As with mental health problems, the key issue in assessing the public health significance of neuroticism for physical health problems is its predictive utility. There is growing evidence from large studies of representative samples that neuroticism significantly predicts longevity in the general population (T. W. Smith & MacKenzie, 2006). For example, a 21-year prospective study of a representative sample of 5,424 British adults found that each 1 standard deviation unit difference in greater neuroticism at baseline was associated with a statistically significant 10% greater mortality from cardiovascular disease, controlling for age, sex, socioeconomic status, smoking, alcohol consumption, physical activity, and initial health (Shipley, Weiss, Der, Taylor, & Deary, 2007). Similarly, a 6-year longitudinal study of a representative sample of 6,158 adults 65 years of age and older found that a high level of neuroticism in the first assessment predicted 33% more deaths from all causes compared to low neuroticism, controlling age, sex, race-ethnicity, education, medical conditions, and initial health (Wilson et al., 2005). In addition, a 5-year longitudinal study of 800 elderly female and male clergy found that participants with
