By William Harms
Photo by Robert Kozloff
“ Using a biological model, medicine had been successful in extending life expectancy...We wanted to study this last third of the lifespan in a way that looked at other aspects of health and well-being.”
George H. Mead Distinguished Service Professor in Sociology
With thousands of participants over nearly 10 years, a sweeping University of Chicago study has made discoveries that are transforming our knowledge about health and aging.
For example, the study has found that extended social networks can help keep blood pressure in check, and that having someone to talk about your health improves your chances of getting needed treatment. People very likely to discuss health matters with their network members were the least likely to have uncontrolled hypertension if they were in large networks, the study showed. Two studies published this fall showed that for older adults, being unable to identify scents is a strong predictor of death within five years, while another found that sleep problems among the elderly may stem from the quality, not quantity of rest.
The UChicago-led National Social Life, Health, and Aging Project has collected information about some of the most intimate aspects of growing older, creating the nation’s most comprehensive look at health in last third of people’s lives. In the process, patients have revealed information about their sex lives, shared details about who is in their social networks, and provided blood samples and other medical measures. That work has produced a rich set of data that allows researchers to examine the biological, psychological/cognitive, and social dimensions of health. The data have led to more than 100 published papers.
Data collection resumed this fall, when interviewers from NORC at the University of Chicago revisited study participants for a field test to begin the third wave of the survey—part of a $15 million study supported by the National Institutes of Health.
“The people who were 57 to 85 in 2005 during the first survey are now aged 67 to 95. We include the same people in our sample so we’re able to understand better how social life and health are connected as people age,” says Linda Waite, the Lucy Flower Professor of Urban Sociology and the principal investigator of the survey.
Scholars know, for instance, that poor health contributes to poor marriage quality. “But unless you have the longitudinal data, you don’t know which came first. Do people first have poor health, which undermines the marriage, or was the marriage poor quality to begin with and that affected health? You only know that if you interview the same people at different times in their lives.”
Taking a closer look a health and marriage
NSHAP is a project based at the independent research organization NORC and the University. The first wave was conducted in 2005 and 2006 with 3,000 people who were randomly chosen as a scientific cross-section of older Americans.
The second wave, conducted in 2010 and 2011, included the spouses and cohabitating romantic partners of the people interviewed in the first round. Round three includes the spouses and partners and the members of the first round who have survived their partners.
The work emerged as a result of conversations among UChicago faculty in medicine and the social sciences aimed at taking understanding of health care to another level, says Edward Laumann, the George H. Mead Distinguished Service Professor in Sociology and a member of the NSHAP research team.
“Using a biological model, medicine had been successful in extending life expectancy, and many people are now living into their 80s. We wanted to study this last third of the lifespan in a way that looked at other aspects of health and well-being,” he says.
What we know about growing old in America
Waite and colleagues have pointed out that wives with husbands in poor physical health are more likely to report high levels of marital conflict, while wives’ health does not affect husbands’ views of conflict in the marriage. She also found that sexual activity and positive mental health can reduce the damage to the marriage brought on by health problems.
NSHAP has provided data for a number of publications by faculty at the University of Chicago Medicine. William Dale, associate professor of medicine and chief of Geriatrics & Palliative Medicine, and his colleagues have found that men who report feeling stressed are nearly 20 percent less likely to get a common blood test to determine if they could have prostate cancer. It is the first time stress has been shown to significantly alter prostate cancer screening practices.
“We think it’s because people under greater stress focus their attention on issues with a shorter time horizon and have more difficulty considering long range problems,” he says.
Dale and his colleagues have done other work, showing that husband's rates of getting colonoscopies for colon cancer screening are higher if their wives are more highly educated and are happier with the marriage.
“Often a person very close to a patient, such as one’s spouse, has a greater impact on his decisions than does the physician. Having an involved spouse in the examination room during a visit with a patient could make a big impact on what treatment they receive,” he says.
Laumann, a leading national figure on social networks, has found an important connection between people’s social lives and health: People with a strong social network also have lower blood pressure, for instance.
The biomarker information also yielded important information about the role of C-reactive protein (CRP), an important indicator of inflammation related to heart disease and various other conditions. Women have higher CRP levels than men, but married men have significantly lower CRP levels than men who have divorced or are widowed.
"However, there is no difference in the CRP levels of married and previously married women,” Laumann says. The differences show that women share more of the burden of care giving in a marriage and accordingly find aging a more stressful experience.
Originally published on November 17, 2014.