Canadian researchers report that smoking, divorce, and alcohol abuse topped a list of behavioural factors associated with death
In a list of 57 social and behavioural factors associated with study subjects who had died, researchers at the University of British Columbia have found that smoking, divorce, and alcohol abuse ranked first, second, and third.
The findings, published in Proceedings of the National Academy of Sciences, are based on surveys with just over 13,600 Americans and an analysis of their health records from 1992 to 2014. Each participant was 50 or older, and the average age was 69.3.
Other behavioural and social factors that topped the list include recent financial difficulties, a history of unemployment, low life satisfaction, never being married, and having a “negative affectivity.” Researchers chose to exclude medical conditions from their analysis so they could get a sense of which social, psychological, economic, and behavioural factors impact mortality the most.
“It shows that a lifespan approach is needed to really understand health and mortality,” explained Eli Puterman, an assistant professor at the university’s school of kinesiology and the study’s lead author.
“Instead of just asking whether people are unemployed, we looked at their history of unemployment over 16 years. If they were unemployed at any time, was that a predictor of mortality? It’s more than just a one-time snapshot in people’s lives, where something might be missed because it did not occur. Our approach provides a look at potential long-term impacts through a lifespan lens.”
While life expectancy rates have improved in other industrialized countries, they have stagnated in the United States over the last three decades.
“If we’re going to put money and effort into interventions or policy changes, these areas could potentially provide the greatest return on that investment,” Puterman said.
That includes not only factors such as smoking, which have been targeted by anti-smoking campaigns for years, but also factors such as unemployment and depression, he said.
“By identifying a factor like negative affectivity—this idea that you tend to see and feel more negative things in your life—we can see that we might need to start targeting this with interventions. Can we shift it and have an impact on mortality rates? Similarly, can we target interventions for the unemployed and those with financial difficulties to reduce their risk?”
The study did have some limitations, as neither food insecurity or domestic abuse were addressed in the analysis.