Psychosocial processes and general susceptibility to chronic disease

The concept of general susceptibility to disease has developed as a unifying explanation for the findings that a variety of diseases are associated with certain social and cultural situations. This hypothesis was tested in a prospective study of 4251 men of Japanese ancestry in Hawaii who answered a psychosocial questionnaire in 1971. The seven-year incidence rates of coronary heart disease, stroke, cancer, and all deaths during the period December 1971-January 1979 were analyzed for association with individual questions and five summary scores measuring geographic and generational mobility, sociocultural and spousal inconsistency, and social networks. Among all questions and summary scores measuring mobility and inconsistency, there was only one statistically significant association with any disease, and this association was in the opposite direction to that predicted by the hypothesis. The measures of social networks were not associated with either the incidence of stroke, cancer, or all diseases combined, but were associated with coronary heart disease, as reported in detail earlier. The authors examined the joint interaction of the postulated stressful processes of mobility and inconsistency with the protective effects of social networks, with special attention to the men in the highest levels of mobility and inconsistency. They found no significant associations, and thus there was no support for the hypothesis that social networks are especially protective among persons in the highest levels of mobility and inconsistency. The inclusion of known health hazards, cigarette smoking, and high systolic blood pressure levels did not alter these findings.