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

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

Author information

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: rainer.reile@ut.ee.
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.

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

PMID:
28359392
DOI:
10.1016/j.puhe.2016.12.034
[Indexed for MEDLINE]

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