title: What does age-comparative self-rated health measure? A cross-sectional study from the Northern Sweden MONICA Project.
abstract: OBJECTIVE
  Self-rated health comprehensively accounts for many health domains. Using self-ratings and a knowledge of associations with health domains might help personnel in the health care sector to understand reports of ill health. The aim of this paper was to investigate associations between age-comparative self-rated health and disease, risk factors, emotions and psychosocial factors in a general population.
  
  
  METHODS
  We based our study on population-based cross-sectional surveys performed in 1999, 2004 and 2009 in northern Sweden. Participants were 25-74 years of age and 5314 of the 7500 people invited completed the survey. Comparative self-rated health was measured on a three-grade ordinal scale by the question 'How would you assess your general health condition compared to persons of your own age?' with the alternatives 'better', 'worse' or 'similar'. The independent variables were sex, age, blood pressure, cholesterol, body mass index, self-reported myocardial infarction, stroke, diabetes, physical activity, smoking, risk of unemployment, satisfaction with economic situation, anxiety and depressive emotions, education and Karasek scale of working conditions. Odds ratios using ordinal regression were calculated.
  
  
  RESULTS
  Age, sex, stroke, myocardial infarction, diabetes, body mass index, physical activity, economic satisfaction, anxiety and depressive emotions were associated with comparative self-rated health. The risk of unemployment, a tense work situation and educational level were also associated with comparative self-rated health, although they were considerably weaker when adjusted for the the other variables. Anxiety, depressive emotions, low economic satisfaction and a tense work situation were common in the population.
  
  
  CONCLUSIONS
  Emotions and economic satisfaction were associated with comparative self-rated health as well as some medical variables. Utilization of the knowledge of these associations in health care should be further investigated.
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Family Medicine, Umeå University, Umeå, Sweden goran.waller@umu.se.
authors.forename: Göran
authors.initials: G
authors.lastname: Waller
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
authors.forename: Urban
authors.initials: U
authors.lastname: Janlert
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Family Medicine, Umeå University, Umeå, Sweden.
authors.forename: Katarina
authors.initials: K
authors.lastname: Hamberg
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Family Medicine, Umeå University, Umeå, Sweden.
authors.forename: Annika
authors.initials: A
authors.lastname: Forssén
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000175:diagnosis*; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D012307:Risk Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000175:diagnosis*; D013548:Sweden / Q000453:epidemiology
keywords: Cardiovascular disease; comparative self-rated health; diabetes; emotions; ordinal regression analysis; population-based study; psychosocial factors; risk factors