Determinants of self rated health and mortality in Russia - are they the same ?
Research into Russia's health crisis during the 1990s includes studies of both mortality and self-rated health, assuming that the determinants of the two are the same. In this paper, we tested this assumption, using data from a single study on both outcomes and socioeconomic, lifestyle and psychological predictor variables.
Methods: We analysed data from 7 rounds (1994-2001) of the Russia Longitudinal Monitoring Survey, a panel study of a general population sample (11,482 adults aged over 18 living in households of 2 or more people). Self-rated health was measured on a 5 point scale and dichotomised by combining responses "very poor" and "poor" into poor health.
Deaths (n=782) during a mean follow up of 4.1 years were reported by another household member. Associations between several predictor variables and poor or very poor self-rated health and mortality were measured using logistic regression and Cox proportional hazards analysis respectively.
Results: Poor self-rated health was significantly associated with mortality; hazard ratios, compared with very good, good or average health, were 1.69 (1.36-2.10) men and 1.74 (1.38-2.20) in women. Low education predicted both mortality and poor self-rated health.
Income was a better predictor of mortality than of self-rated health. Smoking doubled the risk of death but was not related to subjective wellbeing.
Frequent drinkers reported better health but had increased mortality, compared with occasional drinkers. Greater life satisfaction was related to self-rate health but not to mortality.
Conclusions: Although subjective health predicted mortality, the predictors of these two outcomes differed. Influences on subjective health other than serious disease and risk factors for relatively sudden deaths in apparently well people may be important, but require further research.
Meanwhile, caution is required when using findings studies of self-rated health in Russia to understand the determinants of mortality.
Author: Francesca Perlman and Martin Bobak
Credits/Source: International Journal for Equity in Health 2008, 7:19
Published on: 2008-07-25
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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