Trajectories of self-rated health in the last 15 years of life by cause of death

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Stenholm , S , Kivimaki , M , Jylha , M , Kawachi , I , Westerlund , H , Pentti , J , Goldberg , M , Zins , M & Vahtera , J 2016 , ' Trajectories of self-rated health in the last 15 years of life by cause of death ' , European Journal of Epidemiology , vol. 31 , no. 2 , pp. 177-185 .

Title: Trajectories of self-rated health in the last 15 years of life by cause of death
Author: Stenholm, Sari; Kivimaki, Mika; Jylha, Marja; Kawachi, Ichiro; Westerlund, Hugo; Pentti, Jaana; Goldberg, Marcel; Zins, Marie; Vahtera, Jussi
Contributor organization: Clinicum
Department of Public Health
Date: 2016-03
Language: eng
Number of pages: 9
Belongs to series: European Journal of Epidemiology
ISSN: 0393-2990
Abstract: Poor self-rated health is associated with increased risk of mortality, but no previous study has examined how long-term trajectories of self-rated health differ among people at risk of subsequent death compared to those who survive. Data were drawn from French occupational cohort (the GAZEL study, 1989-2010). This nested case-control study included 915 deceased men and women and 2578 controls matched for sex, baseline age, occupational grade and marital status. Self-rated health was measured annually and dichotomized into good versus poor health. Trajectories of poor self-rated health up to 15 years were compared among people who subsequently died to those who survived. Participants contributed to an average 10.3 repeated assessments of self-rated health. Repeated-measures log-binomial regression analysis with generalized estimating equations showed an increased prevalence of poor self-rated health in cases 13-15 years prior to death from ischemic and other cardiovascular disease [multivariable-adjusted risk ratio 2.06, 95 % confidence interval (CI) 1.55-2.75], non-smoking-related cancers (1.57, 95 % CI 1.30-1.89), and suicide (1.78, 95 % CI 1.00-3.16). Prior to death from ischemic and other cardiovascular disease, increased rates of poor self-rated health were evident even among persons who were free of cardiovascular diseases (2.05, 95 % CI 1.50-2.78). In conclusion, perceptions of health diverged between the surviving controls and the deceased already 15 years prior to death. For cardiovascular mortality, decline in self-rated health started before diagnosis of the disease leading to death. The findings suggest that declining self-rated health might capture pathological changes before and beyond the disease diagnosis.
Subject: Self-rated health
Cause-specific mortality
Cohort study
3142 Public health care science, environmental and occupational health
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion

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