Self-rated health in relation to age and gender: influence on mortality risk in the Malmö Preventive Project.
Author
Summary, in English
Aims: A study was undertaken to examine whether poor self-rated health (SRH) can independently predict all-cause
mortality during 22-year follow-up in middle-aged men and women. Subjects and methods: Data are derived from a
population-based study in Malmo¨ , Sweden. This included baseline laboratory testing and a self-administered questionnaire.
The question on global SRH was answered by 15,590 men (mean age 46.4 years) and 10,089 women (49.4 years). Social
background characteristics (occupation, marital status) were based on data from national censuses. Mortality was retrieved
from national registers. Results: At screening 4,261 (27.3%) men and 3,085 (30.6%) women reported poor SRH. Among
subjects rating their SRH as low, 1,022 (24.0%) men and 228 (7.4%) women died during follow-up. Corresponding figures
for subjects rating their SRH as high were 1801 (15.9%) men and 376 (5.4%) women. An analysis of survival in subjects
reporting poor SRH revealed an age-adjusted hazard risk ratio (HR, 95%CI) for men HR 1.5 (1.4–1.7), and for women HR
1.4 (1.2–1.6). The corresponding HR after adjusting for possible social confounders was for men HR 1.3 (1.1–1.4), and
women HR 1.1 (0.9–1.4). When additional adjustment was made for biological risk factors the association for men was still
significant, HR 1.2 (1.1–1.3). Conclusion: Poor SRH predicts increased long-term mortality in healthy, middle-aged
subjects. For men the association is independent of both social background and selected biological variables. The
adjustment for biological variables can be questioned as they might represent mediating mechanisms in a possible causal
chain of events.
mortality during 22-year follow-up in middle-aged men and women. Subjects and methods: Data are derived from a
population-based study in Malmo¨ , Sweden. This included baseline laboratory testing and a self-administered questionnaire.
The question on global SRH was answered by 15,590 men (mean age 46.4 years) and 10,089 women (49.4 years). Social
background characteristics (occupation, marital status) were based on data from national censuses. Mortality was retrieved
from national registers. Results: At screening 4,261 (27.3%) men and 3,085 (30.6%) women reported poor SRH. Among
subjects rating their SRH as low, 1,022 (24.0%) men and 228 (7.4%) women died during follow-up. Corresponding figures
for subjects rating their SRH as high were 1801 (15.9%) men and 376 (5.4%) women. An analysis of survival in subjects
reporting poor SRH revealed an age-adjusted hazard risk ratio (HR, 95%CI) for men HR 1.5 (1.4–1.7), and for women HR
1.4 (1.2–1.6). The corresponding HR after adjusting for possible social confounders was for men HR 1.3 (1.1–1.4), and
women HR 1.1 (0.9–1.4). When additional adjustment was made for biological risk factors the association for men was still
significant, HR 1.2 (1.1–1.3). Conclusion: Poor SRH predicts increased long-term mortality in healthy, middle-aged
subjects. For men the association is independent of both social background and selected biological variables. The
adjustment for biological variables can be questioned as they might represent mediating mechanisms in a possible causal
chain of events.
Department/s
Publishing year
2005
Language
English
Pages
9-183
Publication/Series
Scandinavian Journal of Public Health
Volume
33
Issue
3
Document type
Journal article
Publisher
SAGE Publications
Topic
- Public Health, Global Health, Social Medicine and Epidemiology
Keywords
- Middle Aged
- Mortality
- Physical Examination
- Questionnaires
- Adult
- Age Factors
- Female
- Follow-Up Studies
- Health Status
- Humans
- Life Style
- Male
- Mental Health
- Research Support
- Non-U.S. Gov't
- Risk Factors
- Self Concept
- Sex Factors
- Socioeconomic Factors
- Sweden: epidemiology
Status
Published
Research group
- Orthopedics - Clinical and Molecular Osteoporosis Research
- Joint and Soft Tissue Unit
- Family Medicine and Community Medicine
- Internal Medicine - Epidemiology
ISBN/ISSN/Other
- ISSN: 1651-1905