Self rated health and mortality: a long term prospective study in eastern Finland

Abstract

Study objective-To assess the relation between self rated health and mortality over a period of 23 years, taking into account medical history, cardiovascular risk factors, and education at the beginning of the follow up. Design-A cohort of random population samples. The baseline studies included a self administered questionnaire and a health examination. Mortality data were collected from the national mortality register using personal identification numbers. Setting-The provinces of North Karelia and Kuopio in eastern Finland. Participants-Random samples of working age people (n=21 302) from the population register. Main results-For self rated health, the age adjusted poor to good relative risk for all cause mortality was 2.36 (95% confidence intervals 2.10, 2.64) for men and 1.90 (1.63, 2.22) for women, and for cardiovascular mortality 2.29 (1.96, 2.68) for men and 2.34 (1.84, 2.96) for women. Adjusted for selected potentially fatal diseases from the subjects' medical histories, cardiovascular disease risk factors, and education, the corresponding relative risks for all cause mortality were 1.66 (1.47, 1.88) for men and 1.50 (1.26, 1.78) for women, and for cardiovascular mortality 1.54 (1.29, 1.82) for men and 1.63 (1.26, 2.10) for women. The association between self rated health and mortality attributable to external causes was fairly strong. Conclusions-Poor self rated health is a strong predictor of mortality, and the association is only partly explained by medical history, cardiovascular disease risk factors, and education.

Measures of self-reported morbidity according to age, gender and general medical services eligibility in the national survey of lifestyles, attitudes and nutrition

“…Finally, this report confirms that more global measures of self-rated health status relate to disease specific morbidity ratings, with considerable excess compared with the more Measures of self-reported morbidity according to age, gender and general medical services eligibility in the national survey of lifestyles, attitudes and nutrition 3,4,[24][25][26] and Ireland is unlikely to prove an exception. These findings suggest that different domains are being captured by each of the three measures we report on here.…”

“…Simple, subjective global measures of selfrated health on a four or five point Likert scale have been shown repeatedly in prospective epidemiological studies to predict mortality patterns in such populations. 3,4 Measures of self-reported, disease specific morbidity have also been employed in large scale surveillance projects like monitoring trends and determinants in cardiovascular disease (MONICA) as a means of assessing trends for these conditions and for making between-country comparisons. 5 In this paper, we report on the self-reported rates of both global and general health status and disease specific morbidity for selected conditions, collected as part of the national representative SLAN, whose main findings have already been published.…”

Welfare state regimes and differences in self-perceived health in Europe: A multilevel analysis

“…Second, self-rated health is not as reliable as studies of mortality. However, a growing number of studies have shown that weaker measures of health are strongly correlated with harder health measures, such as death, both in the USA (Idler & Benyamini, 1997) and in Europe (Heistaro, Jousilahti, Lahelma, Vartiainen, & Puska, 2001). Third, the outcomes of poor general health might be sensitive to the cut off point on the health scale.…”

The association between thinness and socio-economic disadvantage, health indicators, and adverse health behaviour: a study of 28 000 Finnish men and women

“…The question about perceived health has been widely used in social epidemiology, 18 and it has found to predict mortality in this data. 19 Height and weight were measured without shoes and in light clothing. Blood pressures were measured twice and the means of the measures were used in this study.…”