Idler E L, Kasl S
Department of Sociology, Rutgers University.
J Gerontol. 1991 Mar;46(2):S55-65. doi: 10.1093/geronj/46.2.s55.
Self-evaluations of health status have been shown to predict mortality, above and beyond the contribution to prediction made by indices based on the presence of health problems, physical disability, and biological or life-style risk factors. Several possible reasons for this association are discussed: (a) methodological shortcomings of previous studies render the association spurious; (b) other psychosocial influences on mortality are involved and explain the association; and (c) self-evaluations of health status have a direct and independent effect of their own. Four-year follow-up mortality data from the Yale Health and Aging Project (N = 2812) are used to explore these possibilities. The analysis controls for the contribution of numerous indicators of health problems, disability and risk factors, and also makes adjustments of standard errors for the complex sample design. The findings favor the third possibility, an independent effect, to the extent that the particular set of psychosocial factors examined did not explain the basic association, and to the extent that the control variables were an adequately comprehensive set.
健康状况的自我评估已被证明能够预测死亡率，其预测效力高于基于健康问题、身体残疾以及生物或生活方式风险因素的指标所做出的预测贡献。文中讨论了造成这种关联的几个可能原因：(a) 以往研究的方法缺陷致使这种关联是虚假的；(b) 存在其他对死亡率有影响的社会心理因素并能解释这种关联；(c) 健康状况的自我评估本身具有直接且独立的影响。来自耶鲁健康与衰老项目（N = 2812）的四年随访死亡率数据被用于探究这些可能性。该分析控制了众多健康问题、残疾及风险因素指标的贡献，并且针对复杂样本设计对标准误差进行了调整。研究结果支持第三种可能性，即存在独立影响，因为所考察的特定社会心理因素集并未解释基本关联，而且控制变量是一组足够全面的变量。
