Health Behavior Change and Mortality

Aim: Identify health behavior risk factors (e.g. smoking, alcohol consumption, nutrition, exercise, seat belt use, dental care, medical care) for mortality. Methods: Seattle Longitudinal Study participants in the 1993 and 1998 waves were included (N=1064). All were residents of the greater Seattle, Washington area and recruited from their health maintenance organization membership in Group Health Cooperative of Puget Sound. The sample was analyzed by age group: young (N=139; 19-42yrs), middle-aged (N=386; 43-62yrs), young-old (N=296; 63-72yrs), old-old (N=243; 73 yrs+); health status: cardiovascular disease and physical disability: condition-free N=734, physical disability N=99, cardiovascular disease N=181, comorbid group: both physical disability and cardiovascular disease N=50; and gender: male N=461; female N=603. Health behavior change was calculated as a difference score to represent magnitude of change. Results: N=865 participants were analyzed, after excluding individuals with missing data and young adults due to low incidence of disease and mortality. There were N=83 deaths recorded from 1998-2003: 59% male, 65% in old-old age group (8% middle-aged, 28% young-old), and 50% condition-free (30% cardiovascular disease, 12% physical disability, 11% comorbid). Logistic Regression results indicated that while health behavior change did not predict mortality, higher levels of physical activity decreased the likelihood of mortality. Conclusions: The findings did not indicate that positive health behavior change prevents premature mortality. However, follow-up analyses did indicate a positive relationship between high physical activity levels and survivorship. To prevent premature mortality it may be salient to maintain a healthy level of physical activity rather than just initiating positive health behavior change.