Self-rated Health In Relation Research Articles

The Associations between Depressive Symptoms and Self-Rated Health in Relation to Sense of Coherence among Adolescents: Cross-Sectional Study.

We investigated the predictors of poor SRH in a representative sample of Lithuanian mainstream school students in grades 7-8. We also checked for gender differences in the associations between SRH and depressive symptoms and other predictors. A total of 2104 7th-8th-grade students participated (response rate 73.95%) and were asked about depressive symptoms, psychosomatic health complaints, negative acts at school, feeling at school, family stress and violence, sense of coherence, self-esteem, and lifestyle. We used a hierarchical regression analysis including a variety of self-rated health predictors. Boys scored significantly higher on physical activity and smoking, whereas girls scored significantly higher on SRH, depressive symptoms, psychosomatic health complaints, and family stress and violence, though the significance was lost in the hierarchical regression. Depressive symptoms were the strongest predictor of poor SRH (standardized β = 0.309, p < 0.001), though other investigated predictors were also significant but had lower effect sizes. Strong evidence was found supporting the buffering role of sense of coherence in the relationship between depressive symptoms and SRH (standardized β = -0.266, p < 0.001). We can conclude that the magnitude of the relationship between depressive symptoms and self-rated health is dependent on the levels of sense of coherence. We did not find gender differences in those associations. As poor SRH is easy to determine, especially with a one-item question, the cases of poorly rated health should be detected early and corrected by interventions in order to prevent poor health outcomes in the future.

The relationship between union membership and self-rated health among racially diverse U.S. healthcare workers: The role of control over work schedules and locations

BackgroundLabor unions are associated with better wages, improved working conditions, and greater worker empowerment, which may result in better health. However, less is known about the relationship between unionization and health among U.S. healthcare workers, whether the relationship differs among racially diverse workers, and how much control over workplace schedules and location mediates the relationship. MethodsWe analyzed a cross-sectional survey of a nationally representative sample of 3000 U.S. healthcare workers collected from March 14 through April 5, 2023. Using ordinal logistic regression, we evaluated whether unionized healthcare workers had better self-rated health (SRH) than their nonunionized counterparts and examined potential differences between White and racially minoritized respondents. We quantified the mediation percentage explained by control over one's schedule and workplace location in the total and stratified samples using Karlson, Holm, and Breen decomposition analysis. ResultsOver a third (36.1%) of racially minoritized respondents were unionized, compared to 22.3% of White respondents. Among racially minoritized workers, a greater share of unionized workers reported excellent health (40.6% vs. 21.8%) than their nonunionized counterparts. In confounder-adjusted ordinal logistic regression analyses, labor union membership was associated with better SRH overall, with a stronger association for racially minoritized workers. Among White healthcare workers, control over workplace arrangements explained 68.1% of the union membership and SRH relationship. For racially minoritized workers, control over workplace arrangements partially mediated the relationship, explaining 17.4% of the variation, suggesting that labor unions may impact health through additional pathways for these workers. ConclusionsThis study provides empirical evidence of the relationship between labor union membership and health among U.S. healthcare workers. We demonstrate that control over schedules and location is an important mechanism by which unionization may protect healthcare workers’ health. Among racially diverse healthcare workers, labor unions may play an important role in health through various pathways beyond workplace control.

A pilot cross-sectional investigation of chronic shame as a mediator of the relationship between subjective social status and self-rated health among middle-aged adults

ABSTRACT Subjective social status (SSS) is an important independent predictor of health outcomes, however, the pathways through which it affects health are poorly understood. Chronic shame has previously been suggested as a potential mechanism but this has never been investigated and the relationship between chronic shame and health is under-researched. The purpose of this pilot study was to explore whether chronic shame explains a significant portion of the association between SSS and self rated health (SRH). Two-hundred American adults aged 30–55 years were recruited via a crowd-sourcing platform and were asked to provide information on their SSS, level of chronic shame, and SRH. Chronic shame significantly mediated the relationship between SSS and SRH. This pilot study provides initial evidence that shame explains a significant portion of the relationship between subjective social status and self-rated health. These findings support the initiation of larger, longitudinal investigations into chronic shame as a mediator of the subjective social status and self-rated health relationship.

Body height among adult male and female Swiss Health Survey participants in 2017: Trends by birth years and associations with self-reported health status and life satisfaction

The increase in adult height for 150 years is linked to overall improvements in nutrition, hygiene, and living standards. Height is positively associated with general health and success on various levels (e.g. quality of life, earnings or happiness). The aim of this study was to investigate whether different subgroups show different trends across birth cohorts. We wanted to know whether taller individuals considered themselves as healthier and their quality of life as better than shorter individuals.We included 19,435 participants from the Swiss population-based Health Survey 2017. GAM were used to assess nonlinear associations between height and birth year. Multinomial logistic regression was used to predict probabilities of self-rated health in relation to height.The increase in average height slows down from the 1970s birth cohorts. Participants with parents from Central/Northern/Western Europe (men 177.9 cm, women: 165.1 cm) or Eastern Europe (men 178.7 cm, women: 165.7 cm) were taller than participants with parents from South America (men 174.3 cm, women: 161. cm) and Asia (men 173.2 cm, women: 160.1 cm). Participants with tertiary education were taller than participants from education levels (mean difference men: 4.5 cm, women: 5.0 cm). Height was positively associated with self-declared aspects of health and life satisfaction.These results support the conclusion that body height as a co-factor of health aspects should be considered in public health research. Although adult body height can no longer be influenced, nutritional status and thus also healthy growth can be influenced in childhood by public health programs, by eliminating social inequalities, and by strengthen healthy living conditions.

Self-rated health and multimorbidity in patients with type 2 diabetes.

The relationship between multimorbidity and self-rated health is well established. This study examined self-rated health in relation to multimorbidity, glycaemia and body weight specifically in adults with type 2 diabetes. Bootstrapped hierarchical logistic regression and structural equation modelling (SEM) were used to analyse survey data from 280 adults with type 2 diabetes. The odds of ‘fair/bad/very bad’ self-rated health increased 10-fold in patients with three (OR = 10.11 (3.36–30.40)) and four conditions (OR = 10.58 (2.9–38.25)), irrespective of glycaemic control (p < 0.001). The relationship between multimorbidity and perceived health was more pronounced in male patients. SEM generated a model with good fit, χ2 (CMIN) = 5.10, df = 3, p = 0.164, χ2 (CMIN)/df = 1.70, RMSEA = 0.05, CFI = 0.97, TLI = 0.95 and NFI = 0.94; self-rated health mediated relations between multimorbidity and BMI. Overall, this study highlights the potential of self-rated health to mediate relationships between multimorbidity and BMI, but not glycaemic control, in adults with type 2 diabetes.

University Students' Self-Rated Health in Relation to Perceived Acoustic Environment during the COVID-19 Home Quarantine.

Background: Online education became mandatory for many students during the Coronavirus disease 2019 (COVID-19) pandemic and blurred the distinction between settings where processes of stress and restoration used to take place. The lockdown also likely changed perceptions of the indoor acoustic environment (i.e., soundscape) and raised its importance. In the present study, we seek to understand how indoor soundscape related to university students’ self-rated health in Bulgaria around the time that the country was under a state of emergency declaration caused by the COVID-19 pandemic. Methods: Between 17 May and 10 June 2020, we conducted a cross-sectional online survey among 323 students (median age 21 years; 31% male) from two universities in the city of Plovdiv, Bulgaria. Self-rated health (SRH) was measured with a single-item. Participants were asked how frequently they heard different types of sounds while at home and how pleasant they considered each of those sounds to be. Restorative quality of the home (the “being away” dimension of the Perceived Restorativeness Scale) was measured with a single-item. A priori confounders and effect modifiers included sociodemographics, house-related characteristics, general sensitivity to environmental influences, and mental health. Our analysis strategy involved sequential exploratory factor analysis (EFA), multivariate linear and ordinal regressions, effect modification tests, and structural equation modeling (SEM). Results: EFA supported grouping perceived sounds into three distinct factors—mechanical, human, and nature sounds. Regression analyses revealed that greater exposure to mechanical sounds was consistently associated with worse SRH, whereas no significant associations were found for human and nature sounds. In SEM, exposure to mechanical sounds related to lower restorative quality of the home, and then to poorer SRH, whereas nature sounds correlated with higher restorative quality, and in turn with better SRH. Conclusions: These findings suggest a role of positive indoor soundscape and restorative quality for promoting self-rated health in times of social distancing.

Self-rated health in relation to fruit and vegetable consumption and physical activity among older cancer survivors.

We aimed to investigate associations of self-rated health with fruit and vegetable consumption (FVC) and physical activity (PA) among older cancer survivors. We used the 2017 Behavioral Risk Factor Surveillance System to identify cancer survivors ≥ 65 years (N = 2663). Self-reported FVC and PA were categorized as ordinal variables to approximate quartiles. Low general health (LGH) was defined as fair or poor self-rated health. A multivariable logistic regression treating LGH as the outcome was used to calculate adjusted odd ratios (aORs) and 95% confidence intervals (CIs) for FVC and PA. Restricted cubic spline depicted non-linear dose-response curves for FVC and PA. In comparative analysis, we used the same logistic regression and dose-response model to calculate ORs of FVC and PA in 73,134 people ≥ 65 years without cancer history. Overall, 470 (17.7%) survivors had LGH. Survivors' mean age was 73.3 years (SD = 5.2), 55.1% of them were female, and 95.4% self-reported as white. In cancer survivors, FVC was not associated with LGH (≥ 28 vs. < 14 times/week: aOR = 1.02, 95% CI = 0.75-1.39, p-trend = 0.50), whereas PA was inversely associated with LGH (≥ 30 vs. < 7 MET-hours/week: aOR = 0.55, 95% CI = 0.41-0.75, p-trend < 0.01). Dose-response curves demonstrated consistent association patterns. In comparative analysis, ORs of PA did not change substantially but we observed inverse association for FVC. An inverse association between PA and LGH was observed among older cancer survivors, but no significant association was obtained for FVC among them. Regular PA may maintain or indicate a favorable health in older cancer survivors, whereas impacts of FVC deserve further investigations.

The role of inflammation in the relationship of self-rated health with mortality and implications for public health: Data from the English Longitudinal Study of Aging (ELSA)

Self-rated health (SRH) predicts mortality after adjustment for potential confounders, including measures of health status. Prodromal disease might lead to worsened SRH and higher mortality. But no study of SRH and mortality has focussed on inflammation. The objective of this study is to investigate the influence of inflammation upon the association between SRH and mortality in a British cohort. The English Longitudinal Study of Ageing (ELSA) involves interviewing participants aged over 50 every two years. We analysed data for 3405 men and 4139 women. Mortality for consenting members was detected by linkage with UK National Health Care registry up to March 2012. Demographic, clinical, and health behaviours at wave 2 were treated as confounders, as well as inflammation-related disease and C-reactive protein (CRP). A five-step hierarchical multivariable logistic regression was estimated. An association was observed between SRH and mortality after adjusting for all variables. In men, compared to those with excellent health, CRP only, and CRP and inflammation-related disease combined, could explain 7.03% and 24.35% of increased risk of dying associated with poor health, respectively. For women, the corresponding figures were 8.95% and 24.28%, respectively. Inflammation is associated with increased risk of death, and may help to explain approximately a quarter of the association between SRH and mortality. Individuals with relatively poor SRH may be aware of underlying inflammation that increases the risk of illness and death, and this may lead to increased use of services, for example. Identifying the cause and treating inflammation in those without a diagnosis may help to increase survival and life quality among those who perceive their health to be relatively poor.

Self-rated health and general procrastination in nurses: a cross-sectional study.

Introductionnurses are responsible for taking care of the health of the general public. Nurses´ own health is among the important factors affecting the quality of patient care. Self-Rated Health (SRH) is one of the indicators used extensively in health research for the assessment of the health status of individuals. The present study was conducted to evaluate self-rated health and its relationship with general procrastination in nurses.Methodsthe present cross-sectional study was conducted in 2019 on 305 Iranian nurses selected by stratified random sampling. The relationship of self-rated health with procrastination was determined using an ordinal logistic regression analysis after adjustments for personal and occupational factors.Resultsself-rated health was poor/bad in 11.3% of the nurses, fair in 23.7%, good in 34.3% and excellent in 30.7%. After adjustments for personal and occupational factors, a significant relationship was observed between procrastination and self-rated health (OR=0.95; 95%CI 0.92, 0.98).Conclusionthe results showed an unfavorable health status in nurses. Given the significant relationship between procrastination and poor self-rated health in nurses, it is essential to consider this relationship for improving nurses´ health.

Racial stratification in self-rated health among Black Mexicans and White Mexicans.

How do Mexicans of distinct racial backgrounds fit into the recognized patterns of racial health disparities? We conduct regression analyses using data from the 2000-2017 National Health Interview Survey to determine if Mexicans who self-identify as White or Black have a relative advantage or disadvantage in self-rated health in relation to Non-Hispanic (NH) Whites and Blacks in the U.S. Our results indicate that both Black Mexicans and White Mexicans have a significant disadvantage in relation to NH-Whites while White Mexicans have a slight advantage in relation to both NH-Blacks and Black Mexicans. Overall, our results suggest that studying health outcomes among Hispanics without considering race may mask inequalities not observed in the aggregate.

Self-rated health, lifestyle habits and risk assessment in 75-year-old persons attending preventive clinic visits with a nurse in primary health care: a cross-sectional study.

To describe self-rated health in relation to lifestyle and illnesses and to identify risk factors for ill health such as pressure ulcers, falls and malnutrition among 75-year-old participants in a new clinical routine involving health assessment followed by tailored one-to-one health promotion at preventive clinic visits to a nurse at primary health care centres (PHCC). There is a rapidly growing ageing population worldwide. It is central to health policy to promote active and healthy ageing. Preventive clinic visits to a nurse in primary health care were introduced as a new clinical intervention in a region in Sweden to improve the quality of health for the older adults. A quantitative cross-sectional population-based study. The sample consisted of 306 individuals in six primary health care centres in Sweden aged 75 years who attended preventive clinic visits to a nurse. Data were collected from March 2014 to May 2015 during structured conversations with a nurse based on self-administered questionnaires, clinical examinations, risk assessments and after the clinic visit existing register data were collected by the researcher. Participants experienced good self-rated health despite being overweight and having chronic illnesses. Daily exercise such as walking and housework was more common than aerobic physical training. The majority had no problems with mobility but reported anxiety, pain and discomfort and had increased risk of falls. It is important to encourage the older adults to live actively and independently for as long as possible. The healthy older adults may benefit from the clinical intervention described here to support the individual's ability to maintain control over their health. Such supportive assessments might help the healthy older adult to achieve active ageing, reducing morbidity and preventing functional decline.

Biological influences on health-ratings: The relationship of self-rated health, biomarkers, and diabetes and how it differs across groups

Introduction Self-ratings of health (SRH) are the most widely used single-indicator of health in many scientific disciplines as well as in epidemiology. Accordingly, many researchers rely on SRH in describing, examining, and explaining (social) inequalities in health. How these ratings come about, however, is still relatively unexplored. For instance, little is known about the extent to which undiagnosed diseases or the severity of present diseases play a role in rating one's health. Biomarkers, such as HbA1c for diabetes, play an interesting role in this regard since they give objective and highly relevant health information beyond what a respondent is willing - or able - to tell. Thus, they offer the possibility of investigating the relevance of diseases unknown to respondents or the severity of diseases. Methods Through the example of diabetes and the pertinent lab-measured HbA1c-concentration in the respondents’ blood, this paper analyzes the relative roles of diagnoses and biomarkers in the evaluation of general health. To do so, this paper draws on diverse health data from 2890 respondents aged 50–79 collected in the 2007 and 2009 waves of the Canadian Health Measures Survey (CHMS). The paper quantifies and compares the contribution of self-reported diagnoses of diabetes and biomarker-indicated diabetes, undiagnosed diabetes, prediabetes, and diabetes-severity to explaining SRH. Their contributions are compared between genders, age, and education. Additionally, separate analyses of all 359 self-reportedly diagnosed diabetics in the sample were conducted in order to investigate the role diabetes-severity plays within diabetics when rating their health. Results Across all subgroups, the influence of undiagnosed (pre)diabetes as well as HbA1c on SRH appears to be subordinate to a manifest diagnosis of diabetes. With the exception of older men (aged 65–79), all models show a greater influence of diagnoses than lab-indicated diabetes while lab-indicated prediabetes generally does not affect SRH when controlling for other health indicators. General and subgroup analyses of the influence of severity within diabetics reveal that HbA1c indeed influences diabtetics’ SRH, although only for older respondents (65 + ) as well as respondents with at least post secondary education. Conclusions While further research is needed, these results highlight the importance of diagnoses of chronic diseases in rating one's health. This paper also suggests that SRH is primarily based on information known to and relevant for the daily lives of respondents while undiagnosed diseases and disease-severity are - at least in the case of diabetes - less relevant.

Self-rated health and social capital in Iraqi immigrants to Sweden: The MEDIM population-based study.

Poor self-rated health is an estimator of quality of life and a predictor of mortality seldom studied in immigrant populations. This work aimed to study self-rated health in relation to social capital, socioeconomic status, lifestyle and comorbidity in immigrants from Iraq - one of the largest non-European immigrant group in Sweden today - and to compare it with the self-rated health of native Swedes. The study was a cross-sectional population-based study conducted from 2010 to 2012 among citizens of Malmö, Sweden, aged 30-65 years and born in Iraq or Sweden. All participants underwent a health examination and answered questionnaires on self-rated health, social capital, comorbidity, lifestyle and socioeconomic status. In total, 1348 Iraqis and 677 Swedes participated. Poor self-rated health was identified in 43.9% of Iraqis and 21.9% of native Swedes ( p<0.001), with the highest prevalence (55.5%) among Iraqi women. Low social capital was highly prevalent in the immigrants. Female gender showed higher odds of poor self-rated health in Iraqis than in Swedes (OR 1.8, 95% CI 1.4-2.5, pinteraction=0.024), independent of other risk factors connected to social capital, socioeconomic status, lifestyle or comorbidity. Although public health initiatives promoting social capital, socioeconomic status and comorbidity in immigrants are crucial, the excess risk of poor self-rated health in Iraqi women is not fully attributed to known risk factors for self-rated health, but remains to be further explored.

Parental health and psychosomatic symptoms in preschool children: A cross-sectional study in Scania, Sweden.

The aim of the study was to assess the association between parental self-rated health and recurrent abdominal pain (RAP) in preschool children. A questionnaire, including questions about sociodemographic and psychosocial factors, lifestyle, parental and child health, was sent to parents of all 4-year-old children in Scania, Sweden. The response rate was 43.6%. The outcome was RAP and the main exposure was parental self-rated health (SRH). Covariates included sociodemographic, lifestyle and psychosocial factors. Logistic regression analyses were used in a five-step model to estimate the odds ratio (OR) and 95% confidence interval (CI) of parental SRH in relation to child RAP. Logistic regression analysis showed higher odds of RAP among children whose parents reported domestic violence, economic worries and poor SRH (mothers OR = 2.1 (95% CI: 1.6, 2.7) and fathers OR = 1.5 (95% CI: 1.1, 2.0)). Adjustment for sociodemographic, lifestyle and psychosocial factors reduced the OR for RAP in the children of mothers with poor SRH (OR = 1.6 (95% CI: 1.2, 2.2)) and fathers with poor SRH (OR = 1.2 (CI 95%: 0.8, 1.7)). Poor SRH was associated with less reading to the child as well as parental perceptions of insufficiency in the interaction with the child. Health professionals have a key position to prevent psychosomatic symptoms in childhood by identifying the living conditions of children with RAP and particularly, to pay attention to parental poor health to identify if support to the family and/or child protection interventions are needed. Health professionals meeting adult patients with poor health should identify whether they are parents and have children who might need information, support and/or protection.

Trends of self-rated health in relation to overweight in the adult population in Brazilian Midwest capitals.

To estimate the trends of self-rated health in relation to overweight in the adult population of the capitals of the Brazilian Midwest region and the Federal District. Cross-sectional study with a population aged 20 to 59 years, using data from the Telephone-based Surveillance of Risk and Protective Factors for Chronic Diseases (VIGITEL), performed between 2008 and 2014. The estimates using the complex sampling design were made using simple linear regression, trend graphs and Boxplot. The categories "poor" and "very poor" didn't increase in the analyzed period. There was an average increase of 0.5 percentage point per year in the categories "fair" and "good" and an average decrease of 1.0 percentage point in the category "very good". The trend analysis of mean body mass index found there was a progressive growth in all cities. The worst health perceptions showed higher values of body mass index in both sexes. We observed the existence of obese people assessing their health positively. Self-rated health remained relatively constant whereas the body mass index continued to grow between 2008 and 2014. The self-rated health of individuals with high body mass index (>30 kg/m2) does not seem to be directly related to their weight. Therefore, it is important to analyze the association of these two variables controlling for morbidity, health behaviors (smoking and alcohol consumption, physical activity and diet), and sociodemographic factors.

The relationship between relative deprivation and self-rated health among Palestinian women in refugee camps in Lebanon

BackgroundRelative deprivation (RD) has been advanced as a theory to explain the relationship between income inequality and health in high-income countries. In this study, we tested the theory in a low-income protracted refugee setting in a middle-income country. MethodsUsing data from the 2010 Socioeconomic Survey of Palestine Refugees in Lebanon, we examined the relationship between RD and health among a representative sample of Palestinian refugee women (N=1047). Data were gathered utilizing a household questionnaire with information on socio-demographics and an individual-level questionnaire with information on the health of each respondent. We examined self-rated health (SRH) as the main health measure but also checked the sensitivity of our results using self-reported chronic conditions. We used two measures for absolute SES: total household monthly expenditures on non-food goods and services and total household monthly expenditures on non-health goods and services. With refugee camp as a reference group, we measured a household’s RD as a household’s rank of absolute SES within the reference group, multiplied by the distance between its absolute SES and the average absolute SES of all households ranked above it. We investigated the robustness of the RD–SRH relationship using these two alternative measures of absolute SES. ResultsOur findings show that, controlling for absolute SES and other possible confounders, women report significantly poorer health when they live in households with a higher score on our RD measure (because of either lower relative rank or lower relative SES compared to households better off in the reference group which we take to be the refugee camp). While RD is always significant as a determinant of SRH under a variety of specifications, absolute SES is not consistently significant. These findings persist when we use self-reported chronic conditions as our measure of health instead of SRH, suggesting that the relationship between health and RD may be operating through a psychosocial mechanism. DiscussionOur findings underscore the importance of examining RD under conditions of poverty and in diverse socio-cultural contexts. They also highlight that public health approaches should be concerned with reducing social inequalities in low-income settings in addition to alleviating poverty.

Latino residential segregation and self-rated health among Latinos: Washington State Behavioral Risk Factor Surveillance System, 2012–2014

The relationship between Latino residential segregation and self-rated health (SRH) is unclear, but might be partially affected by social capital. We investigated the association between Latino residential segregation and SRH while also examining the roles of various social capital measures. Washington State Behavioral Risk Factor Surveillance System (2012–2014) and U.S. Census data were linked by zip code and zip code tabulation area. Multilevel logistic regression models were used to estimate odds of good or better SRH by Latino residential segregation, measured by the Gini coefficient, and controlling for sociodemographic, acculturation and social capital measures of neighborhood ties, collective socialization of children, and social control. The Latino residential segregation – SRH relationship was convex, or ‘U’-shaped, such that increases in segregation among Latinos residing in lower segregation areas was associated with lower SRH while increases in segregation among Latinos residing in higher segregation areas was associated with higher SRH. The social capital measures were independently associated with SRH but had little effect on the relationship between Latino residential segregation and SRH. A convex relationship between Latino residential segregation and SRH could explain mixed findings of previous studies. Although important for SRH, social capital measures of neighborhood ties, collective socialization of children, and social control might not account for the relationship between Latino residential segregation and SRH.

Self-rated health in relation to mental health, physical activity, sedentary behaviour in adolescents

Self-rated health in relation to mental health, physical activity, sedentary behaviour in adolescents

Relationship of self-rated health with fatal and non-fatal outcomes in cardiovascular disease: a systematic review and meta-analysis.

BackgroundPeople who rate their health as poor experience higher all-cause mortality. Study of disease-specific association with self-rated health might increase understanding of why this association exists.ObjectivesTo estimate the strength of association between self-rated health and fatal and non-fatal cardiovascular disease.MethodsA comprehensive search of PubMed MEDLINE, EMBASE, CINAHL, BIOSIS, PsycINFO, DARE, Cochrane Library, and Web of Science was undertaken during June 2013. Two reviewers independently searched databases and selected studies. Inclusion criteria were prospective cohort studies or cohort analyses of randomised trials with baseline measurement of self-rated health with fatal or non-fatal cardiovascular outcomes. 20 studies were pooled quantitatively in different meta-analyses. Study quality was assessed using Newcastle-Ottawa scales.Results‘Poor’ relative to ‘excellent’ self-rated health (defined by most extreme categories in each study, most often’ poor’ or ‘very poor’ and ‘excellent’ or ‘good’) was associated over a follow-up of 2.3–23 years with cardiovascular mortality in studies: where varying degrees of adjustments had been made for cardiovascular disease risk (HR 1.79 (95% CI 1.50 to 2.14); 15 studies, I2 = 71.24%), and in studies reporting outcomes in people with pre-existing cardiovascular disease or ischaemic heart disease symptoms (HR 2.42 (95% CI 1.32 to 4.44); 3 studies; I2 = 71.83%). ‘Poor’ relative to ‘excellent’ self rated health was also associated with the combined outcome of fatal and non-fatal cardiovascular events (HR 1.90 (95% CI 1.26 to 2.87); 5 studies; I2 = 68.61%), Self-rated health was not significantly associated with non-fatal cardiovascular disease outcomes (HR 1.66 (95% CI 0.96 to 2.87); 5 studies; I2 = 83.60%).ConclusionsPoor self rated health is associated with cardiovascular mortality in populations with and without prior cardiovascular disease. Those with current poor self-rated health may warrant additional input from health services to identify and address reasons for their low subjective health.

The relationship of self-rated health with functional status, toxicity and mortality: Results of a prospective pilot study of older patients with newly-diagnosed cancer

To determine the association between self-rated health (SRH) and functional status, comorbidity, toxicity of treatment and mortality in older patients with newly-diagnosed cancer. Patients aged 65 and over, newly diagnosed were recruited at the Jewish General Hospital, Montreal, Canada. SRH and functional status [instrumental activities of daily living (IADL), basic activities of daily living (ADL), Eastern Cooperative Oncology Group performance status (ECOG PS), frailty markers and number of comorbid conditions] were evaluated prior to the start of treatment, and at 3, 6 and 12 months (SRH only). Treatment toxicity and mortality data were abstracted from the chart. Logistic regression was also used to examine the relationship between functional status, comorbidity and SRH at baseline. Logistic and Cox regression were used to examine the association between baseline SRH and treatment toxicity/time to death. There were 112 participants enrolled on this study (median age 74.1). At baseline, 74 patients (66.1%) had a good SRH and 38 patients (33.9%) had poor SRH. Only an increasing number of comorbid conditions was associated with poor SRH at baseline in both univariate and multivariable analysis. We found no association between SRH and toxicity or mortality. A substantial proportion had poor SRH prior to and during cancer treatment. An increasing number of comorbidities was associated with poor SRH at baseline. SRH did not predict toxicity or mortality. Attention to comorbid conditions in older patients with cancer is warranted considering their impact on SRH in this population.