ArticleBMJ public health2026
Association between irregular social rhythm and all-cause mortality, death by illness, suicide and accidental death: a 19-year community-based cohort study in Japan.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Although irregular social rhythms have been suggested to increase the likelihood of all-cause mortality and cause-specific mortality, their associations have not been investigated sufficiently. This study examined whether irregular social rhythms are associated with all-cause mortality, death by illness, suicide and accidental death. Methods: We used data from the Japan Public Health Center-based prospective Study (JPHC Study), a community-based cohort of Japanese adults aged 45-74 years. Social rhythm regularity was assessed at baseline via a self-reported item categorising as regular or irregular. Participants were followed for 19 years, and all-cause mortality and cause-specific mortality, including death by illness, suicide and accidental death, were ascertained using national vital statistics. Risk differences (RDs) and risk ratios (RRs) at 5, 10, 15 and 19 years were estimated. Results: Among 98 349 participants included in the main analyses, those with irregular social rhythms showed a consistently increased risk of all-cause mortality at 5, 10, 15 and 19 years (19-year RD 2.12%, RR 1.11, 95% CI 1.07 to 1.15). Irregular social rhythms were also associated with risk of death by illness (19-year RD 1.85%, RR 1.11, 95% CI 1.07 to 1.15) and accidental death (19-year RD 0.25%, RR 1.29, 95% CI 1.06 to 1.53). Suicide risk was significantly higher only at 5 years (RD 0.06%, RR 1.50, 95% CI 1.02 to 2.02), with no significant association thereafter. Conclusions: Irregular social rhythms may serve as a long-term marker for all-cause mortality and accidental and illness-related mortality, and a possible short-term marker for suicide; however, the association remains uncertain due to the small number of suicide deaths and the null finding in the sensitivity analysis. Social rhythm regularity may be a useful behavioural marker for identifying groups at elevated mortality.
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