Are gender differences in the relationship between self-rated health and mortality enduring? Results from three birth cohorts in Melton Mowbray, United Kingdom.

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 [HR] = 2.7; 95% confidence interval [CI] = 2.1-3.5) than it was in women (HR = 1.9; 95% CI = 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.