared to those with the lowest quintile of social trust, participants within the highest quintile had lower risk for stroke (aHR 0.90, 95% CI 0.87-0.93) and CVD (aHR 0.91, 95% CI 0.89-0.93), and the risk-reducing association of high social trust on CVD risk was preserved after additional adjustments for lifestyle behaviors including smoking, alcohol intake, and physical activity. Conclusion: Higher social trust was associated with reduced risk of stroke and CVD even after considering lifestyle behaviors. Social trust in a community level is an important determinant of stroke risk and enhancing social trust may lead to reduced risk of stroke and CVD.