Research Article
Association of Psychosocial Factors With Risk of Chronic Diseases: A Nationwide Longitudinal Study

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Introduction

This study examines the prospective association between a range of psychosocial factors and common noncommunicable diseases.

Methods

In October 2018, nationally representative data were analyzed from 11,637 adults followed annually between 2003 and 2013. Participants reported on psychosocial factors they experienced in the 12 months preceding each wave. The onset of noncommunicable diseases was defined based on self-reported physician's diagnosis. Generalized estimating equations estimated the ORs and 95% CIs of psychosocial factors on noncommunicable diseases, controlling for other confounders.

Results

Social support index was inversely associated with the onset of anxiety or depression in men (OR=0.95, 95% CI=0.93, 0.98) and women (OR=0.96, 95% CI=0.95, 0.98) and with emphysema in women (OR=0.96, 95% CI=0.93, 0.99). Psychological distress was positively associated with the onset of heart diseases (OR=2.38, 95% CI=1.16, 4.89 for men; OR=2.30, 95% CI=1.10, 4.78 for women), emphysema (OR=1.11, 95% CI=1.03, 1.20 for men; OR=1.08, 95% CI=1.04, 1.12 for women), and circulatory diseases (OR=1.04, 95% CI=1.02, 1.08 for women). Financial stress increased the onset of anxiety or depression (OR=1.36, 95% CI=1.26, 1.63 for men; OR=1.30, 95% CI=1.10, 1.52 for women) and type 2 diabetes in women (OR=1.60, 95% CI=1.18, 2.18). Significant associations of parenting stress and the likelihood of the onset of anxiety or depression were only evident in women.

Conclusions

These findings suggest that several adverse psychosocial risk factors are independently associated with the onset of noncommunicable diseases.

Section snippets

INTRODUCTION

Noncommunicable diseases (NCDs) are the leading cause of morbidity, mortality, and economic burden worldwide. NCDs are responsible for 40 million deaths each year, equivalent to 70% of all deaths.1 Conventional risk factors for NCDs, including smoking, high blood pressure, and unhealthy diet, may not fully account for the burden of NCDs.2,3 There is an increasing body of evidence linking psychosocial factors to the onset of cardiovascular disease (CVD), cancer, type 2 diabetes mellitus (T2DM),

Study Sample

This study used data from the Household, Income and Labour Dynamics in Australia (HILDA) survey. The HILDA survey commenced in 2001 with a national probability sample of 13,969 individuals residing in 7,682 private dwellings. All members of those households aged ≥15 years constituted the basis of the panel to be interviewed in subsequent waves. Those living in institutions were excluded from the initial survey, but people who move into institutions in subsequent years remain in the sample. The

RESULTS

Table 1 presents a summary of participant characteristics. The mean age at Waves 3 and 13 was 43.9 (SD=15.6) and 45.4 (SD=16.6) years, respectively, in men, and 44.3 (SD=15.9) and 45.0 (SD=16.5) years in women. Of Wave 3 respondents, 25% were born overseas. The incidence of onset of NCDs at Waves 3, 7, 9, and 13 is presented in Table 2.

Tables 3 and 4 show the association between longitudinal change in psychosocial factors and onset of NCDs. In the model adjusted for sociodemographics (Model 2),

DISCUSSION

This study shows that several adverse psychosocial risk factors have sex-specific independent contribution to the onset of NCDs. This study adds to the few large-scale studies on psychosocial factors for NCDs but is unique in that it examines the longitudinal associations of psychosocial factors with NCDs while considering the effect of several other risk factors potentially linked to NCDs.

The results complement findings from previous studies9,12,21 that reported a significant inverse

CONCLUSIONS

The findings suggest that several psychosocial factors have sex-specific associations with NCDs, independent of health and lifestyle factors. SSI, psychological distress, financial stress, personal and parenting stress, and positive life events are significantly associated with the onset of NCDs. The benefits from interventions targeting psychosocial risk factors in terms of reducing the burden of NCDs require further investigation.

ACKNOWLEDGMENTS

This study is based on data set from the Household, Income and Labour Dynamics in Australia (HILDA) survey. The HILDA project was initiated and is funded by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs and is managed by the Melbourne Institute of Applied Economic and Social Research.

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

No financial disclosures have been

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