The sense of coherence and risk of injuries: Role of alcohol consumption and occupation

Helsinki Heart Study, Helsinki, Finland.
Journal of Epidemiology & Community Health (Impact Factor: 3.5). 02/2008; 62(1):35-41. DOI: 10.1136/jech.2006.057232
Source: PubMed


To test the hypothesis that individuals with a strong sense of coherence (SOC) have a decreased incidence of external cause injuries and to study the role of alcohol consumption and occupational category in that association.
Participants of the Helsinki Heart Study were followed up for injuries for eight years through the national hospital discharge register and cause of death statistics. Cox proportional hazards models were used to calculate the relative risks.
The Helsinki Heart Study, a clinical trial to prevent coronary heart disease.
4405 Finnish middle-aged employed men.
The SOC was inversely associated with the risk of injuries, with a significant 25% lower incidence in the highest tertile of SOC (7.6 per 1000 person-years) compared with the lowest (10.2 per 1000 person-years). The association remained significant if adjusted for age, but not if adjusted additionally for alcohol consumption or occupation. When considered jointly with occupational category, the injury risk showed a decreasing trend (p = 0.02) with increasing SOC among blue collar but not among white collar workers. The use of alcohol had a great impact on injury risk among those with weak SOC, with incidences of 7.7, 10.2, and 14.9 per 1000 person-years in the non/light, medium, and heavy categories of consumption (p for trend 0.01). No such trend was seen in other SOC tertiles.
There was an effect of SOC on the incidence of injury especially among blue collar workers. A substantial part of the effect was mediated by alcohol consumption.

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    • "Previous studies report conflicting results about the effect of socio-demographic determinants on SOC, highlighting the need for further studies [12, 13, 27, 28, 29]. Such discrepancies may be due to the fact that data are analysed through a univariate method, without taking into account potential confounding effects, and with a low power to detect weak associations. "
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    ABSTRACT: The theory of salutogenesis entails that the ability to use resources for one's wellbeing is more important than the resources themselves. This ability is referred to as the Sense of Coherence (SOC). This paper present the cross-culturally adapted version of the Italian questionnaire (13 items), and the psychometric and statistical testing of the SOC properties. It offers for the first time a view of the distribution of SOC in an Italian sample, and uses a multivariate method to clarify the effects of socio-demographic determinants on SOC. The cross-cultural adaptation of the English SOC questionnaire was carried out according to the guidelines reported in literature. To evaluate the psychometric and statistical properties we assessed reliability, validity and frequency distribution of the collected data. A Generalised Linear Model was used to analyse the effects of socio demographic variables on SOC. The Italian SOC scale demonstrates a good internal consistency (α = 0.825). The model obtained with factorial analysis is not related to the traditional dimensions of SOC represented in more than one factor. The multivariate analysis highlights the joint influence of gender, age and education on SOC. The validated Italian questionnaire is now available. Socio-demographic variables should be taken into account as confounders when SOC values among different populations are compared. Presenting data on SOC of the Italian population makes a control population available for comparisons with specific subgroups, such as patient populations. Now, the Italian challenge is to integrate the salutogenic approach into Public Health police.
    Full-text · Article · Feb 2012 · Clinical Practice and Epidemiology in Mental Health
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    • "A recently published longitudinal study supports the notion that a weakened SOC accompanying smoking and alcohol consumption may partially cause a pathogenic process following a negative life event in initially healthy participants25. Prospective study on the participants Helsinki Heart Clinical Trial also found that SOC was inversely associated with risk of injuries26. "
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    ABSTRACT: With advances in knowledge about health promotion, public health professionals are in search for the determinants of personal health behaviours. This study was carried out to explore the level of engagement of north Indian students in health promoting behaviours; to determine their sense of coherence scores; and to ascertain the determinants of health promoting behaviours of these students. A cross-sectional study was done in four randomly selected colleges of Chandigarh during 2007-2008 in 200 students (100 male, 100 female). Their health promoting lifestyle profile (HPLP) and sense of coherence (SOC) scores were estimated using interviews. The data were analyzed using Pearson's product moment correlation, and also stepwise linear regression analysis. Mean HPLP and SOC scores of the students were 138.69 and 130.87, respectively. Females cared more about their health than males. Male students were more involved in physical activities. There was a linear correlation between the total SOC and HPLP scores (r=0.3). Female students (63%) consulted doctors more than males (50%) and washed their hands more regularly (P<0.05). Only 13 per cent students practiced yoga regularly. Female students had more meaningful relationships with friends and had more faith in God. Regression equation revealed that the two independent variables (SOC and age) accounted for 10.8 per cent of the variance in HPLP. Students with higher SOC scores had higher HPLP scores. Female students were more health conscious than male students. In general, college students in Chandigarh had a good health promoting lifestyle and good sense of coherence.
    Full-text · Article · Nov 2011 · The Indian Journal of Medical Research
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    ABSTRACT: To examine if sense of coherence (SOC) can reduce the adverse effects of job stress on mental health status, self-administered questionnaires were distributed among 740 workers in a manufacturing industry. The questionnaire contained SOC, Job Content Questionnaire (JCQ), and General Health Questionnaire (GHQ-12). Complete answers were recovered from 466 workers (62.8%), consisting of 387 males and 79 females, with ages of 45.1 + or - 12.0 yr, and used for the analysis. The logistic regression analysis revealed the followings: Both for males and females, high GHQ was significantly associated with scores on SOC and JCQ job demand subscale, i.e. the mental health status was adversely related to job demand whereas it was positively associated with SOC. Similarly, the mental health status was affected adversely by managerial work in males, whereas was positively by co-workers support in females. Thus, high SOC enables workers to cope with their job demand, which is a potent job stressor, indicating that SOC is an important factor determining their coping ability to job stress for both genders. Male managerial employees may cope with their strong job stress because of high SOC, protecting their mental health status. Social support seems also significant for prevention of mental well-being of female workers from work-related stressors.
    Preview · Article · Oct 2009 · Industrial Health
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