Reile R, Stickley A, Leinsalu M
Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia; Institute of Social Studies, University of Tartu, Tartu, Estonia; Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden.
Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden.
Public Health. 2017 Apr;145:59-66. doi: 10.1016/j.puhe.2016.12.034. Epub 2017 Jan 20.
To analyze the variation in factors associated with mortality risk at different levels of self-rated health (SRH).
Retrospective cohort study.
Cox regression analysis was used to examine the association between mortality and demographic, socioeconomic and health-related predictors for respondents with good, average, and poor SRH in a longitudinal data set from Estonia with up to 18 years of follow-up time.
In respondents with good SRH, male sex, older age, lower income, manual occupation, ever smoking, and heavy alcohol consumption predicted higher mortality. These covariates, together with marital status, illness-related limitations, and underweight predicted mortality in respondents with average SRH. For poor SRH, only being never married and having illness-related limitations predicted mortality risk in addition to older age and male sex.
The predictors of all-cause mortality are not universal but depend on the level of SRH. The higher mortality of respondents with poor SRH could to a large extent be attributed to health problems, whereas in the case of average or good SRH, factors other than the presence of illness explained outcome mortality.
分析不同自评健康(SRH)水平下与死亡风险相关因素的变化情况。
回顾性队列研究。
采用Cox回归分析,在爱沙尼亚一个长达18年随访时间的纵向数据集中,研究自评健康状况良好、中等和较差的受访者的死亡率与人口统计学、社会经济和健康相关预测因素之间的关联。
在自评健康状况良好的受访者中,男性、年龄较大、收入较低、体力劳动者、曾经吸烟和大量饮酒预示着更高的死亡率。这些协变量,连同婚姻状况、疾病相关限制和体重过轻,预示着自评健康状况中等的受访者的死亡率。对于自评健康状况较差的受访者,除了年龄较大和男性外,只有从未结婚和有疾病相关限制预示着死亡风险。
全因死亡率的预测因素并非普遍适用,而是取决于自评健康水平。自评健康状况较差的受访者死亡率较高,在很大程度上可归因于健康问题,而在自评健康状况中等或良好的情况下,疾病以外的因素解释了结局死亡率。