Does it make sense in a coherent way? Determinants of sense of coherence in Swedish women 40 to 50 years of age.

The aim of this study was to explore how socioeconomic and psychosocial life experiences in childhood and at adult age influence the level of sense of coherence (SOC) in women. The idea was to seek empirical support for establishing whether SOC is an individual construct being developed in early life and basically resistant toward adverse environmental factors or rather an entity influenced by adult psychosocial factors and as such, sensitive to health promotion activities; that is, if evidence could be found for a causal direction from classic factors involved in health promotion, such as social network and support, to SOC. A questionnaire (Krantz & Ostergren, 1999) was mailed to a random sample of 486 women, equivalent to 50% of the women between the ages of 40 and 50 in a medium-sized municipality (population 13,200) in Sweden. The response rate was 81.7% (397 women). Odds ratios (OR) were used to estimate bivariate associations between socioeconomic and psychosocial variables and low SOC. Logistic regression analysis was used to test for confounding and as a method of analyzing the structure of tentative causal chains. It was found that adult factors such as job strain (OR = 3.42, 95% confidence interval [CI] = 2.11-5.54), low social support (OR = 4.00, CI = 2.48-6.46), and low social anchorage (OR = 4.14, CI = 2.57-6.67) were independent predictors for low SOC in adult women. Childhood conditions such as family disruption and child abuse proved not to influence SOC to a statistically significant degree. Our study suggests that SOC is an entity partly associated with an individual's position in the social structure and partly by work conditions and social network and support rather than by childhood conditions. We could not claim this study to be a critical test of Antonovsky's (1979) theories in the full refutationistic sense. To approach this goal, it would take a carefully designed prospective study assessing the effect of different factors on SOC in a true life course perspective.