American Journal of Epidemiology
Volume 188, Issue 2, 2019, Pages 323-331
Death and Chronic Disease Risk Associated with Poor Life Satisfaction: A Population-Based Cohort Study (Article) (Open Access)
Rosella L.C.* ,
Fu L. ,
Buajitti E. ,
Goel V.
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a
Dalla Lana School of Public Health, University of Toronto, 155 College Street 6th Floor, Toronto, ON M5T3M7, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Public Health Ontario, Toronto, ON, Canada
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b
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
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c
Dalla Lana School of Public Health, University of Toronto, 155 College Street 6th Floor, Toronto, ON M5T3M7, Canada
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d
Dalla Lana School of Public Health, University of Toronto, 155 College Street 6th Floor, Toronto, ON M5T3M7, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
Abstract
Life satisfaction is increasingly recognized as an important determinant of health; however, prospective population-based studies on this topic are limited. We estimated the risk of chronic disease and death according to life satisfaction among a population-based cohort in Ontario, Canada (n = 73,904). The cohort included 3 pooled cycles of the Canadian Community Health Survey (2003-2008) linked to 6 years of follow-up (to 2015), using population-based health databases and validated disease-specific registries. The databases capture incident and prevalent cases of diabetes, cancer, chronic obstructive pulmonary disease, heart disease, and death. Multivariable Cox proportional hazard models were used to estimate hazards of incident chronic disease and death, and were adjusted for sociodemographic, behavioral, and clinical confounders, including age, sex, comorbidity, mood disorder, smoking, alcohol consumption, physical activity, body mass index, immigrant status, education, and income. In the fully adjusted models, risk of both death and incident chronic disease was highest for those most dissatisfied with life (for mortality, hazard ratio = 1.59, 95% confidence interval: 1.15, 2.19; for chronic disease, hazard ratio = 1.70, 95% confidence interval: 1.16, 2.51). In this population-based cohort, poor life satisfaction was an independent risk factor for incident chronic disease and death, supporting the idea that interventions and programs that improve life satisfaction will affect population health. © The Author(s) 2018.
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https://www.scopus.com/inward/record.uri?eid=2-s2.0-85060968308&doi=10.1093%2faje%2fkwy245&partnerID=40&md5=ddf52287e5b5e4bc79ce1f5368756b2b
DOI: 10.1093/aje/kwy245
ISSN: 00029262
Cited by: 1
Original Language: English