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Am J Public Health. 2016 Sep;106(9):1644-9. doi: 10.2105/AJPH.2016.303318. Epub 2016 Jul 26.

Psychiatric, Psychological, and Social Determinants of Health in the Nurses' Health Study Cohorts.

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Claudia Trudel-Fitzgerald, Ying Chen, and Laura D. Kubzansky are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA. Ankura Singh and Olivia I. Okereke are with the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA.



To review the contribution of the Nurses' Health Studies (NHS) on factors that influence mental and physical health.


Narrative review of all published articles using data from the NHS, the NHS II, and the Growing Up Today Study focusing on mental health conditions (e.g., depression, posttraumatic stress disorder, anxiety) and psychosocial resources and stressors (e.g., job strain, interpersonal violence, social relationships, sexual orientation) between 1990 and 2016.


Studies have considered a broad array of determinants (e.g., genes, biomarkers, air pollution) and consequent behavioral and disease-related outcomes (e.g., body weight, smoking, cardiometabolic diseases, cancer, autism). Findings suggest anxiety, posttraumatic stress disorder, childhood violence, caregiver burden, and job insecurity may increase the risk of coronary heart disease and diabetes, whereas findings with cancer are mixed. This work directly affects public health actions, as demonstrated by recent inclusion of a gender expression measure in state surveys.


The NHS cohorts have produced novel and influential research on the interplay of psychological and social factors with health. Psychological and social variables are important contributors to the maintenance or decline of physical and mental health.

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