Large variation in predictors of mortality by levels of self-rated health: Results from an 18-year follow-up study

R Reile; A Stickley; M Leinsalu

doi:10.1016/j.puhe.2016.12.034

Large variation in predictors of mortality by levels of self-rated health: Results from an 18-year follow-up study

Public Health. 2017 Apr:145:59-66. doi: 10.1016/j.puhe.2016.12.034. Epub 2017 Jan 20.

Authors

R Reile¹, A Stickley², M Leinsalu³

Affiliations

¹ Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia; Institute of Social Studies, University of Tartu, Tartu, Estonia; Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden. Electronic address: [email protected].
² Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden.
³ Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden; Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.

PMID: 28359392
DOI: 10.1016/j.puhe.2016.12.034

Abstract

Objectives: To analyze the variation in factors associated with mortality risk at different levels of self-rated health (SRH).

Study design: Retrospective cohort study.

Methods: Cox regression analysis was used to examine the association between mortality and demographic, socioeconomic and health-related predictors for respondents with good, average, and poor SRH in a longitudinal data set from Estonia with up to 18 years of follow-up time.

Results: In respondents with good SRH, male sex, older age, lower income, manual occupation, ever smoking, and heavy alcohol consumption predicted higher mortality. These covariates, together with marital status, illness-related limitations, and underweight predicted mortality in respondents with average SRH. For poor SRH, only being never married and having illness-related limitations predicted mortality risk in addition to older age and male sex.

Conclusions: The predictors of all-cause mortality are not universal but depend on the level of SRH. The higher mortality of respondents with poor SRH could to a large extent be attributed to health problems, whereas in the case of average or good SRH, factors other than the presence of illness explained outcome mortality.

Keywords: Estonia; Health concepts; Mortality; Self-rated health.

MeSH terms

Adult
Aged
Cause of Death
Diagnostic Self Evaluation*
Estonia / epidemiology
Female
Follow-Up Studies
Forecasting
Health Status*
Humans
Male
Middle Aged
Mortality*
Predictive Value of Tests
Retrospective Studies
Self Concept*
Self Report*
Sex Distribution
Sex Factors
Socioeconomic Factors
Surveys and Questionnaires