Combined health risk factors and all-cause and cause-specific mortality in the Korean National Health Examination Baseline cohort

The World Health Organization underscores the importance of maintaining a healthy lifestyle to mitigate premature mortality. Key health risk factors (HRFs) are strongly linked to mortality. However, large-scale cohort studies examining the impact of HRFs on mortality remain scarce. This study aims to assess the effects of HRFs on all-cause and cause-specific mortality. This study utilized the Korean National Health Examination Baseline Cohort. HRFs were assessed based on smoking status, alcohol consumption, body mass index, and physical activity, with each factor assigned a score from 0 to 2, with higher scores indicating poorer health behaviors. The chi-square test and Cox-proportional hazards model were employed to assess mortality risk over a 19-year follow-up period. Compared to the 0–1 HRF group, the 7–8 HRF group exhibited a significantly higher risk of all-cause mortality (hazard ratio [HR]: 1.43, p < .0001), CVD mortality (HR: 1.61, p < .0001), and cancer mortality (HR: 1.48, p < .0001). Additionally, younger individuals in the 7–8 HRF group exhibited an increased risk of all-cause and CVD mortality, whereas middle-aged individuals in this group had a higher risk of cancer mortality compared to the 0–1 HRF group. This study identified the effect of HRFs on all-cause and cause-specific mortality using large-scale cohort from 8 million Koreans.The findings of this study highlight the necessity of policy interventions aimed at vulnerable populations at heightened risk of mortality due to HRFs. Targeted public health strategies should be implemented to mitigate these risks based on combined lifestyle-risk profiles.