title: Longitudinal trends in good self-rated health: effects of age and birth cohort in a 25-year follow-up study in Sweden.
abstract: OBJECTIVE
  Although average life expectancy has increased considerably in Sweden, there is less evidence for improved self-rated health (SRH). We analyzed longitudinal trends in SRH between 1980/1981 and 2004/2005 in age and birth cohort subgroups.
  
  
  METHODS
  2,728 males and 2,770 females, aged 16-71 years, were interviewed every eighth year. Mixed models with random intercepts were used to estimate changes in SRH within different age groups and birth cohorts, adjusting for potential confounders.
  
  
  RESULTS
  During the 25-year follow-up, SRH improved in individuals aged ≥48 years, but became poorer or was unchanged in those aged 16-47 years. All birth cohorts showed poorer SRH with increasing age, with an adjusted odds ratio (95% confidence interval) of 0.94 (0.93-0.95) in males and 0.92 (0.91-0.93) in females.
  
  
  CONCLUSIONS
  While SRH in the older age groups improved, SRH became poorer in the youngest. Poorer SRH is deeply worrying for the affected individuals, and may also have a negative impact on the health care system. Although mental illness, socioeconomic factors, and lifestyle may be potential mechanisms, future studies are needed to investigate the reasons behind this trend.
authors: Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden.
authors: Sven-Erik
authors: SE
authors: Johansson
authors: Patrik
authors: P
authors: Midlöv
authors: Jan
authors: J
authors: Sundquist
authors: Kristina
authors: K
authors: Sundquist
authors: Susanna
authors: S
authors: Calling
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012307:Risk Factors; D057566:Self Report; D012737:Sex Factors; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
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