Mortality prediction with a single general self-rated health question

Abstract

Objective: Health planners and policy makers are increasingly asking for a feasible method to identify vulnerable persons with the greatest health needs. We conducted a systematic review of the association between a single item assessing general self‐rated health (GSRH) and mortality. Data Sources: Systematic MEDLINE and EMBASE database searches for studies published from January 1966 to September 2003. Review Methods: Two investigators independently searched English language prospective, community‐based cohort studies that reported (1) all‐cause mortality, (2) a question assessing GSRH; and (3) an adjusted relative risk or equivalent. The investigators searched the citations to determine inclusion eligibility and abstracted data by following a standarized protocol. Of the 163 relevant studies identified, 22 cohorts met the inclusion criteria. Using a random effects model, compared with persons reporting “excellent” health status, the relative risk (95% confidence interval) for all‐cause mortality was 1.23 [1.09, 1.39], 1.44 [1.21, 1.71], and 1.92 [1.64, 2.25] for those reporting “good,”“fair,” and “poor” health status, respectively. This relationship was robust in sensitivity analyses, limited to studies that adjusted for co‐morbid illness, functional status, cognitive status, and depression, and across subgroups defined by gender and country of origin. Conclusions: Persons with “poor” self‐rated health had a 2‐fold higher mortality risk compared with persons with “excellent” self‐rated health. Subjects' responses to a simple, single‐item GSRH question maintained a strong association with mortality even after adjustment for key covariates such as functional status, depression, and co‐morbidity.

Mudanças em dez anos das desigualdades sociais em saúde dos idosos brasileiros (1998-2008)

“…Fonte: Pesquisa Nacional por Amostra de Domicílios, Instituto Brasileiro de Geografi a e Estatística RP ajustada por sexo e IC95% estimados por regressão de Poisson indicadores mais utilizados em inquéritos populacionais devido à simplicidade de obtenção da informação e ao seu valor prognóstico para a mortalidade e a capacidade funcional. 4,8,13 Além disso, ela é uma medida multidimensional que expressa as condições de saúde física e mental, os comportamentos em saúde e o bem-estar social. 8 Entretanto, há controvérsia quanto ao seu uso em pesquisas sobre desigualdades sociais.…”

Longitudinal trends in good self-rated health: effects of age and birth cohort in a 25-year follow-up study in Sweden

“…Self-rated health (SRH) based on a single question asking people to rate their overall health status has been shown to be a reliable measure of individuals' subjective health, and is associated with both morbidity and mortality (DeSalvo et al 2006;Idler and Benyamini 1997;Kaplan et al 1996;Nielsen et al 2008;Singh-Manoux et al 2007). The mechanisms behind this association are not fully known.…”

Self-Reported Health Status Predicts Other-Cause Mortality in Men with Localized Prostate Cancer: Results from the Prostate Cancer Outcomes Study

“…21 A meta-analysis has shown that a single item assessing general self-rated health can accurately predict overall mortality. 22 We used self-reported health status and 15-year vital status data to estimate the risk of other-cause mortality among a population-based cohort of men with localized prostate cancer. We created a nomogram incorporating self-reported health status, age, and race/ethnicity to estimate other-cause mortality at 10 and 15 years after diagnosis.…”