Social engagement and chronic disease risk behaviors: The Multi-Ethnic Study of Atherosclerosis

•Social engagement has been inconsistently associated with health behaviors.•This study compared three dimensions of social engagement and tested interactions.•Only social support was associated with smoking behaviors.•However, neighborhood social cohesion was also relevant to health behaviors.•Only one interaction was found, suggesting largely independent associations.

ObjectiveAlthough engagement in social networks is important to health, multiple different dimensions exist. This study identifies which dimensions are associated with chronic disease risk behaviors.MethodsCross-sectional data on social support, loneliness, and neighborhood social cohesion from 5381 participants, aged 45-84 from the Multi-Ethnic Study of Atherosclerosis was used.ResultsAfter adjusting for individual characteristics and all social engagement variables, social support was associated with lower smoking prevalence (PR = 0.88, 95% CI: 0.82, 0.94), higher probability of having quit (PR = 1.03, 95% CI: 1.01, 1.06) and a slightly higher probability of achieving physical activity recommendations (PR = 1.03, 95% CI: 1.01, 1.06). Neighborhood social cohesion was associated with very slightly higher probability of achieving recommended (PR = 1.03, 95% CI: 1.01, 1.05) or any regular (PR = 1.0, 95% CI: 1.01, 1.04) physical activity, and a higher probability of consuming at least five daily fruit and vegetable servings (PR = 1.05, 95% CI: 1.01, 1.09).ConclusionsBoth social support and neighborhood social cohesion, a less commonly considered aspect of social engagement, appear to be important for chronic disease prevention interventions and likely act via separate pathways.