The impact of changes in self-rated general health on 28-year mortality among middle-aged Danes

Figures & data

Table I.  Percentage of respondents who changed their self-rated general health between two consecutive health examinations at the age of 40–45, 45–51, and 51–60 years.

	Age at each health examination (years)
	40 and 45	45 and 51	51 and 60
Women
n	501	474	352
% who improved in SRH^1	7.8	8.6	8.0
% who declined in SRH^1	11.2	8.9	11.9
% with unchanged poor SRH^1	10.2	13.1	12.2
% with unchanged good SRH^1	70.9	69.4	67.9
Men
n	458	417	310
% who improved in SRH^1	5.9	6.0	3.5
% who declined in SRH^1	7.9	6.2	10.0
% with unchanged poor SRH^1	3.5	4.6	4.5
% with unchanged good SRH^1	82.8	83.2	81.9
Total
n	959	891	662
% who improved in SRH^1	6.9	7.4	5.9
% who declined in SRH^1	9.6	7.6	11.0
% with unchanged poor SRH^1	7.0	9.1	8.6
% with unchanged good SRH^1	76.5	75.9	74.5

Notes: ¹The measure of self-rated general health (SRH) was dichotomised into poor (covers “poor” and “miserable”) and good (covers “extremely good” and “good”).

Table II.  Self-rated general health at two consecutive health examinations and mortality rate per 1000 observation years until date of censoring due to mortality (23 years follow-up): Bivariate analysis.

	Age at each health examination (years)
	40 and 45			45 and 51			51 and 60
	Change in SRH^1	Died after the age of 45		Change in SRH^1	Died after the age of 51		Change in SRH^1	Died after the age of 60
	n	D^2	Mortality rate^3 (95% CI)^5	n	D^2	Mortality rate^3 (95% CI)^5	n	D^2	Mortality rate^3 (95% CI)^5
SRH^4
Improved	66	19	14.2 (8.6; 22.2)	66	9	8.8 (4.0; 16.7)	39	1	3.6 (0.1; 19.8)
Declined	92	18	9.8 (5.8; 15.5)	68	14	13.8 (7.6; 23.2)	73	10	20.7 (9.9; 38.0)
Unchanged poor	67	17	12.8 (7.5; 20.5)	81	14	11.1 (6.1; 18.6)	57	6	15.3 (5.6; 33.4)
Unchanged good	734	98	6.3 (5.1; 7.7)	676	82	7.7 (6.1; 9.5)	493	24	6.9 (4.4; 10.3)
Total N%	959	152	7.6 (6.4; 8.9)	891	119	8.5 (7.1; 10.2)	662	41	8.9 (6.4; 12.1)

Notes: ¹Self-rated general health (SRH). D² Number of deaths. ³Until date of censoring per 1000 observation years. ⁴The measure of self-rated general health was dichotomised into poor (covers “poor” and “miserable”) and good (covers “extremely good” and “good”).⁵The 95% confidence interval (CI).

Table III.  Cox regression analysis until date of censoring due to mortality (23 years follow-up) estimated by changed self-rated general health at age-intervals 40–45, 45–51, and 51–60 years of participants in a health survey.

	Age at each health examination (years)
	40 and 45		45 and 51		51 and 60
	Hazard ratio (95% CI)	p^2	Hazard ratio (95% CI)	p^2	Hazard ratio (95% CI)	p^2
All participants, n	152		119		41
	Analysis without inclusion of covariates
SRH^1		0.0008		0.15		0.01
Improved	2.30 (1.41; 3.76)		1.15 (0.58; 2.28)		0.51 (0.07; 3.78)
Declined	1.56 (0.94; 2.58)		1.82 (1.03; 3.21)		3.01 (1.44; 6.29)
Unchanged poor	2.04 (1.22; 3.41)		1.44 (0.82; 2.54)		2.21 (0.90; 5.40)
Unchanged good	1		1		1
All participants^3	Analysis with inclusion of covariates
SRH ^1		0.004		0.12		0.14
Improved	2.12 (1.27; 3.52)		1.35 (0.67; 2.72)		0.54 (0.07; 4.02)
Declined	1.55 (0.93; 2.58)		1.96 (1.09; 3.53)		2.22 (0.97; 5.09)
Unchanged poor	2.02 (1.19; 3.41)		1.52 (0.82; 2.84)		2.07 (0.78; 5.46)
Unchanged good	1		1		1
Only participants who at both age intervals had chronic illness^3	Analysis with inclusion of covariates
n	43		37		22
SRH^1		0.007		0.21		0.64
Improved	2.24 (1.01; 4.96)		1.04 (0.31; 3.49)		–
Declined	0.83 (0.23; 2.90)		1.97 (0.65; 5.95)		0.69 (0.14; 3.42)
Unchanged poor	4.38 (1.71; 11.22)		2.41 (1.02; 5.69)		1.86 (0.56; 6.20)
Unchanged good	1		1		1
Only participants who at both age intervals had no chronic illnesss^3	Analysis with inclusion of covariates
n	102		61		16
SRH^1		0.04		0.77		0.13
Improved	1.92 (0.92; 4.01)		1.17 (0.46; 3.02)		2.08 (0.27; 16.10)
Declined	2.05 (1.14; 3.68)		1.48 (0.60; 3.66)		4.00 (1.27; 12.59)
Unchanged poor	0.76 (0.23; 1.44)		0.85 (0.30; 2.45)		–
Unchanged good	1		1		1

Notes: ¹Self-rated general health (SRH). The measure of SRH was dichotomised into poor (covers “poor” and “miserable”) and good (covers “extremely good” and “good”). ²P-value of a Wald test for the overall effect of the changes in SRH on mortality. “Pairwise” analysis is to compare the “unchanged good” category with another category within an age-category (i.e. 40–45 years), i.e. by using the 95% CI. ³Analysis with inclusion of covariates with p-value below 0.2 in full model (see appendix).

Table

*	Measured at all health examinations (the ages of 45, 51, and 60 years)
^#	Measured at the age of 40 years
^§	Measured at the age of 45 years
^∂	Measured at the age of 51 years
^◊	Measured at the age of 60 years
^¤	The information was included as baseline information in all statistical analyses
†	Not obtained among women at the 51-year examination