|
Sign In to gain access to subscriptions and/or personal tools.
|
Scandinavian Journal of Public Health, Vol. 36, No. 1,
3-11 (2008)
DOI: 10.1177/1403494807085242
Self-rated general health among 40-year-old Danes and its association with all-cause mortality at 10-, 20-, and 29 years' follow-up
Anni Brit Sternhagen Nielsen
Research Unit and Department of General Practice, University of Copenhagen, Copenhagen, Denmark, a.nielsen{at}gpract.ku.dk
Volkert Siersma
Research Unit and Department of General Practice, University of Copenhagen, Copenhagen, Denmark, Department of Biostatistics, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
Line Conradsen Hiort
Department of Biostatistics, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
Thomas Drivsholm
Research Unit and Department of General Practice, University of Copenhagen, Copenhagen, Denmark, Copenhagen County Research Centre for Prevention and Health, Glostrup University Hospital, Copenhagen, Denmark
Svend Kreiner
Department of Biostatistics, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
Hanne Hollnagel
Research Unit and Department of General Practice, University of Copenhagen, Copenhagen, Denmark, Copenhagen County Research Centre for Prevention and Health, Glostrup University Hospital, Copenhagen, Denmark
Aims: Self-rated general health (SRH) predicts future mortality. We examined all-cause mortality at 10, 20, and 29 years' follow-up and its association with SRH measured at the age of 40 years in a cohort of 1,198 healthy Danes born in 1936 and who were residents in suburban Copenhagen. Methods: The association between SRH (dichotomized into good versus poor) and all-cause mortality was estimated in standard time-homogenous Cox regression models adjusting for covariates related to mortality, and in time-heterogeneous Cox regression models without covariate adjustment, where time-heterogeneity features as a separate risk assessment for each of the three follow-up periods defined by the follow-up examinations. Results: At the age of 40 years, 153 (14.6%) of 1,045 participants reported poor and 85.4% good SRH. Dead participants totalled 36 at the 10-year, 96 at the 20-year, and 207 at the 29-year follow-up. For poor SRH, mortality hazard ratios (multivariate analysis) were persistently significant, but slowly declining with follow-up time. The time-heterogeneous models explain this feature: increased mortality risk was significant only in the first decade after assessment: 2.30 (95% CI 1.11-4.78) vs. 0.91 (95% CI 0.36-2.31) and 0.73 (95% CI 0.34-1.55). Conclusions: The association between poor SRH and mortality emphasizes the importance of health personnel taking account of people's health rating, particularly when a recent assessment has been made. SRH is related to death, even when controlling for known covariates, but it is not a long-term effect.
Key Words: Denmark • follow-up studies • health status • longitudinal studies • mortality • self-rated health
References
- Geest TA, Engberg M., Lauritzen T. Discordance between self-evaluated health and doctor-evaluated health in relation to general health promotion . Scand J Prim Health Care 2004;22:146-51.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Kivinen P., Halonen P., Eronen M., Nissinen A. Self-rated health, physician-rated health and associated factors among elderly men: Rhe Finnish cohorts of the Seven Countries Study . Age Ageing 1998;27:41-7.[Abstract/Free Full Text]
- Moller L., Kristensen TS, Hollnagel H. Self rated health as a predictor of coronary heart disease in Copenhagen, Denmark . J Epidemiol Community Health 1996; 50(:423-8.[Abstract]
- Benyamini Y., Idler EL Community studies reporting association between self-rated health and mortality: Additional studies, 1995 to 1998 . Res Aging 1999;21:392-401.[Free Full Text]
- Idler EL, Benyamini Y. Self-rated health and mortality: A review of twenty-seven community studies . J Health Soc Behav 1997;38:21-37.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- DeSalvo KB, Bloser N., Reynolds K., He J., Muntner P. Mortality Prediction with a single general self-rated health question . J Gen Intern Med 2006;21:267-75.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Strawbridge WJ, Wallhagen MI Self-Rated health and mortality over three decades . Res Aging 1999;21:402-16.[Abstract/Free Full Text]
- Simons LA, McCallum J., Friedlander Y., Simons J. Predictors of mortality in the prospective Dubbo study of Australian elderly . Aust N Z J Med 1996;26:40-8.[ISI][Medline]
[Order article via Infotrieve]
- Kaplan GA, Goldberg DE, Everson SA, Cohen RD, Salonen R., Tuomilehto J., et al. Perceived health status and morbidity and mortality: Evidence from the Kuopio ischaemic heart disease risk factor study . Int J Epidemiol 1996;25:259-65.[Abstract/Free Full Text]
- Meinow B., Kareholt I., Parker MG, Thorslund M. The effect of the duration of follow-up in mortality analysis: The temporal pattern of different predictors . J Gerontol B Psychol Sci Soc Sci 2004;59:S181-S189.[Abstract/Free Full Text]
- Benyamini Y., Blumstein T., Lusky A., Modan B. Gender differences in the self-rated health-mortality association: Is it poor self-rated health that predicts mortality or excellent self-rated health that predicts survival ? Gerontologist 2003;43:396-405.[Abstract/Free Full Text]
- Hollnagel H., Saelan H., Garde K., Larsen S. [The concept of representativity in epidemiological studies. Examples from population study of 40 year olds in Glostrup] . Ugeskr Laeger 1981;143:1781-8.[Medline]
[Order article via Infotrieve]
- Hollnagel H. The health structure of 40-year-old men and women in the Glostrup area, Denmark - an epidemiological survey: General design, sampling results and referrals for further medical care . Dan Med Bull 1980,27:121-30.[ISI][Medline]
[Order article via Infotrieve]
- Moller LF, Kristensen TS, Hollnagel H. [Social status and cardiovascular risk factors in Danish males] . Ugeskr Laeger 1991;154:8-13.[Medline]
[Order article via Infotrieve]
- Drivsholm T., Eplov LF, Davidsen M., Jorgensen T., Ibsen H., Hollnagel H., et al. Representativeness in population-based studies - a detailed description of non-response in a Danish cohort-study. Scand J Public Health 2006;34:623-3.
- Saltin B., Grimby G. Physiological analysis of middle-aged and old former athletes: Comparison with still active athletes of the same ages . Circulation 1968;38:1104-15.[Abstract/Free Full Text]
- Rose GA, Blackburn H. Cardiovascular survey methods . Monogr Ser World Health Organ 1968;56:1-188.[Medline]
[Order article via Infotrieve]
- Dunn OJ Multiple Comparisons among means . J Am Statistical Association 1961;56:52-64.[CrossRef][ISI]
- Nan B., Lin X., Lisabeth LD, Harlow SD A varying-coefficient Cox model for the effect of age at a marker event on age at menopause . Biometrics 2005;61:576-83.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Maddox GL, Douglass EB Self-assessment of health: A longitudinal study of elderly subjects . J Health Soc Behav 1973;14:87-93.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- McCullough ME, Laurenceau JP Gender and the natural history of self-rated health: A 59-year longitudinal study . Health Psychol 2004;23:651-5.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Idler EL Discussion: Gender differences in self-rated health, in mortality, and in the relationship between the two . Gerontologist 2003;43:372-5.[Free Full Text]
- Deeg DJ, Kriegsman DM Concepts of self-rated health: Specifying the gender difference in mortality risk . Gerontologist 2003;43:376-86.[Abstract/Free Full Text]
- Helmer C., Barberger-Gateau P., Letenneur L., Dartigues JF Subjective health and mortality in French elderly women and men . J Gerontol B Psychol Sci Soc Sci 1999;54: S84-S92.[Abstract]
- Van Doom C., Kasl SV Can parental longevity and self-rated life expectancy predict mortality among older persons? Results from an Australian cohort . J Gerontol B Psychol Sci Soc Sci 1998; 53:S28-S34.[Abstract]
- Heistaro S., Jousilahti P., Lahelma E., Vartiainen E., Puska P. Self rated health and mortality: a long term prospective study in eastern Finland . J Epidemiol Community Health 2001; 55:227-32.[Abstract/Free Full Text]
- Joutsenniemi KE, Martelin TP, Koskinen SV, Martikainen PT, Harkanen TT, Luoto RM, et al. Official marital status, cohabiting, and self-rated health: Time trends in Finland, 1978-2001 . Eur J Public Health 2006;16: 476-83.[Abstract/Free Full Text]
- Pijls LT, Feskens EJ, Kromhout D. Self-rated health, mortality, and chronic diseases in elderly men. The Zutphen Study, 1985-1990 . Am J Epidemiol 1993;138:840-8.[Abstract/Free Full Text]
- Appels A., Bosma H., Grabauskas V., Gostautas A., Sturmans F. Self-rated health and mortality in a Lithuanian and a Dutch population . Soc Sci Med 1996;42:681-9.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Heidrich J., Liese AD, Lowel H., Keil U. Self-rated health and its relation to all-cause and cardiovascular mortality in southern Germany: Results from the MONICA Augsburg cohort study 1984-1995 . Ann Epidemiol 2002;12:338-45.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
- Idler EL, Kasl S. Health perceptions and survival: Do global evaluations of health status really predict mortality ? J Gerontol 1991;46:S55-S65.[ISI][Medline]
[Order article via Infotrieve]
- Manderbacka K. Examining what self-rated health question is understood to mean by respondents . Scand J Soc Med 1998;26:145-53.[ISI][Medline]
[Order article via Infotrieve]
- Malterud K., Hollnagel H. Positive self-assessed general health in patients with medical problems: A qualitative study from general practice . Scand J Prim Health Care 2004;22: 11-15.[CrossRef][ISI][Medline]
[Order article via Infotrieve]
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
|
