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Self-rated Health with special reference to Prevalence, Determinants and Consequences
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Objectives: The overall aim was to investigate determinants and consequences of global non-comparative self-ratings of health (SRH). Concerning determinants, the aim was more specifically to investigate the association between age, year of investigation, stress-theory based psychobiological variables, and SRH.

Materials and methods: Papers I and IV were based on eight ongoing population-based cohort studies, with sampling performed 1973-2003. The study-population consisted of 11,880 men and women, aged 25-99 years, providing 14,470 observations. Papers II and III were based on a longitudinal study of 212 adult, healthy, women and men.

Results: In women, SRH declined linearly with age and year of investigation, after adjustment for influence of covariates, while in men the association was based on a third degree polynomial function. The most important covariates were complaint score, sick-leave or disability pension, and leisure time physical activity. The final model explained 76.2% of the variance in women and 74.5% in men. SRH was directly associated with psychological resources and inversely associated with psychological strain, in healthy, adult, women and men. In men with SRH which decreased to fair or poor, higher levels of prolactin and lower levels of testosterone were observed at follow-up as compared to baseline. There were no associations between endocrine variables and SRH in women. There was a significant inverse association between SRH and mortality, disability pension, and sick-leave during follow-up, in women and men, adjusted for covariates. Associations between SRH and mortality were robust during the follow-up period.

Conclusions: Age and year of investigation were associated with SRH, but differently in women and men. Psychological resources and psychological strain were consistently associated with SRH, but there were no robust associations between endocrine measures and SRH. SRH was associated with mortality, disability pension, and sick-leave, during follow-up. The association between SRH and mortality was robust during the follow-up period

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2010. , p. 73
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 612
Keywords [en]
Self-rated health, determinants, consequences
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
URN: urn:nbn:se:uu:diva-132363ISBN: 978-91-554-7925-1 (print)OAI: oai:DiVA.org:uu-132363DiVA, id: diva2:358993
Public defence
2010-12-07, Rudbecksalen, Rudbecklaboratoriet, Dag Hammarskjölds väg 20, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2010-11-16 Created: 2010-10-19 Last updated: 2011-05-13Bibliographically approved
List of papers
1. Effects of age and secular trends on self-rated health: a population-based study of nearly 15,000 observations among Swedish women and men during 1973-2003
Open this publication in new window or tab >>Effects of age and secular trends on self-rated health: a population-based study of nearly 15,000 observations among Swedish women and men during 1973-2003
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2010 (English)Article in journal (Other academic) Submitted
Identifiers
urn:nbn:se:uu:diva-132360 (URN)
Available from: 2010-10-26 Created: 2010-10-19 Last updated: 2012-10-30Bibliographically approved
2. Endocrine measures of stress and self-rated health: A longitudinal study
Open this publication in new window or tab >>Endocrine measures of stress and self-rated health: A longitudinal study
2003 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 55, no 4, p. 317-320Article in journal (Refereed) Published
Abstract [en]

Objective: Simple global self-ratings of health have been found to hold considerable predictive validity in relation to morbidity and mortality. Inverse associations between chronic stress and self-rated health (SRH) have been found and suggested to explain part of the predictive validity of SRH. Studies including biological data are, however, few. The purpose of this paper is to study the relationship between endocrine measures of stress and SRH.

Methods: A longitudinal study of 102 healthy middle-aged men. Written questionnaires and blood samples were collected at baseline and at follow-up 1 year later.

Results: A decrease in SRH below the level of good was associated with significantly increased s-prolactin and decreased s-testosterone. Poorer SRH and increased levels of s-prolactin were significantly associated with increased vital exhaustion at follow-up.

Conclusion: Our study identifies a possible biological pathway, which might be of relevance in understanding the well-established association between SRH and health.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-64718 (URN)10.1016/S0022-3999(02)00634-7 (DOI)
Available from: 2008-10-17 Created: 2008-10-17 Last updated: 2017-11-30Bibliographically approved
3. Self-rated health, life-style, and psychoendocrine measures of stress in healthy adult women
Open this publication in new window or tab >>Self-rated health, life-style, and psychoendocrine measures of stress in healthy adult women
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2010 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 115, no 4, p. 266-274Article in journal (Refereed) Published
Abstract [en]

Background. Self-rated health (SRH) is a robust predictor of subsequent health outcome, independent of objective health measures and life-style-related health risk factors. However, the determinants of SRH are as yet largely unknown. In accordance with the prevailing stress theory, we hypothesized that SRH is associated with personal coping resources, psychological strain, life-style variables, and endocrine variables.

Methods. A total of 106 healthy women, 22-59 years of age, were followed for up to 3 years with annual blood sampling (cortisol, prolactin, testosterone) and written questionnaires in which information on SRH, psychological strain, coping resources, socio-economic and life-style variables was sought.

Results. In bivariate, screening logistic regression analyses, intended to find candidate variables for a final analysis model, all coping resource variables (sense of coherence, mastery, and self-esteem) were significantly related to SRH, and so were two psychological strain variables (vital exhaustion, and sleep disturbances), one life-style variable (fitness), but none of the endocrine variables. In the final multivariate analysis model, including all candidate variables, only vital exhaustion (P < 0.0001), fitness (P = 0.0002), and sense of coherence (P = 0.0006) were independently associated with SRH, together explaining 74% of the SRH variance.

Conclusion. Some elements of the hypothesis, i.e. the effects of coping resources, psychological strain, and life-style variables on SRH, were supported by the results, while others, i.e. effects of endocrine measures on SRH, were not, indicating a possible gender difference.

Place, publisher, year, edition, pages
Informa Healthcare, 2010
Keywords
Cortisol, prolactin, self-rated health, sense of coherence, testosterone, vital exhaustion
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-132358 (URN)10.3109/03009734.2010.496910 (DOI)000283555900008 ()
Available from: 2010-10-26 Created: 2010-10-19 Last updated: 2018-05-24Bibliographically approved
4. Effects of self-rated health on sick-leave, disability-pension, hospital admissions and mortality: a population-based study of nearly 15,000 observations among Swedish women and men followed 1973-2003
Open this publication in new window or tab >>Effects of self-rated health on sick-leave, disability-pension, hospital admissions and mortality: a population-based study of nearly 15,000 observations among Swedish women and men followed 1973-2003
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(English)Manuscript (preprint) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-132361 (URN)
Available from: 2010-10-26 Created: 2010-10-19 Last updated: 2012-10-30Bibliographically approved

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