title: Self-rated health and mortality in a prospective Chinese elderly cohort study in Hong Kong.
abstract: OBJECTIVE
  In the West, self-rated health reliably predicts death, but conceptualizations of health and cause-composition of mortality may be contextually specific. Little is known as to how self-rated health predicts death in non-Western settings.
  
  
  METHODS
  Multivariable Cox regression analysis was used to assess the adjusted associations of age-comparative and self-comparative self-rated health with death from all- and specific-causes using a population-based cohort of 66,820 Chinese (65+years) enrolled from 1998 to 2001 at 18 Elderly Health Centers in Hong Kong, and followed until May 31, 2012.
  
  
  RESULTS
  During an average of 10.9 years follow-up, 19,845 deaths occurred with 6336 from cancer. Worse age-comparative self-rated health, compared with better, was positively associated with death from all-causes (hazard ratio 1.68, 95% confidence interval 1.59, 1.77), cardiovascular disease (hazard ratio 1.83, 95% confidence interval 1.66, 2.02), stroke (hazard ratio 1.93, 95% confidence interval 1.63, 2.29), ischemic heart disease (hazard ratio 1.77, 95% confidence interval 1.51, 2.08), cancer (hazard ratio 1.17, 95% confidence interval 1.06, 1.30) and respiratory disease (hazard ratio 2.25, 95% confidence interval 2.01, 2.52), adjusted for age and sex. Self-comparative self-rated health was not associated with higher mortality.
  
  
  CONCLUSIONS
  Age-comparative self-rated health predicted death in older people from a non-Western setting although the association was less marked than in Western settings.
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Shen
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; School of Public Health, The City University of New York and Hunter College, NY, USA. Electronic address: cms1@hkucc.hku.hk.
authors.forename: C Mary
authors.initials: CM
authors.lastname: Schooling
authors.affiliation: Department of Health, Hong Kong SAR, China.
authors.forename: Wai Man
authors.initials: WM
authors.lastname: Chan
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Jiang Xiu
authors.initials: JX
authors.lastname: Zhou
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Janice M
authors.initials: JM
authors.lastname: Johnston
authors.affiliation: Department of Health, Hong Kong SAR, China.
authors.forename: Siu Yin
authors.initials: SY
authors.lastname: Lee
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Tai Hing
authors.initials: TH
authors.lastname: Lam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D015331:Cohort Studies; D059026:Diagnostic Self Evaluation; D005260:Female; D006304:Health Status; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality / Q000208:ethnology*; D009369:Neoplasms / Q000401:mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D057566:Self Report
keywords: Aging; Cohort study; Mortality; Self-rated health