The effect of point of reference on the association between self-rated health and mortality

Soc Sci Med. 2003 Apr;56(7):1447-52. doi: 10.1016/s0277-9536(02)00141-7.

Abstract

This study examines the effect of point of reference on the predictive validity of self-rated health for mortality in a 5-year follow-up period. Two self-rated health measures are examined: an age group comparative question and a global question with no explicit point of reference. The baseline data (SweOld) is a nationally representative interview survey among Swedish people aged 77+ in 1992. Mortality for the 1992-1996 period was analysed using Cox proportional hazards regression models. Age-referential self-rated health was found to be a better predictor of elderly men's mortality both in non-adjusted models and in models adjusting for age and both self-rated health measures. In separate analyses, both measures were found to be equally strong predictors of women's mortality. When adding both measures into the model simultaneously, the age-referential question lost much of its predictive power. The findings suggest that self-rated health measures are not insensitive to differences in question wording.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Geriatric Assessment / methods*
  • Health Status*
  • Humans
  • Male
  • Mortality*
  • Proportional Hazards Models
  • Risk Assessment / methods
  • Self-Assessment*
  • Surveys and Questionnaires / standards*
  • Sweden / epidemiology