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Correspondence: Address correspondence to Dr. Nicola Spiers, Department of Epidemiology and Public Health, University of Leicester, 22-28 Princess Road West, Leicester, LE1 6TP, United Kingdom. E-mail: nas6{at}le.ac.uk
Purpose:The purpose of this study was to assess whether there is an enduring gender difference in the ability of self-rated health to predict mortality and investigate whether self-reported physical health problems account for this difference.Design and Methods:Cox models for 4-year survival were fitted to data from successive cohorts aged 75–81 years registered with a primary care practice in the U.K. Midlands surveyed in 1981, 1988, and 1993–1995. Results:Self-rated health was consistently a stronger predictor in men (hazard ratio 
; 95% confidence interval 
2.1–3.5) than it was in women (
1.5–2.4). Women surveyed in 1993–1995 were more likely than men to report problems that were disabling but not life-threatening, whereas men were more likely to report potentially life-threatening problems. However, these differences did not explain the association of self-rated health with mortality. More than half of those who reported a potentially life-threatening problem said that their health was good.Implications:Self-rated health is more strongly associated with mortality in men, but this is unlikely to be explained by differences in the nature of their physical health problems.
Key Words: Aged • Self-report • Self-perceived health • Cox regression
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