Psychological distress, life expectancy, and all-cause mortality in the United States: results from the 1997-2014 NHIS-NDI record linkage study

Ann Epidemiol. 2021 Apr:56:9-17. doi: 10.1016/j.annepidem.2021.01.002. Epub 2021 Jan 13.

Abstract

Purpose: Previous research has shown a significant association between psychological distress (PD) and all-cause mortality. However, this association is not fully explored, and life expectancy by PD is unknown.

Methods: We used the pooled 1997-2014 data from the National Health Interview Survey linked to National Death Index (n = 513,081) to examine the association of the Kessler 6-item PD scale with life expectancy and all-cause mortality. Life expectancy by PD was computed using the standard life table method. Cox regression was used to model survival time as a function of PD and sociodemographic, behavioral, and health characteristics.

Results: The age-adjusted mortality rate for adults with serious PD (SPD) was 2632 deaths per 100,000 person-years, compared with 1428 for those without PD. Life expectancy was inversely related to PD. At age 18, those with SPD had a life expectancy of 45.0 years, compared with 55.6 years for those without PD. The age-adjusted relative risk of all-cause mortality was 125% higher for adults with SPD (hazard ratio = 2.25; 95% confidence interval = 2.14, 2.37) than those without PD. Mortality risk associated with SPD remained (hazard ratio = 1.14; 95% confidence interval = 1.08, 1.20) after covariate adjustment.

Conclusions: U.S. adults with SPD had significantly higher mortality risk and lower life expectancy.

Keywords: All-cause mortality; Life expectancy; Longitudinal; NHIS-NDI; Psychological distress.

MeSH terms

  • Adolescent
  • Adult
  • Aged, 80 and over
  • Health Surveys
  • Humans
  • Life Expectancy*
  • Mortality
  • Proportional Hazards Models
  • Psychological Distress*
  • Stress, Psychological / epidemiology
  • United States / epidemiology