TY  - JOUR
PY  - 2012//
TI  - Sex/Gender and socioeconomic differences in the predictive ability of self-rated health for mortality
JO  - PLoS one
A1  - Nishi, Akihiro
A1  - Kawachi, Ichiro
A1  - Shirai, Kokoro
A1  - Hirai, Hiroshi
A1  - Jeong, Seungwon
A1  - Kondo, Katsunori
SP  - e30179
EP  - e30179
VL  - 7
IS  - 1
N2  - BACKGROUND: Studies have reported that the predictive ability of self-rated health (SRH) for mortality varies by sex/gender and socioeconomic group. The purpose of this study is to evaluate this relationship in Japan and explore the potential reasons for differences between the groups. METHODOLOGY/PRINCIPAL FINDINGS: The analyses in the study were based on the Aichi Gerontological Evaluation Study's (AGES) 2003 Cohort Study in Chita Peninsula, Japan, which followed the four-year survival status of 14,668 community-dwelling people who were at least 65 years old at the start of the study. We first examined sex/gender and education-level differences in association with fair/poor SRH. We then estimated the sex/gender- and education-specific hazard ratios (HRs) of mortality associated with lower SRH using Cox models. Control variables, including health behaviors (smoking and drinking), symptoms of depression, and chronic co-morbid conditions, were added to sequential regression models. The results showed men and women reported a similar prevalence of lower SRH. However, lower SRH was a stronger predictor of mortality in men (HR = 2.44 [95% confidence interval (CI): 2.14-2.80]) than in women (HR = 1.88 [95% CI: 1.44-2.47]; p for sex/gender interaction = 0.018). The sex/gender difference in the predictive ability of SRH was progressively attenuated with the additional introduction of other co-morbid conditions. The predictive ability among individuals with high school education (HR = 2.39 [95% CI: 1.74-3.30]) was similar to that among individuals with less than a high school education (HR = 2.14 [95% CI: 1.83-2.50]; p for education interaction = 0.549). CONCLUSIONS: The sex/gender difference in the predictive ability of SRH for mortality among this elderly Japanese population may be explained by male/female differences in what goes into an individual's assessment of their SRH, with males apparently weighting depressive symptoms more than females.<p />  <p>Language: en</p>
LA  - en
SN  - 1932-6203
UR  - http://dx.doi.org/10.1371/journal.pone.0030179
ID  - ref1
ER  -