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      Self-rated health status as a health measure: The predictive value of self-reported health status on the use of physician services and on mortality in the working-age population

      , , , ,
      Journal of Clinical Epidemiology
      Elsevier BV

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          Abstract

          The validity of various self-reported health assessments in predicting physician contracts and all-cause mortality was investigated in a prospective study in Finland. The follow-up periods were one year for the use of physician services and ten years ten months for the mortality. The study cohort comprised 1340 men and 1500 women, 35-63 years of age at the beginning of the study. The initial health assessments were derived from postal questionnaires in 1980 (response rate 77.5%). The survey was repeated one year later to verify the stability of the respondents' perceived health status. The data on the physician contacts and mortality were registered independently. The stability of perceived health status was relatively good and the perceived health was inversely associated with the number of physician contacts per year. A consistent inverse association, standardized by age, sex and social status, was observed between perceived health status and perceived physical fitness and mortality, while the predictive value of self-reported chronic diseases was low. The results suggest that the subjective health assessments are valid health status indicator in middle-aged populations, and they can be used in cohort studies and population health monitoring.

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          Most cited references36

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          Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes.

          Our model proposes a taxonomy or classification scheme for different measures of health outcome. We divide these outcomes into five levels: biological and physiological factors, symptoms, functioning, general health perceptions, and overall quality of life. In addition to classifying these outcome measures, we propose specific causal relationships between them that link traditional clinical variables to measures of HRQL. As one moves from left to right in the model, one moves outward from the cell to the individual to the interaction of the individual as a member of society. The concepts at each level are increasingly integrated and increasingly difficult to define and measure. AT each level, there are an increasing number of inputs that cannot be controlled by clinicians or the health care system as it is traditionally defined.
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            Physical fitness and all-cause mortality. A prospective study of healthy men and women.

            We studied physical fitness and risk of all-cause and cause-specific mortality in 10,224 men and 3120 women who were given a preventive medical examination. Physical fitness was measured by a maximal treadmill exercise test. Average follow-up was slightly more than 8 years, for a total of 110,482 person-years of observation. There were 240 deaths in men and 43 deaths in women. Age-adjusted all-cause mortality rates declined across physical fitness quintiles from 64.0 per 10,000 person-years in the least-fit men to 18.6 per 10,000 person-years in the most-fit men (slope, -4.5). Corresponding values for women were 39.5 per 10,000 person-years to 8.5 per 10,000 person-years (slope, -5.5). These trends remained after statistical adjustment for age, smoking habit, cholesterol level, systolic blood pressure, fasting blood glucose level, parental history of coronary heart disease, and follow-up interval. Lower mortality rates in higher fitness categories also were seen for cardiovascular disease and cancer of combined sites. Attributable risk estimates for all-cause mortality indicated that low physical fitness was an important risk factor in both men and women. Higher levels of physical fitness appear to delay all-cause mortality primarily due to lowered rates of cardiovascular disease and cancer.
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              Perceived health and mortality: a nine-year follow-up of the human population laboratory cohort.

              The association between perceived health ratings ("excellent," "good," "fair," and "poor") and mortality was assessed using the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, California, and a subsequent nine-year follow-up. Risk of death during this period was significantly associated with perceived health rating in 1965. The age-adjusted relative risk for mortality from all causes for those who perceived their health as poor as compared to excellent was 2.33 for men and 5.10 for women. The association between level of perceived health and mortality persisted in multiple logistic analyses with controls for age, sex, 1965 physical health status, health practices, social network participation, income, education, health relative to age peers, anomy, morale, depression, and happiness.
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                Author and article information

                Journal
                Journal of Clinical Epidemiology
                Journal of Clinical Epidemiology
                Elsevier BV
                08954356
                May 1997
                May 1997
                : 50
                : 5
                : 517-528
                Article
                10.1016/S0895-4356(97)00045-0
                9180644
                63dd8c3b-f7d3-4b08-bdc5-074a45d3154f
                © 1997

                https://www.elsevier.com/tdm/userlicense/1.0/

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