Articles

Preferences Offset Stressors in Determining Survivability

Pure stress-based models of health predict that accumulated stresses promote illnesses that result in lower life expectancies. However, in mixed subjective preference models, effects of stress, seen as negative preference, can potentially be offset by achievement of positive personal preferences. According to mixed preference models, preventive medicine strategies for promoting health can operate either by alleviating stress or by enhancing subjective preferences. Over many decades we developed a theory and practice of rational, psychoacoustically-driven architectural acoustic design of concert halls.1-3 The theory incorporates both negative acoustic annoyance attributes (stressors, negative preferences) and positive ones. Using self-assessment surveys of 30 dialysis patients in Kobe, Japan, we used the methodology to assess the effects of subjective preferences on delaying onset of dialysis treatment (dialysis onset age, DOA). Hayashi’s multivariate regression method (I) for nonparametric data 5,8 was used to estimate effects of reported factors. Of these, six factors proved predictive of DOA (p-values): better or worse interpersonal relations (0.003), decades of full-time work (0.050), alcohol consumption (0.031) according to individual preference, present noisy home environment (0.090), other pollution (0.060), smoking (0.115). Other factors were either weakly- or un- correlated: hospitalizations, house moves, past hypertension, proteinuria, sex, pet ownership, presence of bad odors, past noise pollution. Preventative measures that enhance subjective preferences may thus delay the need for dialysis.