GLOBAL SELF-RATINGS OF HEALTH AND MORTALITY - HAZARD IN THE NORTH-CAROLINA PIEDMONT

We analyzed the first 5 years of surveillance data from the Establishe d Population for the Epidemiologic Studies of the Elderly (EPESE) in t he Piedmont of North Carolina (n = 4162) to estimate the effect of a g lobal self-rating of health on survival. Covariates used in Cox propor tional hazard models included sociodemographic factors, chronic medica l conditions, activities of daily living, use of health services, heal th risk behaviors, cognitive function, affective mood, and negative li fe events. Adjusted risk of mortality associated with poor (compared t o excellent) self-ratings of health was significantly elevated among u rban men only. Confounders of the association between survival and ove rall health assessment varied widely by subgroup. Pooled estimates fro m heterogeneous populations may mask significant subgroup differences both in the pattern of variables that mediate crude risk and also in t he magnitude of residual risk of global self-ratings of health.