Original article
Global self-ratings of health and mortality: Hazard in the North Carolina Piedmont

https://doi.org/10.1016/0895-4356(96)00138-2Get rights and content

Abstract

We analyzed the first 5 years of surveillance data from the Established Population for the Epidemiologic Studies of the Elderly (EPESE) in the Piedmont of North Carolina (n = 4162) to estimate the effect of a global self-rating of health on survival. Covariates used in Cox proportional hazard models included sociodemographic factors, chronic medical conditions, activities of daily living, use of health services, health risk behaviors, cognitive function, affective mood, and negative life events. Adjusted risk of mortality associated with poor (compared to excellent) self-ratings of health was significantly elevated among urban men only. Confounders of the association between survival and overall health assessment varied widely by subgroup. Pooled estimates from heterogeneous populations may mask significant subgroup differences both in the pattern of variables that mediate crude risk and also in the magnitude of residual risk of global self-ratings of health.

References (29)

  • DJH Deeg et al.

    Medical and social predictors of longevity in the elderly: Total predictive value and interdependence

    Soc Sci Med

    (1989)
  • E Singer et al.

    Mortality and mental health: Evidence from the midtown Manhattan restudy

    Soc Sci Med

    (1976)
  • FD Wolinsky et al.

    Perceived health status and mortality among older men and women

    J. Gerontol

    (1992)
  • J McCallum et al.

    Self-rated health and survival: A 7- year follow-up study of Australian elderly

    Am J Public Health

    (1994)
  • JM Mossey et al.

    Self-rated health: A predictor of mortality among the elderly

    Am J Public Health

    (1982)
  • G Kaplan et al.

    Subjective state of health and survival in elderly adults

    J Gerontol

    (1988)
  • GA Kaplan et al.

    Perceived health and mortality: A nine-year follow-up of the human population laboratory cohort

    Am J Epidemiol

    (1983)
  • EL Idler et al.

    Health perceptions and survival: Does global evaluation of health status really predict mortality?

    J Gerontol

    (1991)
  • EL Idler et al.

    Self-evaluated health and mortality among the elderly in New Haven, Connecticut, and Iowa and Washington Counties, Iowa, 1982–1986

    Am J Epidemiol

    (1990)
  • MD Grant et al.

    Self-reported health and survival in the longitudinal study of aging, 1984–1986

    J Clin Epidemiol

    (1996)
  • E Idler

    Cohesiveness and Coherence: Religion and the Health of the Elderly

    (1994)
  • DE Schoenfeld et al.

    Self-rated health and mortality in the high functioning elderly-A closer look at healthy individuals: MacArthur Field Study of Successful Aging

    J Gerontol

    (1994)
  • EL Idler et al.

    Self-rated health and mortality in the NHANES- I epidemiologic follow-up study

    Am J Public Health

    (1990)
  • Cited by (0)

    The research on which this publication was based was performed pursuant to Contract N01-AG-1-2102 with the National Institute on Aging, in support of the Established Populations for Epidemiologic Studies of the Elderly (Duke). The content of this publication does not necessarily reflect the views or policies of the U.S. Department of Health and Human Services.

    View full text