Abstract
The aim of this study was to investigate what psychosocial predictors, life-style factors and health behaviors in early adulthood are of importance for self-ratings of health after the age of 45. Like-sexed adult twins born 1926–1950 (n = 16,080) from the Swedish Twin Registry that participated in a questionnaire in 1973 and in a telephone interview conducted between 1998 and 2002 were included. Exposure data was collected in 1973 and information on self-rated health and covariates was collected at the second contact 25 years later. Logistic regression using Generalized Estimating Equations was used to evaluate the associations. Conditional logistic regression was used to control for familial and genetic effects in the sample. Pain, lack of exercise, smoking, obesity, unemployment, perceived stress and personality are associated with future poor self-rated health, after controlling for age, sex, illness, education and socio-economic status. Familial and genetic effects influence the associations between recurrent headache, exercise, obesity, and poor self-rated health. Overall, these findings provide support for long-term effects of health behavior and psychosocial risk factors on poor self-ratings of health, beyond the influence of obvious health consequences such as disorders or illnesses. Genetic and familial factors are of importance only for some of these associations.
Similar content being viewed by others
References
Bath PA (2003) Differences between older men and women in the self-rated health - mortality relationship. Gerontologist 43(3): 387–395
Idler EL, Benyamini Y (1997) Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 38: 21–37
Idler EL (2003) Discussion: Gender differences in self-rated health, in mortality, and in the relationship between the two. Gerontologist 43(3): 372–375
Bjorner JB, Søndergaard Kristensen T, Orth-Gomér K, Tibblin G, Sullivan M, Westerholm P (1996) Self-rated health: A useful concept in research, prevention and clinical medicine. Swedish Council for Planning and Coordination of Research (FRN), Stockholm
Undén AL, Elofsson S (1998) Självupplevd hälsa: Faktorer som påverkar människors egen bedömning [Self-rated health: Factors influencing perceived health status]. Swedish Council for Planning and Coordination of Research (FRN), Stockholm
Mantyselka PT, Turunen JHO, Ahonen RS, Kumpusalo EA (2003) Chronic pain and poor self-rated health. J Am Med Assoc 290: 2435–2442
Lamb KL, Roberts K, Brodie DA (1990) Self-perceived health among sports participants and non-sports participants. Soc Sci Med 31: 963–969
Ferraro KJ, Yu Y (1995) Body weight and self-ratings of health. J Health Soc Behav 36: 274–284
Fylkesnes K, Forde OH (1991) The Tromso study: Predictors of self-evaluated health – has society adopted the expanded health concept? Soc Sci Med 32(2): 141–146
Schulz R, Mittelmark M, Kronmal R, et al. (1994) Predictors of perceived health status in elderly men and women. The Cardiovascular Health Study. J Aging Health 6: 419–447
Manderbacka K, Lundberg O, Martikainen P (1999) Do risk factors and health behaviours contribute to self-ratings of health? Soc Sci Med 48: 1713–1720
Månsson N-O, Merlo J (2001) The relation between self-rated health, socioeconomic status, body mass index and disability pension among middle-aged men. Eur J Epidemiol 17: 65–69
Markides KS, Lee DJ (1990) Predictors of well-being and functioning in older Mexican americans and anglos: an eight year follow-up. J Gerontol: Soc Sci 45: 69–73
Power C (1991) Social and economic background and class inequalities in health among young adults. Soc Sci Med 32: 411–417
Power C, Matthews S, Manor O (1998) Inequalities in self-rated health: Explanations from different stages of life. Lancet 351: 1009–1014
Borg V, Kristensen TS (2000) Social class and self-rated health: Can the gradient be explained by differences in life style or work environment? Soc Sci Med 51: 1019–1030
Borg V, Kristensen TS, Burr H (2000) Work environment and changes in self-rated health: A five year follow-up study. Stress Med 6: 37–47
Mossey JM (1995) Importance of self-perceptions for health status among older persons. In: Gatz M (eds) Emerging issues in mental health and aging. 1st ed. American Psychological Association, Washington, DC, pp. 124–162
Leedham B, Meyerowitz BE, Muirhead J, Frist WH (1995) Positive expectations predict health after heart transplantation. Health Psychol 14(1): 74–79
Farmer MM, Ferraro KF (1997) Distress and perceived health: Mechanisms of health decline. J Health Soc Behav 38: 298–311
Lichtenstein P, De Faire U, Floderus B, Svartengren M, Svedberg P, Pedersen NL (2002) The Swedish Twin Registry: A unique resource for clinical, epidemiological and genetic studies. J Intern Med 252: 184–205
Gold CH, Malmberg B, McClearn GE, Pedersen NL, Berg S (2002) Gender and health: A study of older unlike-sex twins. J Gerontol: Soc Sci 57(3): S168–S176
Statistics-Sweden. Reports on statistical co-ordination (1982):4. Swedish socio-economic classification. Örebro: Statistiska centralbyrån (SCB); (1983)
Floderus-Myrhed B, Pedersen NL, Rasmuson I (1980) Assessment of heritability for personality, based on a short form of the Eysenck Personality Inventory: A study of 12, 898 twin pairs. Behav Genet 10: 153–162
SAS/STAT. SAS/STAT Users Guide. V8 ed. Cary, NC, USA: SAS Institute Inc.; 1999–2001
Pawitan Y. In all likelihood. London: Oxford University Press; 2001
McCullagh P, Nelder JA (1989) Generalized linear models. Chapman Hall, London
Hosmer DW Jr., Lemeshow S (2000) Applied logistic regression. 2nd ed. John Wiley & Sons, Inc., New York
Hardin JW, Hilbe JM. Generalized estimating equations. London: Chapman Hall; 2003
Duffy D. The co-twin control study. In: Spector TD, Snieder H, MacGregor AJ (eds), Advances in sib-pair analysis. London: Oxford University Press; 2000
Leinonen R, Kaprio J, Jylha M, et al. (2005) Genetic influences underlying self-rated health in older female twins. J Am Geriat Soc 53: 1002–1007
Svedberg P, Lichtenstein P, Pedersen NL (2001) Age and sex differences in genetic and environmental factors for self- rated health: A twin study. J Gerontol: Soc Sci 56: 171–178
Harris JR, Pedersen NL, McClearn GE, Plomin R, Nesselroade JR (1992) Age differences in genetic and environmental influences for health from the Swedish Adoption/Twin Study of Aging. J Gerontol: Psychol Sci 47: 213–220
Hartvigsen J, Christensen K, Frederiksen H (2004) Back and neck pain exhibit many common features in old age: A population-based study of 4,486 Danish twins 70–102 years of age. Spine 29: 576–580
Lyngberg AC, Rasmussen BK, Jorgensen T, Jensen R (2005) Incidence of primary headache: A Danish epidemiologic follow-up study. Am J Epidemiol 161(11): 1066–1073
Barsky AJ, Cleary PD, Klerman GL (1992) Determinants of perceived health status of medical outpatients. Soc Sci Med 34: 1147–1154
Watson D, Pennebaker JW (1989) Health complaints, stress, and distress: Exploring the central role of negative affectivity. Psychol Rev 96(2): 234–254
Costa PT Jr. (1987) Influence of the normal personality dimension of neuroticism on chest pain symptoms and coronary artery disease. Am J Cardiol 60(18): 20J–26J
Schapiro IR, Ross-Petersen L, Saelan H, Garde K, Olsen JH, Johansen C (2001) Extroversion and neuroticism and the associated risk of cancer: A Danish cohort study. Am J Epidemiol 153: 757–763
Cohen S, Doyle WJ, Skoner DP, Fireman PF, Gwaltney JM, Newson JT (1995) State and trait negative affect as predictors of objective symptoms of respiratory viral infections. J Personality Soc Psychol 68: 159–169
Hagberg M, Hagberg B, Saveman B-I (2002) The significance of personality factors for various dimensions of life quality among older people. Aging Mental Health 6: 178–185
Barger SD (2006) Do psychological characteristics explain socioeconomic stratification of self-rated health. J Health Psychol 11: 21–35
Goodwin R, Engstrom G (2002) Personality and the perception of health in the general population. Psychol Med 32: 325–332
Christensen K, Holm NV, McGue M, Corder L, Vaupel JW (1999) A Danish population-based twin study on general health in the elderly. J Aging Health 11: 49–64
Idler EL, Kasl S (1991) Health perceptions and survival: Do global evaluations of health status really predict mortality? J Gerontol: Soc Sci 46: S55–S65
Svensson DA, Larsson B, Waldenlind E, Pedersen NL (2002) Genetic and environmental influences on expression of recurrent headache as a function of the reporting age in twins. Twin Res 5: 277–286
Cope MB, Allison DB (2006) Obesity: Person and population. Obesity 14(suppl 4): S156–S159
Kilicarslan A, Isildak M, Guven GS, et al. (2006) Demographic, socioeconomic and educational aspects of obesity in an adult population. J Natl Med Assoc 98(8): 1313–1317
Stubbe JH, Boomsma DI, De Geus EJ (2005) Sports participation during adolescence: A shift from environmental to genetic factors. Med Sci Sports Exercise 37(4): 563–570
Costa PT Jr., McCrae RR (1997) Longitudinal stability of adult personality. In: Hogan R, Johnson JA, Briggs SR (eds) Handbook of personality psychology. Academic Press, Orlando, FL, pp. 169–204
Acknowledgements
The Swedish Twin Registry is supported by grants from the Swedish Department of Higher Education, the Swedish Scientific Council, and AstraZeneca. SALT was funded by the Swedish Council of Coordination of Research (FRN) and by a grant from the National Institutes of Health (AG 08724).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Svedberg, P., Bardage, C., Sandin, S. et al. A prospective study of health, life-style and psychosocial predictors of self-rated health. Eur J Epidemiol 21, 767–776 (2006). https://doi.org/10.1007/s10654-006-9064-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10654-006-9064-3