Abstract
ObjectiveThe possible contributions of psychosocial functioning and intelligence differences to socioeconomic status (SES)-related inequalities in premature death were investigated. None of the previous studies focusing on inequalities in mortality has included measures of both psychosocial functioning and intelligence.MethodsThe study was based on a cohort of 49 321 men born 1949–1951 from the general community in Sweden. Data on psychosocial functioning and intelligence from military conscription at ∼18 years of age were linked with register data on education, occupational class, and income at 35–39 years of age. Psychosocial functioning was rated by psychologists as a summary measure of differences in level of activity, power of initiative, independence, and emotional stability. Intelligence was measured through a multidimensional test. Causes of death between 40 and 57 years of age were followed in registers.ResultsThe estimated inequalities in all-cause mortality by education and occupational class were attenuated with 32% (95% confidence interval: 20–45%) and 41% (29–52%) after adjustments for individual psychological differences; both psychosocial functioning and intelligence contributed to account for the inequalities. The inequalities in cardiovascular and injury mortality were attenuated by as much as 51% (24–76%) and 52% (35–68%) after the same adjustments, and the inequalities in alcohol-related mortality were attenuated by up to 33% (8–59%). Less of the inequalities were accounted for when those were measured by level of income, with which intelligence had a weaker correlation. The small SES-related inequalities in cancer mortality were not attenuated by adjustment for intelligence.ConclusionsDifferences in psychosocial functioning and intelligence might both contribute to the explanation of observed SES-related inequalities in premature death, but the magnitude of their contributions likely varies with measure of socioeconomic status and cause of death. Both psychosocial functioning and intelligence should be considered in future studies.
Highlights
Individuals exhibit differences in intelligence (IQ) and personality traits that are relatively stable over the life course [1]
Attained socioeconomic status (SES) is related both to personality traits and to IQ [2,3], and in a previous study we found that IQ was associated with SES in terms of education and occupational class, whereas aspects of personality may relate more to SES measured by income level [22]
The present study shows that lower psychosocial functioning and IQ both contribute to accounting for SES-related inequalities in premature death among middle-aged Swedish men
Summary
Individuals exhibit differences in intelligence (IQ) and personality traits that are relatively stable over the life course [1]. The possible importance of personality traits, i.e., people’s tendencies to behave, think, and feel in certain ways [14,15], has recently been supported in analyses of data from the French GAZEL study [16] and the Midlife Development in the United States (MIDUS) cohort [17]. In both studies, associations between SES and mortality were attenuated after adjustment for measures of personality. It is possible that these factors are to some extent overlapping explanations of observed inequalities in mortality [19]
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