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International Journal of Public Health

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01-03-2015 | Original Article

Longitudinal trends in good self-rated health: effects of age and birth cohort in a 25-year follow-up study in Sweden

Authors: Sven-Erik Johansson, Patrik Midlöv, Jan Sundquist, Kristina Sundquist, Susanna Calling

Published in: International Journal of Public Health | Issue 3/2015

Abstract

Objectives

Although average life expectancy has increased considerably in Sweden, there is less evidence for improved self-rated health (SRH). We analyzed longitudinal trends in SRH between 1980/1981 and 2004/2005 in age and birth cohort subgroups.

Methods

2,728 males and 2,770 females, aged 16–71 years, were interviewed every eighth year. Mixed models with random intercepts were used to estimate changes in SRH within different age groups and birth cohorts, adjusting for potential confounders.

Results

During the 25-year follow-up, SRH improved in individuals aged ≥48 years, but became poorer or was unchanged in those aged 16–47 years. All birth cohorts showed poorer SRH with increasing age, with an adjusted odds ratio (95% confidence interval) of 0.94 (0.93–0.95) in males and 0.92 (0.91–0.93) in females.

Conclusions

While SRH in the older age groups improved, SRH became poorer in the youngest. Poorer SRH is deeply worrying for the affected individuals, and may also have a negative impact on the health care system. Although mental illness, socioeconomic factors, and lifestyle may be potential mechanisms, future studies are needed to investigate the reasons behind this trend.

Adams SA, Matthews CE, Ebbeling CB et al (2005) The effect of social desirability and social approval on self-reports of physical activity. Am J Epidemiol 161(4):389–398CrossRefPubMedCentralPubMed

af Sillen U, Nilsson JA, Mansson NO et al (2005) Self-rated health in relation to age and gender: influence on mortality risk in the Malmo Preventive Project. Scand J Public Health 33(3):183–189CrossRefPubMed

Andreasson AN, Szulkin R, Unden AL et al (2013) Inflammation and positive affect are associated with subjective health in women of the general population. J Health Psychol 18(3):311–320 Epub 2012 Apr 10CrossRefPubMed

Caman OK, Calling S, Midlov P et al (2013) Longitudinal age-and cohort trends in body mass index in Sweden—a 24-year follow-up study. BMC Public Health 13:893CrossRefPubMedCentralPubMed

Chen H, Cohen P, Kasen S (2007) Cohort differences in self-rated health: evidence from a three-decade, community-based, longitudinal study of women. Am J Epidemiol 166(4):439–446CrossRefPubMed

Cuzick J (1985) A Wilcoxon-type test for trend. Stat Med 4(1):87–90CrossRefPubMed

DeSalvo KB, Bloser N, Reynolds K et al (2006) Mortality prediction with a single general self-rated health question. A meta-analysis. J Gen Intern Med 21(3):267–275CrossRefPubMedCentralPubMed

Fridh M MB, Lindström M, Grahn M, Rosvall M (2013) Folkhälsorapport Skåne 2013. En undersökning om vuxnas livsvillkor, levnadsvanor och hälsa (In Swedish). Malmö

Fries JF (1980) Aging, natural death, and the compression of morbidity. N Engl J Med 303(3):130–135CrossRefPubMed

Fries JF (2003) Measuring and monitoring success in compressing morbidity. Ann Intern Med 139(5 Pt 2):455–459CrossRefPubMed

Giskes K, Kunst AE, Benach J et al (2005) Trends in smoking behaviour between 1985 and 2000 in nine European countries by education. J Epidemiol Community Health 59(5):395–401CrossRefPubMedCentralPubMed

Hagquist C (2010) Discrepant trends in mental health complaints among younger and older adolescents in Sweden: an analysis of WHO data 1985–2005. J Adolesc Health 46(3):258–264CrossRefPubMed

Halford C, Welin C, Bogefeldt J et al (2012) A population-based study of nearly 15 000 observations among Swedish women and men during 1973–2003. BMJ Open 2(6):e001353CrossRefPubMedCentralPubMed

Hsu HC, Luh DL, Chang WC et al (2013) Joint trajectories of multiple health-related behaviors among the elderly. Int J Public Health 58(1):109–120CrossRefPubMed

Idler EL (1993) Age differences in self-assessments of health: age changes, cohort differences, or survivorship? J Gerontol 48(6):S289–S300CrossRefPubMed

Idler EL, Benyamini Y (1997) Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 38(1):21–37CrossRefPubMed

Ishizaki T, Yoshida H, Suzuki T et al (2009) The association between self-rated health status and increasing age among older Japanese living in a rural community over a 6-year period: a longitudinal data analysis. Gerontology 55(3):344–352CrossRefPubMed

Kachi Y, Inoue M, Nishikitani M et al (2013) Determinants of changes in income-related health inequalities among working-age adults in Japan, 1986–2007: time-trend study. Soc Sci Med 81:94–101CrossRefPubMed

Kaplan GA, Goldberg DE, Everson SA et al (1996) Perceived health status and morbidity and mortality: evidence from the Kuopio ischaemic heart disease risk factor study. Int J Epidemiol 25(2):259–265CrossRefPubMed

Leopold L, Engelhardt H (2013) Education and physical health trajectories in old age. Evidence from the Survey of Health, Ageing and Retirement in Europe (SHARE). Int J Public Health 58(1):23–31PubMed

Mantzavinis GD, Pappas N, Dimoliatis ID et al (2005) Multivariate models of self-reported health often neglected essential candidate determinants and methodological issues. J Clin Epidemiol 58(5):436–443CrossRefPubMed

Marques-Vidal P, Ravasco P, Paccaud F (2012) Differing trends in the association between obesity and self-reported health in Portugal and Switzerland. Data from national health surveys 1992–2007. BMC Public Health 12:588CrossRefPubMedCentralPubMed

McCullough ME, Laurenceau JP (2004) Gender and the natural history of self-rated health: a 59-year longitudinal study. Health Psychol 23(6):651–655CrossRefPubMed

Mor V (2005) The compression of morbidity hypothesis: a review of research and prospects for the future. J Am Geriatr Soc 53(9 Suppl):S308–S309CrossRefPubMed

Nielsen AB, Siersma V, Hiort LC et al (2008) Self-rated general health among 40-year-old Danes and its association with all-cause mortality at 10-, 20-, and 29 years’ follow-up. Scand J Public Health 36(1):3–11CrossRefPubMed

Nordberg L (1989) Generalized Linear Modeling of Sample survey data. J Off Stat 5(3):223–239

Rosen M, Haglund B (2005) From healthy survivors to sick survivors–implications for the twenty-first century. Scand J Public Health 33(2):151–155CrossRefPubMed

Sacker A, Clarke P, Wiggins RD et al (2005) Social dynamics of health inequalities: a growth curve analysis of aging and self assessed health in the British household panel survey 1991-2001. J Epidemiol Community Health 59(6):495–501CrossRefPubMedCentralPubMed

Sacker A, Worts D, McDonough P (2011) Social influences on trajectories of self-rated health: evidence from Britain, Germany, Denmark and the USA. J Epidemiol Community Health 65(2):130–136CrossRefPubMed

Salonna F, Geckova AM, Zezula I et al (2012) Does social support mediate or moderate socioeconomic differences in self-rated health among adolescents? Int J Public Health 57(3):609–617CrossRefPubMedCentralPubMed

Singh-Manoux A, Gueguen A, Martikainen P et al (2007) Self-rated health and mortality: short- and long-term associations in the Whitehall II study. Psychosom Med 69(2):138–143CrossRefPubMed

Sodergren M, Sundquist J, Johansson SE et al (2008) Physical activity, exercise and self-rated health: a population-based study from Sweden. BMC Public Health 8:352CrossRefPubMedCentralPubMed

StataCorp (2011) Stata Statistical Software: Release 12, College Station, TX: StataCorp LP

Statistics Sweden (1996) Living Conditions. Appendix 16. The Swedish survey of living conditions. Design and methods, Stockholm. http://www.scb.se/sv_/Hitta-statistik/Statistik-efter-amne/Levnadsforhallanden/Levnadsforhallanden/Undersokningarna-av-levnadsforhallanden-ULFSILC/12200/Teknisk-information-om-ULFSILC/

Statistics Sweden (2013) Summary of census (Befolkningsstatistik i sammandrag) 1960–2012, Statistics Sweden. In Swedish. http://www.scb.se/Pages/TableAndChart____26040.aspx. Accessed 5 Sep 2013

Sundquist J, Johansson SE (1997) Self reported poor health and low educational level predictors for mortality: a population based follow up study of 39,156 people in Sweden. J Epidemiol Community Health 51(1):35–40CrossRefPubMedCentralPubMed

Thorslund M, Parker MG (2005) How do the elderly feel actually? Contradictory research results indicate both improved and impaired health. Lakartidningen 102(43):3119–3124PubMed

Wärneryd B (1991) Återintervjustudie i undersökningen av levnadsförhållanden 1989 (ULF) (Living conditions. Reinterview in ULF 1989) Appendix 12. In Swedish. Stockholm

Wiklund M, Malmgren-Olsson EB, Ohman A et al (2012) Subjective health complaints in older adolescents are related to perceived stress, anxiety and gender—a cross-sectional school study in Northern Sweden. BMC Public Health 12:993CrossRefPubMedCentralPubMed

Zack MM, Moriarty DG, Stroup DF et al (2004) Worsening trends in adult health-related quality of life and self-rated health-United States, 1993-2001. Public Health Rep 119(5):493–505CrossRefPubMedCentralPubMed

Zheng H, Yang Y, Land KC (2011) Variance Function Regression in Hierarchical Age-Period-Cohort Models: applications to the Study of Self-Reported Health. Am Sociol Rev 76(6):955–983CrossRefPubMedCentralPubMed

Title: Longitudinal trends in good self-rated health: effects of age and birth cohort in a 25-year follow-up study in Sweden
Authors: Sven-Erik Johansson
Patrik Midlöv
Jan Sundquist
Kristina Sundquist
Susanna Calling
Publication date: 01-03-2015
Publisher: Springer Basel
Published in: International Journal of Public Health / Issue 3/2015
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-015-0658-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Longitudinal trends in good self-rated health: effects of age and birth cohort in a 25-year follow-up study in Sweden

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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