Self-rated general health among 40-year-old Danes and its association with all-cause mortality at 10-, 20-, and 29 years' follow-up

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...

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Bibliographic Details
Published in:Scandinavian journal of public health 2008-01, Vol.36 (1), p.3-11
Main Authors: NIELSEN, ANNI BRIT STERNHAGEN, SIERSMA, VOLKERT, HIORT, LINE CONRADSEN, DRIVSHOLM, THOMAS, KREINER, SVEND, HOLLNAGEL, HANNE
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Cause of Death
Cohort Studies
Denmark
Denmark - epidemiology
Epidemiology
Female
Follow-Up Studies
General aspects
Health Status
Health Surveys
Humans
Life Style
Longitudinal Studies
Male
Medical sciences
Middle Aged
Miscellaneous
Mortality
Original articles
Outcome Assessment (Health Care)
Physical Examination
Public health. Hygiene
Public health. Hygiene-occupational medicine
Risk Factors
Self Concept
Selfassessment
Socioeconomic Factors
Surveys and Questionnaires
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Summary: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.
ISSN:1403-4948
1651-1905
DOI:10.1177/1403494807085242