Self-reported life satisfaction and 20-year mortality in healthy Finnish adults

The authors investigated the role of self-reported life satisfaction in mor tality with a prospective cohort study (1976-1995). A nationwide sample of healthy adults (18-64 years, n = 22,461) from the Finnish Twin Cohort respo nded to a questionnaire about life satisfaction and known predictors of mor tality in 1975. A summary score for life satisfaction (LS), defined as inte rest in life, happiness, loneliness, and general ease of living (scale rang e, 4-20), was determined and used as a three-category variable: the satisfi ed (LS, 4-6) (21%), the intermediate group (LS, 7-11) (65%), and the dissat isfied (LS, 12-20) (14%). Mortality data were analyzed with Cox regression. Dissatisfaction was linearly associated with increased mortality. The age- adjusted hazard ratios of all-cause, disease, or injury mortality among dis satisfied versus satisfied men were 2.11 (95% confidence interval (CI): 1.6 8, 2.64), 1.83 (95% CI: 1.40, 2.39), and 3.01 (95% CI: 1.94, 4.69), respect ively. Adjusting for marital status, social class, smoking, alcohol use, an d physical activity diminished these risks to 1.49 (95% CI: 1.16, 1.92), 1. 35 (95% CI: 1.01, 1.82), and 1.93 (95% CI: 1.19, 3.12), respectively. Dissa tisfaction was associated with increased disease mortality, particularly in men with heavy alcohol use (hazard ratio = 3.76, 95% CI: 1.61, 8.80). Wome n did not show similar associations between life satisfaction and mortality . Life dissatisfaction may predict mortality and serve as a general health risk indicator. This effect seems to be partially mediated through adverse health behavior.