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Life dissatisfaction as a predictor of fatal injury in a 20-year follow-up


Heli Koivumaa-Honkanen Department of Psychiatry, 4975, Kuopio University Hospital, PO 1777, FIN-70211 Kuopio, Finland E-mail:


Objective: To investigate the role of life satisfaction (LS) in fatal injuries with special references to unintentional injuries and whether health status modifies this relationship.

Method: A sample of adult Finns unselected for health status (n=29 173) responded in 1975 to a LS scale. Nationwide registry for deaths was used. The dissatisfied were compared with the satisfied by Cox regression.

Results: During 1976–1995, 469 fatal injuries occurred, of which 235 were unintentional. Dissatisfaction predicted fatal unintentional [hazard ratio (HR)=2.83; 95% confidence interval (CI) 1.77–4.51] and intentional injury (HR=3.26; 2.01–5.30). The risk of fatal unintentional injury was 7.8-fold (women) and 4.0-fold (men) increased in the sick and dissatisfied compared with the healthy and satisfied. A repeatedly reported dissatisfaction (1975, 1981) provided a HR of 5.17 (1.48–18.0) for unintentional injury death during 1981–1995. The found effect was partly mediated through health behavior and social situation.

Conclusion: Life dissatisfaction predicts both unintentional and intentional injury death.