El. Idler et al., Survival, functional limitations, and self-rated health in the NHANES I epidemiologic follow-up study, 1992, AM J EPIDEM, 152(9), 2000, pp. 874-883
Citations number
40
Categorie Soggetti
Envirnomentale Medicine & Public Health","Medical Research General Topics
This study examined relative hazards for mortality and functional limitatio
ns according to poor self-ratings of health using prospective data from the
NHANES I Epidemiologic Follow-up Study, a representative sample of US adul
ts aged 25-74 years that has been followed since the First National Health
and Nutrition Examination Survey (NHANES I) was conducted in 1971-1975. Fol
low-up data were taken from death records and from the 1982 and 1992 reinte
rviews. Respondents (n = 6,913) provided extensive baseline data through ph
ysician examinations, laboratory testing, and self-reports of conditions, s
ymptoms, and risk behaviors. Functional limitations were assessed among sur
vivors in 1982 and 1992. Cox regression models accounting for sample design
indicated that baseline self-rated health was associated with a significan
tly reduced hazard of mortality for males but not for females through 1992;
adjusted hazards ratios for excellent health as compared with poor health
were 0.52 for males (95% confidence interval: 0.36, 0.73) and 0.80 for fema
les (95% confidence interval: 0.51, 1.23). Self-rated health also predicted
1982 and 1992 functional limitation for both men and women and 1992 functi
on net of 1982 function for men only. Self-rated health contributes unique
information to epidemiologic studies that is not captured by standard clini
cal assessments or self-reported histories, but evidence suggests that the
effect may be stronger for men than for women.