Does personality explain social inequalities in mortality? The French GAZEL cohort study
Open accessAbstract
BACKGROUND: The 'indirect-selection' hypothesis proposes that some quality of the individual, a personality characteristic or intelligence, leads to both socioeconomic position (SEP) and health. We aim to quantify the contribution of personality measures to the associations between SEP and mortality. METHODS: Of the GAZEL cohort, 14 445 participants aged 39-54 years in 1993 and followed-up over 12.7 years, completed the Bortner-Type-A-scale, the Buss-Durkee-Hostility-Inventory and the Grossarth-Maticek and Eysenck-Personality-Stress-Inventory. Indicators of SEP, such as father's social class, education, occupational grade and income, were assessed at baseline. Relative indices of inequality in Cox regression models were used to estimate associations. RESULTS: In age-adjusted analyses, risk of death was inversely associated with SEP among men and women. Among men, the attenuation in this association depended on the measures of SEP and was 28-29% for 'neurotic-hostility', 13-22% for 'anti-social' and 13-16% for 'CHD-prone' personality. In women, the attenuation was evident only for type-A-behaviour, by 11%. After controlling simultaneously for all personality factors that predicted mortality, associations between SEP and mortality were attenuated in men: by 34% for education, 29% for occupational position and 28% for income; but were only attenuated by 11% for income in women. For cardiovascular mortality, the corresponding percentages of reduction were 42, 31 and 44% after adjustment for 'CHD-prone' personality in men. CONCLUSIONS: Personality measures explained some of the mortality gradients observed for measures of adult socioeconomic position in men, but had little explanatory power in women. Whether personality represents a predictor or an outcome of social circumstances needs further research.
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In a recent study of all-cause mortality in France, adjustment of SES estimates for personality attenuated SES relative risks by 24%-36% in men and 11% in women.
“In a recent study of all-cause mortality in France, adjustment of SES estimates for personality attenuated SES relative risks by 24%-36% in men and 11% in women (9).”
From Personality, Socioeconomic Status, and All-Cause Mortality in the United States (2010) · cites this paper as [9]
Limited studies on personality, SES, and longevity to date suggest a mild degree of confounding between mortality risk related to Neuroticism and low control, and mortality risk related to low social position (supporting indirect selection).
“Limited studies on personality, SES, and longevity to date suggest a mild degree of confounding between mortality risk related to Neuroticism and low control, and mortality risk related to low social position (supporting indirect selection).”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [204]
In these studies, both personality and SES still exert independent mortality risks when confounding is controlled.
“In these studies, both personality and SES still exert independent mortality risks when confounding is controlled.”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [204]
These traits thus far explain less than 20% of the associations between low-SES and mortality.
“These traits thus far explain less than 20% of the associations between low-SES and mortality [62, 129, 204].”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [204]
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- Authors
- Nabi, H., Kivimaki, M., Marmot, M. G., Ferrie, J., Zins, M., Ducimetiere, P., Consoli, S. M., & Singh-Manoux, A.
- Affiliations
- Inserm (FR)
- University College London (GB)
- Hôpital Européen Georges-Pompidou (FR)
- Corresponding author
- Nabi, H.
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-02-14
- Volume
- 37
- Issue
- 3
- Pages
- 591-602
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- PMC
- PMC2650255
- OpenAlex
- W2115538016
- Cited by
- 63
- References
- 76
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 1 · 2020: 3 · 2019: 13 · 2018: 1 · 2017: 1 · 2015: 4 · 2014: 3 · 2013: 4 · 2012: 8
- FWCI
- 6.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HAL (submittedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- British Heart Foundation (RG/07/008/23674)
- European Science Foundation
- Institut National de la Santé et de la Recherche Médicale
- Academy of Finland (117604)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Health › Public Health and Social Inequalities
- Keywords
- personality, social inequalities in mortality, socioeconomic position, Type A behavior pattern, hostility, neuroticism, antisocial personality, cardiovascular mortality, sex differences, GAZEL cohort, occupational class, income
- MeSH terms
- Adult, Cardiovascular Diseases, Educational Status, Female, France, Health Status, Humans, Income, Life Style, Male, Middle Aged, Mortality, Personality, Risk, Sex Factors, Social Mobility, Socioeconomic Factors, Cohort Studies, Linear Models
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