Background:
To identify factors which determine high life satisfaction (LS) and to analyse the prognostic influence of LS on mortality.
Methods:
Data collection was conducted on 2,675 participants, age 25-74 years, as part of the MONICA Augsburg Project 1994-95. Multivariate logistic regression analyses were used to determine factors associated with high LS (measured with one item, 6-level Likert scale, where "high"=very satisfied / most of the time very satisfied with ones personal life). After 12 years mean follow-up, a total of 245 deaths occurred. We calculated age- and sex-adjusted incident mortality rates per 10,000. Hazard ratios (HRs) were estimated from Cox proportional hazards models.
Results:
Independent determinants of LS were income, health-perception, and social support, as well as somatisation, anger or depressive symptoms (all p<0.05). Participants with higher LS (n=721, 27%) benefited the most with respect to absolute mortality risk reduction (higher LS=67; mid = 98; low = 140 per 10,000). The sex-stratified analyses indicated an independent association of higher LS and survival for men (HR 0.55; 95% CI 0.37 – 0.81) but not for women.
Conclusions:
Baseline assessment demonstrated that psychological, social and life-style factors, but not somatic co-morbidities, were relevant determinants of LS. Moreover, the analysis showed that men with higher LS have a substantial long-term survival benefit. The observed association between LS and mortality may be attributed to common underlying causes such as social network integration and/or self-rated health.