Mortality and Chronic Disease Risk Associated With Poor Life Satisfaction: A Population-Based Cohort Study

Abstract

Life satisfaction is increasingly recognized as an important determinant of health; however, prospective population-based studies are limited. The objective was to estimate the risk of developing chronic disease and death according to life satisfaction among a population-based cohort in Ontario, Canada (N = 73,904). The cohort included three pooled cycles of the Canadian Community Health Survey (2003-2008), linked to 6 years of follow-up (to 2015) using population-based health databases and validated disease-specific registries. The databases capture incident and prevalent diabetes, cancer, chronic obstructive pulmonary disease, heart disease and mortality. Multivariable Cox proportional hazard models were used to estimate hazards of incident chronic disease and mortality, adjusting for sociodemographic, behavioural and clinical confounders including age, sex, comorbidity, mood disorder, smoking, alcohol consumption, physical activity, BMI, immigrant status, education, and income. In the fully adjusted models, risk of both death and incident chronic disease was highest for those most dissatisfied with life (mortality HR = 1.59, 95% CI: 1.15, 2.19; chronic disease HR = 1.74, 95% CI: 1.19, 2.56). In this population-based cohort, poor life satisfaction is an independent risk factor for incident chronic disease and mortality, supporting the idea that interventions and programs that improve life satisfaction will impact population health.