American Journal of Epidemiology Vol. 131, No. 1: 91-103
Copyright © 1990 by The Johns Hopkins University School of Hygiene and Public Health
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SELF-EVALUATED HEALTH AND MORTALITY AMONG THE ELDERLY IN NEW HAVEN, CONNECTICUT, AND IOWA AND WASHINGTON COUNTIES, IOWA, 1982–1986
1Department of Sociology and Institute for Health, Health Care Policy, and Aging Research, Rutgers University New Brunswick, NJ
2Department of Epidemiology and Public Health, Yale University School of Medicine New Haven, CT
3Department of Preventive Medicine, University of Iowa Iowa City, LA
Reprint requests to Dr. Ellen L Idler, Institute for Health, Health Care Policy, and Aging Research, Rutgers University, 30 College Avenue, New Brunswick, NJ 08903
The ability of global self-evaluations of health to predict survival in follow-up studies is tested in two samples of elderly, noninstitutlonalized adults. Data from the Yale Health and Aging Project, New Haven, Connecticut (n=2,812), and the 65+ Rural Health Study, Iowa and Washington counties, Iowa (n=3,673), were used to investigate the association between 1982 self-evaluated global health status (excellent, good, fair, poor) and survivorship from 1982 to 1988. Despite extensive controls for physical health status in the form of measures of disabilities and chronic conditions, sociodemographic characteristics, and health risk behaviors at the beginning of the follow-up period, and the use of analytic techniques which take into account the stratified sample design of the New Haven data, poor self-perceptions of health significantly increase the risk of mortality. Adjusted odds ratios for the extreme categories ("poor" as compared with "excellent") for New Haven men and women were 5.33 (95% confidence interval (Cl) 1.93–14.75) and 2.99 (95% Cl 1.30–6.91), respectively; for Iowa men and women they were 4.84 (95% Cl 2.22–10.57) and 3.16 (95% Cl 1.49–6.71). Respondents reporting "fair" and "good" health also show elevated risks of mortality in dose-response fashion. Self-perceptions of health status appear to be a factor of unique pro spective significance in mortality studies.
aged; chronic disease; health surveys; mortality; prospective studies
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