J Prev Med Public Health.  2012 Jan;45(1):14-20. 10.3961/jpmph.2012.45.1.14.

Impact of Individual and Combined Health Behaviors on All Causes of Premature Mortality Among Middle Aged Men in Korea: The Seoul Male Cohort Study

• Rhee CW
• Kim JY
• Park BJ
• Li ZM
• Ahn YO

• KMID: 1120119
• DOI: http://doi.org/10.3961/jpmph.2012.45.1.14

Abstract

OBJECTIVES
The aim of this study was to evaluate and quantify the risk of both individual and combined health behaviors on premature mortality in middle aged men in Korea.
METHODS
In total, 14 533 male subjects 40 to 59 years of age were recruited. At enrollment, subjects completed a baseline questionnaire, which included information about socio-demographic factors, past medical history, and life style. During the follow-up period from 1993 to 2008, we identified 990 all-cause premature deaths using national death certificates. A Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of each health risk behavior, which included smoking, drinking, physical inactivity, and lack of sleep hours. Using the Cox model, each health behavior was assigned a risk score proportional to its regression coefficient value. Health risk scores were calculated for each patient and the HR of all-cause premature mortality was calculated according to risk score.
RESULTS
Current smoking and drinking, high body mass index, less sleep hours, and less education were significantly associated with all-cause premature mortality, while regular exercise was associated with a reduced risk. When combined by health risk score, there was a strong trend for increased mortality risk with increased score (p-trend < 0.01). When compared with the 1-9 score group, HRs of the 10-19 and 20-28 score groups were 2.58 (95% confidence intervals [CIs], 2.19 to 3.03) and 7.09 (95% CIs, 5.21 to 9.66), respectively.
CONCLUSIONS
Modifiable risk factors, such as smoking, drinking, and regular exercise, have considerable impact on premature mortality and should be assessed in combination.

Keyword

Cohort studies; Life style; Mortality; Risk factors

MeSH Terms

Adult
Alcohol Drinking/mortality
Body Mass Index
*Cause of Death
Cohort Studies
Exercise/physiology
Follow-Up Studies
*Health Behavior
Humans
Korea
Life Style
Male
*Men's Health
Middle Aged
Proportional Hazards Models
Risk Factors
Smoking/mortality