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Differences Between Older Men and Women in the Self-Rated Health–Mortality Relationship

Correspondence: Address correspondence to Peter A. Bath, Health Informatics Research Group, Centre for Health Information Management Research (CHIMR), Department of Information Studies, University of Sheffield, Western Bank, Sheffield S10 2TN, United Kingdom. E-mail: p.a.bath{at}shef.ac.uk

Purpose: The aims of this study were to examine differences between older men and women: (a) in the ability of self-rated health to predict mortality, (b) in the effect of different follow-up periods on the self-rated health mortality relationship, and (c) in the relative importance of self-rated health and self-rated change in health in predicting mortality. Design and Methods: By using data from the Nottingham Longitudinal Study of Activity and Ageing, the author assessed relationships between self-rated health and self-rated change in health and 4- and 12-year mortality in separate unadjusted and adjusted Cox proportional hazards regression models in men and women. Results: The differences between men and women in the hazard ratios for poor self-rated health were not significant, although there were differences in the explanatory factors. The relationship between self-rated health and short-term and long-term mortality was explained by age and health among men. The relationship between self-rated health and short-term mortality was explained by age, physical and mental health, and physical activity among women. The relationship between self-rated health and long-term mortality was explained by age, physical health, and physical activity among women. The relationship between self-rated change in health and short-term mortality was explained by age among men and women. The relationship between self-rated change in health and long-term mortality was explained by age and physical health among men and women. Social engagement was an independent predictor of short- and long-term mortality among men and women in this study. Implications: The finding that low self-rated health was not an independent predictor of mortality among men or women, contrary to many, but not all, previous studies, may be related to differences in study design and/or across cultures. Further research investigating relationships between self-rated health and mortality and potential explanatory variables should analyze men and women separately and should consider the length of follow-up period. The benefits of individual physical and social activities in reducing mortality merit further investigation.

Key Words: Self-rated health • Self-rated change in health • Mortality • Gender differences • Social engagement

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