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Killie IL, Braaten T, Lorem GF, Borch KB. Associations Between Self-Rated Health and Mortality in the Norwegian Women and Cancer (NOWAC) Study. Clin Epidemiol 2024; 16:109-120. [PMID: 38404707 PMCID: PMC10893877 DOI: 10.2147/clep.s433965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024] Open
Abstract
Purpose We investigated the association between self-rated health (SRH) and cancer incidence and SRH and all-cause mortality among Norwegian women. Population and Methods We used data from 110,104 women in the Norwegian Women and Cancer (NOWAC) cohort aged 41-70 years at baseline. We used flexible parametric survival analysis with restricted cubic splines to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between SRH and mortality in the entire cohort. We employed the same method in a multistate design to assess associations between baseline SRH and 1) cancer incidence, and 2) all-cause mortality in subgroups of women who did and did not receive a cancer diagnosis during follow-up. Results With very good SRH as reference category for all associations and median age at end of follow-up, lower SRH was associated with increased mortality (HRgood SRH 1.19, 95% CI 1.12-1.26) and HRpoor SRH 1.81, 95% CI 1.66-1.97). Lower SRH at baseline was associated with cancer incidence (HRgood SRH 1.14, 95% CI 1.08-1.20 and HRpoor SRH 1.44, 95% CI: 1.32-1.58). Poor baseline SRH was associated with increased mortality for women who received a cancer diagnosis (HRpoor SRH 1.20, 95% CI 1.04-1.39), and SRH showed a strong association with increased mortality for women who stayed cancer free (HRgood SRH 1.59, 95% CI 1.44-1.77 and HRpoor SRH 3.34, 95% CI 2.91-3.84). Conclusion Lower SRH at baseline predicted increased cancer risk and all-cause mortality in middle-aged to older women. Poor SRH at baseline predicted all-cause mortality in women who later received a cancer diagnosis. Both good and poor SRH at baseline predicted all-cause mortality in women who stayed cancer-free, and the association was stronger for these women compared to both the entire cohort and to women who were subsequently diagnosed with cancer.
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Affiliation(s)
- Ida Løken Killie
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Tonje Braaten
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Geir Fagerjord Lorem
- Department of Psychology, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Kristin Benjaminsen Borch
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
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Aboagye-Mensah EB, Azap RA, Odei JB, Gray DM, Nolan TS, Elgazzar R, White D, Gregory J, Joseph JJ. The association of ideal cardiovascular health with self-reported health, diabetes, and adiposity in African American males. Prev Med Rep 2020; 19:101151. [PMID: 32685362 PMCID: PMC7358269 DOI: 10.1016/j.pmedr.2020.101151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 06/18/2020] [Accepted: 06/20/2020] [Indexed: 11/17/2022] Open
Abstract
African American (AA) men have the highest age-adjusted all-cause mortality rate in the United States of America (US) and a high burden of cardiovascular risk factors. The African American Male Wellness Walk (AAMWW) seeks to reduce such health disparities among AA males. The association of a combination of ideal cardiovascular health (ICH) metrics (blood pressure, glucose, cholesterol, body mass index (BMI), physical activity, and smoking) with self-reported health, diabetes, and body fat percentage was examined among 729 AA male participants from the 2017 and 2018 AAMWWs. Six metrics of ICH were categorized into a three-tiered ICH score 0-2, 3-4, 5-6. Linear and logistic regression modeling was performed with adjustment for age and insurance. Seven percent of men attained 5-6 ICH metrics at baseline. Participants with 5-6 ICH metrics versus 0-2 had 256% higher odds of excellent self-reported health compared to good, fair or poor (p < 0.0001). After exclusion of glucose from the ideal cardiovascular health score, participants with 3-4 versus 0-2 ICH metrics had a 48% lower odds of diabetes (p < 0.0031). After exclusion of BMI from the ICH score, participants with 5 ICH metrics had a 14.1% lower body fat percentage versus participants with 0-2 ICH metrics (p = 0.0057). Attainment of higher ideal cardiovascular health scores is associated with higher odds of self-reported health, lower odds of diabetes and lower body fat percentage among AA men. Future strategies leading to greater attainment of cardiovascular health in AA males will be important to advance health equity.
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Affiliation(s)
| | | | - James B. Odei
- The Ohio State University College of Public Health, United States
| | - Darrell M. Gray
- The Ohio State University College of Medicine, United States
- The Ohio State University Comprehensive Cancer Center, United States
| | - Timiya S. Nolan
- The Ohio State University Comprehensive Cancer Center, United States
- The Ohio State University College of Nursing, United States
| | - Rana Elgazzar
- The Ohio State University College of Medicine, United States
| | | | - John Gregory
- National Center for Urban Solutions, United States
| | - Joshua J. Joseph
- The Ohio State University College of Medicine, United States
- Corresponding author at: The Ohio State University College of Medicine, 579 McCampbell Hall, 1581 Dodd Drive, Columbus, OH 43210, United States.
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Associations of personality traits with quality of life and satisfaction with life in a longitudinal study with up to 29 year follow-up. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2019.109725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Folker AP, Hegelund ER, Mortensen EL, Wimmelmann CL, Flensborg-Madsen T. The association between life satisfaction, vitality, self-rated health, and risk of cancer. Qual Life Res 2018; 28:947-954. [PMID: 30536220 DOI: 10.1007/s11136-018-2083-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE Only few prospective studies have been conducted on the contribution of quality of life-related factors to the risk of cancer. The aim of this study was to investigate the prospective associations of three quality of life-related factors with the risk of cancer; life satisfaction, vitality, and self-rated health. METHODS In 2009-2011, 7189 participants in the Copenhagen Aging and Midlife Biobank were asked to rate their life satisfaction, their vitality, and their health. The study population was followed until the end of 2015 for registration of cancer in the Danish National Patient Register. RESULTS During the follow-up period, cancer was diagnosed in 312 individuals. Life satisfaction was not associated with the risk of cancer. Vitality was significantly associated with the risk of cancer, but the association became non-significant after adjustment for age, sex, socioeconomic position, and lifestyle factors. However, when additionally adjusting for life satisfaction, individuals who rated their vitality as low had a hazard ratio of 1.46 (95% confidence interval [CI] 1.04-2.07) for the development of cancer. Individuals who rated their health as poor had a hazard ratio of 1.70 (95% CI 1.27-2.26) for the development of cancer, compared with individuals with good, very good, or excellent self-rated health. The association remained significant after adjustment for basic confounders, life satisfaction, and vitality. CONCLUSION A better grasp of the significance of quality of life-related factors for the risk of cancer may be of great importance to population-based cancer prevention that aims to target early risk factors for development of cancer across widespread cancer sites.
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Affiliation(s)
- Anna Paldam Folker
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455, Copenhagen K, Denmark.
| | - Emilie Rune Hegelund
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen K, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen K, Denmark
| | - Cathrine Lawaetz Wimmelmann
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen K, Denmark
| | - Trine Flensborg-Madsen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen K, Denmark
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Roelsgaard IK, Olesen AM, Simonsen MK, Johansen C. Self-rated health and cancer risk - a prospective cohort study among Danish women. Acta Oncol 2016; 55:1204-1209. [PMID: 27548996 DOI: 10.1080/0284186x.2016.1210822] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Self-rated health (SRH) has been shown to be a strong predictor of mortality from a number of major chronic diseases, however, the association with cancer remains unclear. The aim of this study was to investigate a possible association between change in SRH and cancer incidence. MATERIALS AND METHODS SRH and information on lifestyle and other risk factors were obtained for 13-636 women in the Danish Nurse Cohort. Cancers that developed during 12 years of follow-up were identified in the National Patient Registry. An association between SRH and cancer was examined in a Cox proportional hazards model with adjustment for age, smoking, alcohol, marital status, physical activity, body mass index and estrogen replacement therapy. RESULTS No significant association was found between SRH and overall cancer incidence in the age-adjusted Cox proportional hazards model (1.04; 95% CI 0.93-1.16), even after adjustment for potential confounding factors (HR 1.08; 95% CI 0.96-1.21). Likewise, there was no significant association between SRH and breast cancer (HR 1.09; 95% CI 0.89-1.33), lung cancer (HR 1.03; 95% CI 0.71-1.49) or colon cancer (HR 1.08; 95% CI 0.75-1.54). CONCLUSION SRH is not significantly associated with the incidence of all cancers or breast, lung or colon cancer among Danish female nurses. Women who reported a decrease in SRH between 1993 and 1999 had the same risk for cancer as those who reported unchanged or improved SRH.
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Affiliation(s)
| | | | | | - Christoffer Johansen
- Rigshospitalet, Copenhagen, Denmark
- The Danish Cancer Society Research Centre, Copenhagen, Denmark
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Riise HKR, Riise T, Natvig GK, Daltveit AK. Poor self-rated health associated with an increased risk of subsequent development of lung cancer. Qual Life Res 2013; 23:145-53. [PMID: 23771730 DOI: 10.1007/s11136-013-0453-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2013] [Indexed: 12/31/2022]
Abstract
PURPOSE Self-rated health has shown to be a strong predictor of mortality and some major chronic diseases. The purpose of this study was to investigate whether poor self-rated health also was related to an increased risk of subsequent development of cancer. METHODS Information on self-rated health, life-style factors, and other health-related risk factors was ascertained in a cohort of 25,532 persons participating in the Hordaland Health Study in 1997-1999. Information on development of cancer during 10 years of follow-up was obtained from the Norwegian Cancer Registry. The relationship between self-rated health and development of cancer was examined using Cox regression analysis adjusting for smoking and other life-style factors. RESULTS Respondents reporting a poor health showed a non-significant increased risk of overall cancer. Sub-analysis of the four most common types of cancer showed a statistically significant association between self-rated health and lung cancer. The adjusted hazard ratio was 3.88 (95% CI; 0.99, 15.8) for those rating their health as poor compared to very good (p for trend = 0.038). For the other types of cancer, we found a non-significant elevated risk associated with poor self-rated health. CONCLUSION Respondents who perceive their health as poor had an increased risk of developing lung cancer also after adjusting for smoking. This suggests that self-rated health reflects a broad range of factors important for development of this cancer type. Nevertheless, due to the explorative analysis of the specific cancer types, these findings need to be repeated before elaborate interpretations can be made.
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Affiliation(s)
- Hilde Kristin Refvik Riise
- Department of Global Public Health and Primary Care, University of Bergen, Postbox 7804, 5020, Bergen, Norway,
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Johansen C. Mind as a risk factor for cancer-some comments. Psychooncology 2012; 21:922-6. [PMID: 22865749 DOI: 10.1002/pon.3143] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 07/05/2012] [Indexed: 11/12/2022]
Affiliation(s)
- Christoffer Johansen
- Unit of Survivorship, The Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.
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Zheng DD, Christ SL, Lam BL, Arheart KL, Galor A, Lee DJ. Increased mortality risk among the visually impaired: the roles of mental well-being and preventive care practices. Invest Ophthalmol Vis Sci 2012; 53:2685-92. [PMID: 22427599 PMCID: PMC3366723 DOI: 10.1167/iovs.11-8794] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 02/07/2012] [Accepted: 03/12/2012] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Mechanisms by which visual impairment (VI) increases mortality risk are poorly understood. We estimated the direct and indirect effects of self-rated VI on risk of mortality through mental well-being and preventive care practice mechanisms. METHODS Using complete data from 12,987 adult participants of the 2000 Medical Expenditure Panel Survey with mortality linkage through 2006, we undertook structural equation modeling using two latent variables representing mental well-being and poor preventive care to examine multiple effect pathways of self-rated VI on all-cause mortality. Generalized linear structural equation modeling was used to simultaneously estimate pathways including the latent variables and Cox regression model, with adjustment for controls and the complex sample survey design. RESULTS VI increased the risk of mortality directly after adjusting for mental well-being and other covariates (hazard ratio [HR] = 1.25 [95% confidence interval: 1.01, 1.55]). Poor preventive care practices were unrelated to VI and to mortality. Mental well-being decreased mortality risk (HR = 0.68 [0.64, 0.74], P < 0.001). VI adversely affected mental well-being (β = -0.54 [-0.65, -0.43]; P < 0.001). VI also increased mortality risk indirectly through mental well-being (HR = 1.23 [1.16, 1.30]). The total effect of VI on mortality including its influence through mental well-being was HR 1.53 [1.24, 1.90]. Similar but slightly stronger patterns of association were found when examining cardiovascular disease-related mortality, but not cancer-related mortality. CONCLUSIONS VI increases the risk of mortality directly and indirectly through its adverse impact on mental well-being. Prevention of disabling ocular conditions remains a public health priority along with more aggressive diagnosis and treatment of depression and other mental health conditions in those living with VI.
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Affiliation(s)
- D Diane Zheng
- Department of Epidemiology & Public Health, University of Miami School of Medicine, Miami, FL 33136, USA.
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