Chronic Diseases in Canada

Volume 31, no. 2, March 2011

General social support and work social support and the risk of recurrence after a first myocardial infarction: 6-year prospective study

Thiam A. (1); Brisson C. (1)

Background/Purpose/Objectives: This study evaluated the effect of low general social support (GSS) and low work social support (WSS) on the risk of recurrent coronary heart disease (CHD).

Study design/Methods: A cohort of 972 women and men who had had a first acute myocardial infarction was recruited from Quebec hospitals. Three interviews were conducted over the 6 years of follow-up and medical files were examined to identify the following CHD events: a fatal CHD, a non-fatal myocardial infarction and an unstable angina. We evaluated GSS (emotional or informational support and positive social interaction) using the French version of the medical outcomes study Social Support Survey and WSS (relationships with colleagues and supervisor) using Faucett's questionnaire, based on the Interpersonal Relationships Inventory. We used Cox regression to analyze the data.

Results: A total of 206 CHD events occurred during the follow-up period. There was significant moderate association between continuous exposure to low GSS and the risk of recurrent CHD (adjusted hazard ratio = 1.66, CI: 1.08–2.57). No association was observed between low WSS and risk of recurrent CHD.

Conclusions: Our study shows that post-myocardial patients who have little social support in their general environment (but not specifically at work) are at higher risk of recurrent CHD. We also show that there is a need for future studies on this topic.

Prevalence and risk factors for underhousing among trans people in Ontario: a cross-sectional study

Warner A. J. (2); Bauer G. R. (2) ; Scanlon K. (3); Pyne J. (4)

Background/Purpose/Objectives: Lack of adequate housing and housing discrimination, which occurs in Canada and worldwide, negatively impacts the health and well being of those affected. Trans populations experience disproportionately high rates of homelessness, which may compromise their ability to access safe and stable housing. In this study, we calculate prevalence estimates for underhousing and potential risk factors, and construct an exploratory predictive model of identified risk factors among the trans population.

Study design/Methods: Data were obtained from the Trans PULSE survey, a cross-sectional, community-based survey sampling trans people living in Ontario (n = 433). We performed univariate and bivariate analyses using a logistic predictive model for underhousing weighted by probability of recruitment.

Results: An estimated 33.1% of Ontario trans people are underhoused. Significant risk factors from the multivariable predictive model are having a personal income less than $15,000 (odds ratio [OR] = 3.57, 95% CI: 1.18–11.11; ref: > $30,000), always being perceived by others as trans (OR = 7.14, 95% CI: 1.08–50.00; ref: never), having a high frequency of alcohol use (OR = 2.72, 95% CI: 1.03–7.19; ref: never users).

Conclusions: Housing discrimination may be occurring, placing trans communities at high risk for underhousing. Additional study is needed to further improve and re-evaluate services and policies to best serve trans communities.

Author References

1. URESP, Centre de recherche FRSQ du Centre hospitalier affilié universitaire de Québec, Québec, Canada
2. Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
3. The 519 Church Street Community Centre, Toronto, Ontario, Canada
4. Trans PULSE Project, Ontario, Canada