Persistence of health habits and their relationship to mortality

This paper explores the relationship of seven personal health practices and subsequent mortality in the $\text{9}\text{1}\text{2}$ years between an initial survey of 6,928 adults made in Alameda County, California, in 1965 and a follow-up survey in 1974. The seven health practices are: never smoking cigarettes, regular physical activity, moderate or no use of alcohol, 7–8 hr sleep/day regularly, maintaining proper weight, eating breakfast, and not eating between meals. When accumulated to form a health practice score from 0 to 7, the number of health practices showed a striking inverse relationship with age-adjusted mortality rates, especially for men. Men following seven health practices had a mortality rate only 28% that of men following zero to three health practices. Women following seven health practices had a mortality rate 43% that of women following zero to three health practices. Both the health practices themselves and their relationship to mortality are shown to be reasonably stable over the $\text{9}\text{1}\text{2}$-year period of follow-up. These results lend support to the hypothesis that good health practices and not the initial health status of the survey respondents are largely responsible for the observed mortality relationships. These and other methodological issues are explored.