Do risk factors and health behaviours contribute to self-ratings of health?

This study examined the relative importance of five risk factors and health behaviours(namely dietary habits, leisure time exercise, smoking, alcohol consumption and body mass index) on self-ratings of hearth among the Swedis h adult population. The data come from the 1991 Swedish Level of Living Sur vey, a face-to-face survey interview based on a sample representative of th e Swedish population aged between Is and 75 years (n = 5306). The analyses were carried out using logistic regression analysis. With the exception of the consumption of dietary fat, all the risk factors and health behaviours studied were associated with self-rated health. When they were adjusted for health problems and functional limitations most of t he associations weakened or disappeared altogether, but smoking and use of vegetables in the diet were still associated with self-rated health. Self-r atings of young adults (18-34 years) were found to be related to body mass index even when health problems were adjusted for, with both obesity and un derweight contributing to less than good self-rated health. The results indicate that risk factors and health behaviours do not, in gen eral, directly contribute to self-ratings of health. Instead, their-effect is mediated by more specific health problems and their functional consequen ces. However, smoking and not consuming vegetables, as well as obesity and underweight among young respondents, were found to have an independent asso ciation with self-rated health. This may reflect the effects of health prob lems not captured by our indicators of ill health, but may also indicate th at risk factors and risky behaviours are considered to have an effect on on e's perceived health even in the absence of health consequences; (C) 1999 E lsevier Science Ltd. All rights reserved.