title: Self-rated health and mortality: a follow-up study of a Spanish population.
abstract: OBJECTIVE
  Self-rated health (SRH) is known to be a valid indicator for the prediction of health outcomes. The aims of this study were to describe and analyse the associations between SRH and health status, socio-economic and demographic characteristics; and between SRH and mortality in a Spanish population.
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  A sample of 5275 adults (age ≥21 years) residing in the Valencian Community (Spanish Mediterranean region) was surveyed in 2005 and followed for four years. SRH was categorized into good and poor health. The response variable was mortality (dead/alive), obtained from the local mortality register. Logistic regression models were adjusted in order to analyse the associations between SRH and health status, socio-economic and demographic characteristics; odds ratios were calculated to measure the associations. Poisson regression models were adjusted in order to analyse the associations between mortality and explanatory variables; the relative risk of death was calculated to measure the associations.
  
  
  RESULTS
  Poor SRH was reported by 25.9% of respondents, and the mortality rate after four years of follow-up was 3.6%. An association was found between SRH and the presence of chronic disease and disability in men and women. A perception of poor health vs good health led to a mortality risk of 3.0 in men and 2.7 in women. SRH was predictive of mortality, even after adjusting for all other variables. In men and women, the presence of disability provided additional predictive ability.
  
  
  CONCLUSIONS
  SRH was predictive of mortality in both men and women, and acted as a mediator between socio-economic, demographic and health conditions and mortality.
authors.affiliation: Research Unit for the Analysis of Mortality and Health Statistics, Department of Community Nursing, Preventive Medicine, Public Health and History of Science, University of Alicante, Alicante, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Tamayo-Fonseca
authors.forename: J A
authors.initials: JA
authors.lastname: Quesada
authors.forename: A
authors.initials: A
authors.lastname: Nolasco
authors.forename: I
authors.initials: I
authors.lastname: Melchor
authors.forename: J
authors.initials: J
authors.lastname: Moncho
authors.forename: P
authors.initials: P
authors.lastname: Pereyra-Zamora
authors.forename: R
authors.initials: R
authors.lastname: López
authors.forename: J
authors.initials: J
authors.lastname: Calabuig
authors.forename: X
authors.initials: X
authors.lastname: Barber
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059026:Diagnostic Self Evaluation; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Adult; Health status; Longitudinal studies; Mortality; Self-assessment; Spain