Burström B, Fredlund P
Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, SE 171 76 Stockholm, Sweden.
J Epidemiol Community Health. 2001 Nov;55(11):836-40. doi: 10.1136/jech.55.11.836.
To analyse the predictive power of self rated health for mortality in different socioeconomic groups.
DESIGN, SETTING, PARTICIPANTS: Analysis of mortality rates and risk ratios of death during follow up among 170 223 respondents aged 16 years and above in the Swedish Survey of Living Conditions 1975-1997, in relation to self rated health stated at the interview, by age, sex, socioeconomic group, chronic illness and over time.
There was a strong relation between poor self rated health and mortality, greater at younger ages, similar among men and women and among persons with and without a chronic illness. The relative relation between self rated health and subsequent death was stronger in higher than in lower socioeconomic groups, possibly because of the lower base mortality of these groups. However, the absolute mortality risk differences between persons reporting poor and good self rated health were similar across socioeconomic groups within each sex. The mortality risk difference between persons reporting poor and good self rated health was considerably higher among persons with a chronic illness than among persons without a chronic illness. The mortality risk among persons reporting poor health was increased for shorter (<2 years) as well as longer (10+ years) periods of follow up.
The results suggest that poor self rated health is a strong predictor of subsequent mortality in all subgroups studied, and that self rated health therefore may be a useful outcome measure.
分析自我评定健康状况对不同社会经济群体死亡率的预测能力。
设计、背景、参与者:对1975 - 1997年瑞典生活条件调查中16岁及以上的170223名受访者随访期间的死亡率和死亡风险比进行分析,这些数据与访谈时自述的自我评定健康状况、年龄、性别、社会经济群体、慢性病以及时间有关。
自我评定健康状况差与死亡率之间存在密切关系,在年轻人中更为明显,男性和女性之间以及患有和未患有慢性病的人群之间相似。自我评定健康状况与随后死亡之间的相对关系在社会经济地位较高的群体中比在较低的群体中更强,这可能是因为这些群体的基础死亡率较低。然而,在每个性别中,自述健康状况差和良好的人群之间的绝对死亡风险差异在不同社会经济群体中相似。自述健康状况差和良好的人群之间的死亡风险差异在患有慢性病的人群中比在未患有慢性病的人群中要高得多。在较短(<2年)以及较长(10年以上)的随访期内,自述健康状况差的人群的死亡风险都会增加。
结果表明,自我评定健康状况差是所有研究亚组中随后死亡率的有力预测指标,因此自我评定健康状况可能是一个有用的结果指标。