Journal Article

Sense of Coherence and Mortality in Men and Women in the EPIC-Norfolk United Kingdom Prospective Cohort Study

Paul Surtees, Nicholas Wainwright, Robert Luben, Kay-Tee Khaw and Nicholas Day

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 158, issue 12, pages 1202-1209
Published in print December 2003 | ISSN: 0002-9262
Published online December 2003 | e-ISSN: 1476-6256 | DOI:
Sense of Coherence and Mortality in Men and Women in the EPIC-Norfolk United Kingdom Prospective Cohort Study

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This study tested the hypothesis that a personality disposition defined by a strong sense of coherence is associated with a reduced risk of mortality. The authors prospectively examined, for ≤6 years, the relation between a strong sense of coherence and mortality due to all causes, cardiovascular disease, and cancer among 20,579 participants aged 41–80 years from the European Prospective Investigation into Cancer (EPIC)-Norfolk Study in the United Kingdom. Data were collected in 1996–2002. Participants were recruited by post from general practice age-sex registers and subsequently completed a postal assessment of their sense of coherence. During follow-up, 1,024 deaths were recorded. A strong sense of coherence was associated with a 30% reduction in mortality from all causes (rate ratio = 0.69, p < 0.0001), cardiovascular disease (rate ratio = 0.70, p = 0.001), and cancer (rate ratio = 0.74, p = 0.003), independent of age, sex, and prevalent chronic disease. These associations were consistent by sex, except that no association was observed for cancer mortality in women. The association for all-cause mortality remained after adjustment for cigarette smoking history, social class, body mass index, systolic blood pressure, cholesterol, hostility, and neuroticism (rate ratio = 0.76, p = 0.002). Results suggest that a strong sense of coherence may confer some resilience to the risk of chronic disease.

Keywords: cardiovascular diseases; mortality; neoplasms; personality; prospective studies; psychology; Abbreviations: EPIC, European Prospective Investigation into Cancer; HLEQ, Health and Life Experiences Questionnaire; SOC, sense of coherence.

Journal Article.  5226 words.  Illustrated.

Subjects: Public Health and Epidemiology

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