ArticleJAMA network open2023
Associations of Social, Cultural, and Community Engagement With Health Care Utilization in the US Health and Retirement Study.
Article in JAMA network open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
9 citing papers in PubMed.
- Patient Digital Engagement With After Visit Summary in Ambulatory Care.JAMA network open · 2026Article
- Sociocultural Determinants of Mental Health in Indigenous Older Adults: Results from the U.S. Health and Retirement Study.Journal of cross-cultural gerontology · 2026Article
- Factors associated with nonpharmacological treatment use among older adults with chronic low back pain tapering opioids.Pain management · 2025Article
- Low Social Engagement and Risk of Death in Older Adults.Journal of the American Geriatrics Society · 2025Article
- Multidimensional health status and its impact on health care consumption behavior among elderly people with chronic diseases: evidence from CHARLS in China.Frontiers in psychology · 2025Article
- Predictors of Patient Engagement in a Care Coordination Program.Patient preference and adherence · 2025Article
- Reducing inequity through tackling social determinants of cardiovascular diseases in China.BMJ (Clinical research ed.) · 2024Article
- Leisure Engagement and Self-Perceptions of Aging: Longitudinal Analysis of Concurrent and Lagged Relationships.The journals of gerontology. Series B, Psychological sciences and social sciences · 2024Article
- Leisure engagement in older age is related to objective and subjective experiences of aging.Nature communications · 2024Article
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Authors and funding
6 authors.
Funding
Abstract
Importance: There is growing evidence for the health benefits associated with social, cultural, and community engagement (SCCE), including for supporting healthy behaviors. However, health care utilization is an important health behavior that has not been investigated in association with SCCE. Objective: To examine the associations between SCCE and health care utilization. Design, Setting, and Participants: This population-based cohort study used data from the 2008 to 2016 waves of the Health and Retirement Study (HRS), a longitudinal panel study using a nationally representative sample of the US population aged 50 years and older. Participants were eligible if they reported SCCE and health care utilization in the relevant HRS waves. Data were analyzed from July to September 2022. Exposures: SCCE was measured with a 15-item Social Engagement scale (including community, cognitive, creative, or physical activities) at baseline (frequency) and longitudinally over 4 years (no, consistent, increased, or decreased engagement). Main Outcomes and Measures: Health care utilization was assessed in association with SCCE within 4 overarching categories: inpatient care (ie, hospital stays, hospital readmissions, length of hospital stays), outpatient care (ie, outpatient surgery, physician visits, number of physician visits), dental care (including dentures), and community health care (ie, home health care, nursing home stays, nights in a nursing home). Results: A total of 12 412 older adults (mean [SE] age, 65.0 [0.1] years; 6740 [54.3%] women) were included in short-term analyses with 2 years of follow-up. Independent of confounders, more SCCE was associated with shorter hospital stays (incidence rate ratio [IRR], 0.75; 95% CI, 0.58-0.98), greater odds of outpatient surgery (odds ratio [OR], 1.34; 95% CI, 1.12-1.60) and dental care (OR, 1.73; 95% CI, 1.46-2.05), and lower odds of home health care (OR, 0.75; 95% CI, 0.57-0.99) and nursing home stays (OR, 0.46; 95% CI, 0.29-0.71). Longitudinal analysis included 8635 older adults (mean [SE] age, 63.7 [0.1] years; 4784 [55.4%] women) with data on health care utilization 6 years after baseline. Compared with consistent SCCE, reduced SCCE or consistent nonparticipation in SCCE was associated with more inpatient care utilization, such as hospital stays (decreased SCCE: IRR, 1.29; 95% CI, 1.00-1.67; consistent nonparticipation: IRR, 1.32; 95% CI, 1.04-1.68) but lower levels of subsequent outpatient care, such as physician visits (decreased SCCE: OR, 0.68; 95% CI, 0.50-0.93; consistent nonparticipation: OR, 0.62; 95% CI, 0.46-0.82) and dental care utilization (decreased SCCE: OR, 0.68; 95% CI, 0.57-0.81; consistent nonparticipation: OR, 0.51; 95% CI, 0.44-0.60). Conclusions and Relevance: These findings suggest that more SCCE was associated with more dental and outpatient care utilization and reduced inpatient and community health care utilization. SCCE might be associated with shaping beneficial early and preventive health-seeking behaviors, facilitating health care decentralization and alleviating financial burden by optimizing health care utilization.
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