Self rated health and mortality: a long term prospective study in eastern Finland.
OBJECTIVE
To assess the relation between self rated health and mortality over a period of 23 years, taking into account medical history, cardiovascular risk factors, and education at the beginning of the follow up.


METHODS
A cohort of random population samples. The baseline studies included a self administered questionnaire and a health examination. Mortality data were collected from the national mortality register using personal identification numbers.


METHODS
The provinces of North Karelia and Kuopio in eastern Finland.


METHODS
Random samples of working age people (n=21 302) from the population register.


RESULTS
For self rated health, the age adjusted poor to good relative risk for all cause mortality was 2.36 (95% confidence intervals 2.10, 2.64) for men and 1.90 (1.63, 2.22) for women, and for cardiovascular mortality 2.29 (1.96, 2.68) for men and 2.34 (1.84, 2.96) for women. Adjusted for selected potentially fatal diseases from the subjects' medical histories, cardiovascular disease risk factors, and education, the corresponding relative risks for all cause mortality were 1.66 (1.47, 1.88) for men and 1.50 (1.26, 1.78) for women, and for cardiovascular mortality 1.54 (1.29, 1.82) for men and 1.63 (1.26, 2.10) for women. The association between self rated health and mortality attributable to external causes was fairly strong.


CONCLUSIONS
Poor self rated health is a strong predictor of mortality, and the association is only partly explained by medical history, cardiovascular disease risk factors, and education.
National Public Health Institute, Helsinki, Finland. sami.heistaro@ktl.fi
S
S
Heistaro
P
P
Jousilahti
E
E
Lahelma
E
E
Vartiainen
P
P
Puska
D000328:Adult; D002318:Cardiovascular Diseases / Q000401:mortality; D003627:Data Interpretation, Statistical; D004522:Educational Status; D005260:Female; D005387:Finland / Q000453:epidemiology; D006304:Health Status; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D009026:Mortality; D011446:Prospective Studies; D012307:Risk Factors; D012650:Self Disclosure