The Costs of Coping: Long-Term Mortality Risk in Aging Men

OBJECTIVES: Prospective associations between coping and all-cause mortality risk are understudied, particularly among nonmedical samples. We assessed independent and joint associations of multiple components of the transactional stress and coping model with all-cause mortality in a cohort of community-dwelling men. We were particularly interested in how coping effort related to mortality. METHODS: Participants included 743 men from the Veterans Affairs Normative Aging Study who completed 1+ stress and coping assessment in 1993-2002 (baseline age: M = 68.4, standard deviation [SD] = 7.1) and had mortality follow-up through 2020. The Brief California Coping Inventory assessed coping with a past-month stressor. Cox regression evaluated associations of problem stressfulness, coping strategies, total coping effort, and coping efficiency with all-cause mortality risk. RESULTS: Over a mean follow-up of 16.7 years (SD = 7.1), 473 (64%) men died. Problem stressfulness was not associated with mortality risk (hazard ratio [HR]: 1.07, 95% confidence interval [CI]: 0.98-1.17), adjusted for demographics and health conditions. When examining coping via specific strategies, only social coping was associated with higher mortality risk (HR: 1.15, 95% CI: 1.05-1.26) after Bonferroni correction. Total coping effort was associated with 14% greater risk of all-cause mortality (95% CI: 1.04-1.26), independent of problem stressfulness, demographics, and health conditions. Coping efficiency, a benefit-cost ratio of coping efficacy to total coping effort, was not associated with mortality risk in adjusted models. DISCUSSION: Total coping effort may be an important indicator for longevity among aging men, above and beyond problem stressfulness and specific coping strategies, which have been the foci in prior research.