Elderly/Long-term Care

Self-rated health may not be the best way to identify mortality risks among less-educated, black older persons

For the past 20 years, studies have shown that how people rate their own health is a strong predictor of mortality. Indeed, self-rated health by older, more educated black and white persons is strongly linked to their mortality risk. In other words, they seem to have a good grasp of their health status and health risks. However, self-rated health may not be the best measure of mortality risk among less educated, black older adults, suggests a new study.

The University of California, San Francisco researchers looked at self-ratings of health and mortality among 14,004 white and 2,428 black adults aged 50 and older, who participated in the 1998 Health and Retirement Study. Self-rated health was a much stronger predictor of mortality in whites than blacks. For example, whites who rated their health as poor had 10.4 times higher risk of dying than whites who rated their health as excellent. However, blacks who rated their health as poor had nearly three times smaller risk of dying than whites who rated their health as poor. Higher educational levels strengthened the relationship between self-rated health and mortality in blacks and whites.

The authors suggest that whites may have more access to health providers and may incorporate health concerns noted by providers into their own self-ratings of health. On the other hand, blacks may value aspects of health that are less associated with mortality. It would be inaccurate to conclude that whites are more accurate in their health ratings than blacks, note the authors.

Their study was supported in part by the Agency for Healthcare Research and Quality (HS00006).

See "The relationship between self-rated health and mortality in older black and white Americans," by Sei J. Lee, M.D., M.A.S., Sandra Y. Moody-Ayers, M.D., C. Seth Landefeld, M.D., and others, in the October 2007 Journal of the American Geriatric Society 55, pp. 1624-1629.

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