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  • Cited by 2
  • Print publication year: 1994
  • Online publication date: August 2016

A multivariate analysis of health-related practices: a nine-year mortality follow-up of the Alameda County Study

from Section 4 - Health practices and the modification of health risk behaviour



Wingard, D. L. (Dept. of Community and Family Medicine, School of Medicine, U. of California, San Diego, CA 92093), L. F. Berkman and R. J. Brand. A multivariate analysis of health-related practices: a nine-year mortality follow-up of the Alameda County Study. Am J Epidemiol 1982;116:765-75.

Associations between several common health-related practices and a variety of health outcomes have been reported. However, the independent associations between each of these practices and mortality from all causes have not been assessed. In the present report, a multiple logistic analysis of seven potentially health-related practices (individually and in a summary index) and mortality from all causes is conducted, using data from the Human Population Laboratory Study of a random sample of 6928 adults living in Alameda County, California in 1965 and a subsequent nine-year mortality follow-up. Many covariables such as physical health status and socioeconomic status are simultaneously analyzed. The health-related practices examined are: 1) never smoking; 2) regular physical activity; 3) low alcohol consumption; 4) average weight status; 5) sleeping seven to eight hours/night; 6) not skipping breakfast; and 7) not snacking between meals. The analysis reveals that five of the practices are associated with lower mortality from all causes. Neither eating breakfast nor not snacking have significant independent associations with lower mortality. After covariable adjustment, respondents who reported few low-risk practices have a relative risk of 2.3 (p < 0.001) when compared with those who had many low-risk practices. Mortality risks for possible combinations of health-related practices are discussed.

alcohol drinking; exertion; longevity; longitudinal studies; mortality; sleep; smoking

In the last 20 years, a considerable body of evidence has accumulated which indicates that certain common behaviors, notably cigarette smoking, alcohol consumption, and physical inactivity, play an important role in the development of disease. Since its beginning, the Human Population Laboratory has had a strong commitment to conducting research in this area. Based on cross-sectional data, Belloc and Breslow (1) reported an association between good physical health status and seven potentially health-related practices: never smoking, physical activity, moderate or no alcohol consumption, average weight, sleeping seven or eight hours/night, eating breakfast, and not snacking between meals. In subsequent work, these same health-related practices have been found to be associated with low six- and nine-year mortality risk (2, 3).