University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box PSYCH, Rochester, NY 14642, USA.
Am J Epidemiol. 2010 Jan 1;171(1):83-92. doi: 10.1093/aje/kwp323. Epub 2009 Dec 4.
The authors assessed the extent to which socioeconomic status (SES) and the personality factors termed the "big 5" (neuroticism, extraversion, openness to experience, agreeableness, conscientiousness) represented confounded or independent risks for all-cause mortality over a 10-year follow-up in the Midlife Development in the United States (MIDUS) cohort between 1995 and 2004. Adjusted for demographics, the 25th versus 75th percentile of SES was associated with an odds ratio of 1.43 (95% confidence interval (CI): 1.11, 1.83). Demographic-adjusted odds ratios for the 75th versus 25th percentile of neuroticism were 1.38 (95% CI: 1.10, 1.73) and 0.63 (95% CI: 0.47, 0.84) for conscientiousness, the latter evaluated at high levels of agreeableness. Modest associations were observed between SES and the big 5. Adjusting each for the other revealed that personality explained roughly 20% of the SES gradient in mortality, while SES explained 8% of personality risk. Portions of SES and personality risk were explained by health behaviors, although some residual risk remained unexplained. Personality appears to explain some between-SES strata differences in mortality risk, as well as some individual risk heterogeneity within SES strata. Findings suggest that both sociostructural inequalities and individual disposition hold public health implications. Future research and prevention aimed at ameliorating SES health disparities may benefit from considering the risk clustering of social disadvantage and dispositional factors.
作者评估了社会经济地位(SES)和被称为“大五”(神经质、外向性、开放性、宜人性、尽责性)的人格因素在多大程度上代表了混杂或独立的风险,这些风险与 1995 年至 2004 年间美国中年发展(MIDUS)队列中 10 年全因死亡率有关。在调整了人口统计学因素后,SES 的第 25 百分位与第 75 百分位的比值为 1.43(95%置信区间(CI):1.11,1.83)。神经质的第 75 百分位与第 25 百分位的人口统计学调整比值分别为 1.38(95%CI:1.10,1.73)和 0.63(95%CI:0.47,0.84),而尽责性则评估为高度宜人性。SES 与“大五”之间存在适度关联。对每个因素进行调整后发现,人格因素大约解释了 SES 梯度死亡率差异的 20%,而 SES 解释了人格风险的 8%。健康行为解释了 SES 和人格风险的一部分,但仍有一些剩余风险无法解释。人格似乎解释了 SES 分层死亡率风险之间的一些差异,以及 SES 分层内的一些个体风险异质性。研究结果表明,社会结构不平等和个体倾向都对公共卫生具有重要意义。未来旨在改善 SES 健康差异的研究和预防工作可能受益于考虑社会劣势和性格因素的风险聚集。