Berchick Edward R, Lynch Scott M
Duke University Population Research Institute, Duke University, Box 90989, Durham, NC 27708, USA.
Department of Sociology, Duke University, Box 90088, Durham, NC 27708, USA.
SSM Popul Health. 2017 Dec;3:275-282. doi: 10.1016/j.ssmph.2017.01.010. Epub 2017 Jan 31.
Self-rated health (SRH) is a commonly used measure for assessing general health in surveys in the United States. However, individuals from different parts of the United States may vary in how they assess their health. Geographic differences in health care access and in the prevalence of illnesses may make it difficult to discern true regional differences in health when using SRH as a health measure. In this article, we use data from the 1986 and 1989-2006 National Health Interview Survey Linked Mortality Files and estimate Cox regression models to examine whether the relationship between SRH and five-year all-cause mortality differs by Census region. Contrary to hypotheses, there is no evidence of regional variation in the predictive validity of SRH for mortality. At all levels of SRH, and for both non-Hispanic white and non-Hispanic black respondents, SRH is equally and strongly associated with five-year mortality across regions. Our results suggest that differences in SRH across regions are not solely due to differences in how respondents assess their health across regions, but reflect true differences in health. Future research can, therefore, employ this common measure to investigate the geographic patterning of health in the United States.
自评健康状况（SRH）是美国调查中用于评估总体健康状况的常用指标。然而，来自美国不同地区的个人在评估自身健康状况的方式上可能存在差异。医疗保健可及性和疾病患病率的地理差异可能使得在将SRH用作健康指标时，难以辨别健康方面真正的地区差异。在本文中，我们使用1986年以及1989 - 2006年全国健康访谈调查关联死亡率文件中的数据，并估计Cox回归模型，以检验SRH与五年全因死亡率之间的关系是否因人口普查区域而异。与假设相反，没有证据表明SRH对死亡率的预测有效性存在区域差异。在所有SRH水平上，对于非西班牙裔白人及非西班牙裔黑人受访者而言，SRH在各地区与五年死亡率均同等强烈相关。我们的结果表明，各地区SRH的差异并非仅仅源于受访者在各地区评估自身健康状况方式的不同，而是反映了健康方面的真实差异。因此，未来的研究可以采用这一通用指标来调查美国健康状况的地理模式。
