Open Access Research article

Sense of coherence and diabetes: A prospective occupational cohort study

Anne M Kouvonen1*, Ari Väänänen2, Stephen A Woods1, Tarja Heponiemi3, Aki Koskinen4 and Salla Toppinen-Tanner2

Author Affiliations

1 Institute of Work, Health & Organisations, University of Nottingham, 8 William Lee Buildings, Nottingham Science and Technology Park, University Boulevard, Nottingham NG7 2RQ, UK

2 Finnish Institute of Occupational Health, Topeliuksenkatu 42 a A, FIN-00250 Helsinki, Finland

3 National Research and Development Centre for Welfare and Health (STAKES), POB 220, FIN-00531 Helsinki, Finland

4 Department of Psychology, University of Helsinki, POB 9, FIN-00014 University of Helsinki, Finland

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BMC Public Health 2008, 8:46  doi:10.1186/1471-2458-8-46

Published: 6 February 2008



Sense of coherence (SOC) is an individual characteristic related to a positive life orientation leading to effective coping. A weak SOC has been associated with indicators of general morbidity and mortality. However, the relationship between SOC and diabetes has not been studied in prospective design. The present study prospectively examined the relationship between a weak SOC and the incidence of diabetes.


The relationship between a weak SOC and the incidence of diabetes was investigated among 5827 Finnish male employees aged 18–65 at baseline (1986). SOC was measured by questionnaire survey at baseline. Data on prescription diabetes drugs from 1987 to 2004 were obtained from the Drug Imbursement Register held by the Social Insurance Institution.


During the follow-up, 313 cases of diabetes were recorded. A weak SOC was associated with a 46% higher risk of diabetes in participants who had been =<50 years of age on entry into the study. This association was independent of age, education, marital status, psychological distress, self-rated health, smoking status, binge drinking and physical activity. No similar association was observed in older employees.


The results suggest that besides focusing on well-known risk factors for diabetes, strengthening SOC in employees of =<50 years of age can also play a role in attempts to tackle increasing rates of diabetes.