This study extends the findings on SRH in the NHEFS and other studies in several ways. In a previous report, we found SRH associated with mortality to 1982 among men, but not among women, after health status was adjusted.

Idler EL, Angel RJ. Self-rated health and mortality in the NHANES-I Epidemiologic Follow-Up Study. American Journal of Public Health 1990;80:446-52.

This study extends the follow-up period by 10 years, adds a large number of additional health status covariates including results from a physician's examination, and analyzes an additional endpoint, ADL/IADL limitations. The use of an endpoint prior to death suggests that SRH has an impact, not only on life expectancy, but also on functional limitations in the period prior to death. The use of additional endpoints is important because it could help us understand the process by which SRH affects health.

The findings were weaker for women than they were for men. This pattern has been seen in a number of other studies. We might speculate that women's excess chronic disease morbidity may lead to higher levels of knowledge and better health status reporting. A new focus on gender differences could also help explain the process by which SRH predicts both mortality and functional limitations.

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