Abstract

Background: Based on data from the European Prospective Investigation into Cancer, Norfolk (EPIC-Norfolk) study, we have previously shown a strong sense of coherence (SOC) to be associated with a reduced rate of all-cause mortality.

Objectives: To investigate the extent to which the SOC mortality association can be explained by socioeconomic status and lifestyle choices.

Design and setting: Prospective population-based cohort study.

Participants: 18 287 study participants aged 41–80 years who reported no pre-existing chronic disease at baseline and who completed an assessment of SOC.

Results: Based on 1599 deaths during a mean follow-up of 8.3 years, a strong SOC was associated with a 20% reduced risk of all-cause mortality. Measures of lifestyle choice (cigarette smoking, physical activity, dietary intakes of fruit, vegetables and fibre) and socioeconomic status (social class and education) explained 23% of this association.

Conclusions: The SOC concept embraces multiple sets of chronic disease risk factors that include lifestyle choices and those associated with socioeconomic status, and is a potential aid in understanding differences in health outcomes in similar individuals.