Survival, Functional Limitations, and Self-rated Health in the NHANES I Epidemiologic Follow-up Study, 1992

Abstract

This study examined relative hazards for mortality and functional limitations according to poor self-ratings of health using prospective data from the NHANES I Epidemiologic Follow-up Study, a representative sample of US adults aged 25-74 years that has been followed since the First National Health and Nutrition Examination Survey (NHANES I) was conducted in 1971-1975. Follow-up data were taken from death records and from the 1982 and 1992 reinterviews. Respondents (n = 6,913) provided extensive baseline data through physician examinations, laboratory testing, and self-reports of conditions, symptoms, and risk behaviors. Functional limitations were assessed among survivors in 1982 and 1992. Cox regression models accounting for sample design indicated that baseline self-rated health was associated with a significantly reduced hazard of mortality for males but not for females through 1992; adjusted hazards ratios for excellent health as compared with poor health were 0.52 for males (95% confidence interval: 0.36, 0.73) and 0.80 for females (95% confidence interval: 0.51, 1.23). Self-rated health also predicted 1982 and 1992 functional limitation for both men and women and 1992 function net of 1982 function for men only. Self-rated health contributes unique information to epidemiologic studies that is not captured by standard clinical assessments or self-reported histories, but evidence suggests that the effect may be stronger for men than for women.

Functional Ability, Physical Activity and Self-rated Health in Old Age A Cross Sectional Population-based Study in Norway

“…SRH on the other hand, seemed to represent a construct close to FA, which is in accordance with some results in a follow-up study of survival, functional limitations and SRH [18].…”

“…All the physically active groups showed significantly higher HDL-cholesterol and lower triglyserides and wais circumference than the inactive women and men. SRH is widely used both in Norway and elsewhere and has repeatedly been indirectly validated against mortality [14,18,20,21]. In a review of twenty-seven longitudinal community studies [14] the authors conclude that SRH represent a source of valuable data on health status.…”

Hypertension labelling was associated with poorer self-rated health in the Third US National Health and Nutrition Examination Survey

“…16 Further, global SRH is an integrative measure of health status that has established criterion validity impacting major objective health outcomes. For example, global SRH covaries with functional ability, 17,18 prospectively predicts physician use 19 and mortality across socioeconomic strata 20 even after adjustment for objective disease. [21][22][23] The predictive utility of SRH is in part why it is routinely collected in public health surveys.…”

Ageing, Human Rights and Public Policies

“…Many explanations have been put forward for these differences (Spizzichino and Egidi, 2007). First, non-fatal chronic diseases are more common among women (Molarius and Janson, 2002;Hoeymans and others., 1999;Idler, Russell and Davis, 2000). Second, women are more attentive to and familiar with their health, and are therefore more likely to report their health problems (Idler, 2003).…”