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

Surtees, P.·2003·American Journal of Epidemiology

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Abstract

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 < or =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.

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Authors: Surtees, P.
Affiliations: University of Cambridge (GB)
Corresponding author: Surtees, P.
Venue: American Journal of Epidemiology
Publisher: Oxford University Press (OUP)
Published: 2003-12-15
Volume: 158
Issue: 12
Pages: 1202-1209
ISSN: 0002-9262 (ISSN-L)
DOI: 10.1093/aje/kwg272
OpenAlex: W2101075322
Cited by: 252
References: 42
Citations by year: 2026: 2 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 12 · 2021: 5 · 2020: 12 · 2019: 8 · 2018: 5 · 2017: 10 · 2016: 9 · 2015: 17 · 2014: 15 · 2013: 12 · 2012: 14
FWCI: 25.49
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Epidemiology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Social Sciences › Health › Health disparities and outcomes
Keywords: sense of coherence, mortality, all-cause mortality, cardiovascular mortality, cancer mortality, personality, sex differences, EPIC-Norfolk cohort, chronic disease risk, resilience
MeSH terms: Adult, Aged, Attitude, Cardiovascular Diseases, Female, United Kingdom, Humans, Male, Middle Aged, Neoplasms, Personality, Prospective Studies, Cohort Studies

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

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