National Social Life, Health, and Aging Project (NSHAP)
by NORC at the University of Chicago
Linda Sherman, Boomer Tech Talk, interviewer
Louise Hawkley, Ph.D, Senior Research Scientist
Jen Hanis-Martin, Ph.D, Research Scientist
NORC at the University of Chicago NSHAP had an exhibitor booth at the Aging in America conference (AiA18) hosted by American Society on Aging March 26 – 29 in SF. I met their colleague, Gregg Reynolds, Senior Business Analyst, Academic Research Centers during a session at the conference and he introduced me to their communications lead, Jen, for the interview. I conducted the interview in the AiA18 press room.
Here is the link to the NORC website that explains the National Social Life, Health, and Aging Project (NSHAP) study. You will find a wealth of information and links here. This research is available to other researchers working in the field of aging.
If you are wondering what NORC stands for, it is explained on their website.
Linda: Hello, my name is Linda Sherman, I am @LindaSherman on Twitter and @BoomerTechTalk and I am here today with two scientists from NORC, which does a study called the National Social Life Health and Aging study which is amazing and you’re going to hear all about it in this interview. They do have a Twitter handle themselves which is @norcnews. So first of all, if you could give us some background on how the study is set up; the three waves and that kind of thing in general.
Jen: The first wave of data was collected in 2005-2006. The study was designed by a team of investigators who are all faculty at the University of Chicago and some investigators at NORC at the University of Chicago like Louise Hawkley here.
Linda: Oh please can you mention your name
Jen: I’m Jen Hanis-Martin, I’m a research scientist at NORC and I’ve been with the project since about 2012 actually. Two waves of data were collected before I joined the project, the second wave was collected 2010-2011 and then we completed a third wave of data collection 2015-2016 and all three waves are available for researchers to analyze.
It’s funded by the National Institute on Aging, which is underneath the NIH that’s National Institute on Health, and they have funded all three waves of data collection for us. It’s available to researchers for free through the University of Michigan has a project there that hosts aging data. And we’re here at this conference actually promoting the existence of the data set, trying to encourage people to use it. We produced it to be a public good, available for people to learn about aging and what that involves with health and social relationships.
Linda: The link to the studies is on your page on your website, you actually have a website?
Jen: Yes its www.norc.org, and when you go to that website, you’re going to just search NSHAP and it’ll pop up lots of wonderful information about the project, publications that have been published through analyzing the data, a lot of information about the investigators, the team, the kind of sample of all the three waves; just a wealth of information at the website.
Linda: So Louise, obviously there’s a whole lot of data in this survey but we’d like to just focus on a few areas and one of them is my favorite which is social isolation. Could you talk about what happened with the kind of questions that you asked and the results that you got on social isolation?
Louise: Yes again that’s a rich area with many findings, but in terms of the questions we ask, one of the notable features of NSHAP is that we collect what’s called a network roster. We ask these older adults, and this is a nationally representative sample of over 3000 people when we started; each one of them is asked in an at home interview, to identify up to five people who are really important to them and with whom they discuss important matters.
And then about each of the people they identify, we ask them; who are these people to you, what relationship are they to you, are they your family members, are they friends, are they neighbours, are they your pastor; and we ask them, how often do you see these people, how well do you like these people. And then we also ask outside of this network roster, we ask people about their social activity, do they volunteer, are they members of groups. We also asked them functional, what we call functional aspects of their social relationships. Do they feel that they’re getting support, social support from the relationships, is there conflict in any of these relationships; to what extent do they feel lonely, which is distinct from being alone, whether they feel lonely or depressed or anxious or stressed. And then a whole raft of other questions to which we can relate these social measures.
Our key findings, there are many. One of the things I was remembering as one of our colleagues at Cornell was looking at how social networks change over time in this older adult population. So they start out at 57 to 85 when we first went to them in 2005, went back five years later and as you would expect in this age group they lose people in their network, a spouse dies, a sibling dies, friends move away; whatever it might be there are changes in their networks even if they themselves haven’t changed where they are, who they are.
But then interestingly, they’re replacing those ties by and large; any tie that they’ve lost; they have found somebody else with whom to share important matters. It’s not tit for tat but it’s quite a revelation in the sense that most people assume that once you lose those people you just have a withering social network and that’s the end of that. It doesn’t have to be that way evidently because these people clearly found a way to recreate a network.
One of the other things that I wrote a paper on with a colleague that was published recently where we were looking at feelings of loneliness and how those changed over time and what we did was try to look at changes in whether people– sort of a split. If you were lonely in 2005, were you still lonely in 2010 or had you managed to recover, were you not lonely in 2010 and vice versa. What if you were not lonely, did you stay not lonely or did you become lonely and how could you understand what factors gave rise to your risk for one or the other change?
And one of the things that came out; if you recovered from loneliness, it wasn’t that you had better… I mean more relationships, more social contact would seem to be the most robust predictor of getting over loneliness is avoiding conflictual relationships. So you can imagine if you have relationships that are maybe they are smallish in number but it’s really important that they be good quality relationships. So if they were strained, that was a high risk for becoming lonely. You didn’t lose the relationship but you lost the quality that you needed to feel well connected. So those are two of the highlights for the social aspect.
There are other findings that relate social relationships to health and that’s one of the key reasons why this study is done. Not only to see how health changes affect one’s social relationships – the other way around, can your social relationships somehow buffer the trajectory of health and ease that trajectory so that you don’t get worse quickly, kind of slowdown that decline or maintain even keel. Or on the other hand are there social relationships, whether it’s the quality of the network or the quality of the support you get or the amount of engagement you have in the community that could actually accelerate the aging health trajectory.
There are studies– there’s one study recently that was kind of cool in the sense that it you might say it’s intuitive on one hand but this was a very nice data representation of reality which was we looked at married couples and the likelihood that they would have a colonoscopy screening. And it turned out that wives were critical to husbands getting colonoscopy screening; it didn’t go the other way, but men who got colonoscopy screening by large were inched that way by a helpful wife. One other thing that is not related to social relationships per se, that it’s also been a very important contribution to the field more generally and this was work done by Martha McClintock and others on the NSHAP investigator team.
We called it in-house, and the publication title as well, “Reconceptualising Health”. We tend to have a very medical model of what health is; its physiological markers, its health conditions that are diagnosed, treated or not. And we think that lifestyle is going to play a big difference in whether you get better or not. Well way back already in the late forties, The World Health Organization said, ‘Health is more than the absence of disease; it’s the presence of well-being in every aspect of our lives’ and social is one of the big components of life that needs to be in good shape to really be considered healthy.
And so these investigators looked at the data from NSHAP to compare a medical model of how you might classify people along medical criteria and then they added the social factors that we knew about these same people, reclassified those people. Do they look the same, do they classify the same way, no not at all. And we know that because the mortality rates differed depending on the social component of their lives; everything else remaining relatively constant. So that was an important acknowledgement that the social has to be considered as part of overall health.
Linda: By any chance, Yoga happens to be a passion of mine. Did you look at yoga and the benefits of that and I also think that yoga is a very social thing if you manage to get into a yoga class.
Louise: No we didn’t look at specific exercise types. There are sub studies that some of our investigators do that use individual exercise types and there certainly is a lot of evidence suggesting that yoga is very helpful physically and probably also socially; I don’t know if anyone’s measured that explicitly. But we do have and it’s not exactly on your point but we always have a hard time in national surveys finding out how do we measure people’s physical activity, how do we know what they’re actually doing, do we trust them when they tell us they’re working out for 30 minutes every day for five days of the week; maybe, maybe not and a lot of the over the counter kind of measures like a Fitbit or something like that don’t capture the full range of motion at least not the kind of motion older adults do.
Fitbit’s are designed for young active people, older adults activity is not running up and down the stairs. And we wanted to know can we capture the more subtle everyday movements that an older adult is likely to have like getting up from a chair, walking across the room to the kitchen. And we used a research grade accelerometer it’s something designed specifically to capture very discreetly and very sensitively, many types of activity-
Linda: Does it have a brand?
Louise: It probably does but I don’t know it.
Linda: It’s okay
Louise: It’s not something you’d be able to get over the counter because its research grade.
Linda: Yes, but other researchers will be watching this.
Louise: Yes it could be learned maybe even on the website [laughing]. The other thing that comes out of that is the capacity to measure people’s sleep, which is a really interesting outcome, predictor is another measure we’re obtaining at NSHAP and it isn’t just how much sleep you get; when you’re wearing one of these accelerometers, you get to measure wake time after sleep onset, so people have many awakenings during the night; where their body is moving even though they may not recall that they are awake, they’re not sleeping soundly.
So there are other parameters of sleep that we can get and those indicators end up being pretty important too for health outcomes, this is something… work that Diane Lauderdale is doing, she’s another scientist on the study; yeah and so that’s an important aspect to the study that few other National surveys are able to do.
Linda: How about numbers of hours of sleep, do you have a factoid on this?
Louise: I don’t have immediately but I do remember them looking at what’s optimal sleep in populations more generally and there is a kind of a curvilinear relationship; like too little is not great but too much is not great either, so there is sort of an optimal window on average. You know 7.5 hours probably a nice target but there’s a lot of individual variability and the same amount of sleep is not necessary for everybody; there’s normal ranges for a diverse population.
Linda: Well thank you very much.
About the Aging in America Conference
This article is one in a series of reports I am writing following my attendance at the Aging in America Conference (AiA18) hosted by American Society on Aging (ASA).
I highly recommend this conference. The next one is April 15 – 18 in New Orleans. Locations through 2023 have been decided so that you can plan ahead. Thousands of dedicated professionals attend the conference. Their desire to do good and better for the older adults they serve is palpable. There are ten+ concurrent sessions during five time slots for four days, a feast of information sharing. “Over 3,000 attendees from across the nation and abroad attend the annual ASA Aging in America Conference conference to learn, network and participate in the largest multidisciplinary conference covering issues of aging and quality of life for older adults.”
It seems to me that the purpose of the conference is to freely share information so that everyone working in the field of aging can make advances that will benefit older adults. The presence of NORC NSHAP scientists in the exhibit hall and in attendance at the conference is evidence of that.
Here are the articles we have published to date covering the March 2018 AiA18:
– Reducing Bullying Between Older Adults
– Prevention of Distressing and Harmful Resident-to-Resident Interactions in Dementia in Long-Term Care Homes