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© 1996 Oxford University Press

research-article

Perceived Health Status and Morbidity and Mortality: Evidence from the Kuopio Ischaemic Heart Disease Risk Factor Study

GEORGE A KAPLAN*, DEBBIE E GOLDBERG**, SUSAN A EVERSON**, RICHARD D COHEN{dagger}, RIITTA SALONEN{ddagger}, JAAKKO TUOMILEHTO§ and JUKKA SALONEN{ddagger}

* Human Population Laboratory, California Department of Health Services 151 Berkeley Way, Annex 2, Suite 300, Berkeley, CA 94704–1011, USA.
** Human Population Laboratory, Western Consortium for Public Health Berkeley, CA, USA.
{dagger} Human Population Laboratory, California Public Health Foundation Berkeley, CA, USA.
{ddagger} Research Institute of Public Health and Department of Community Health and General Practice, University of Kuopio kuopio, Finland.
§ Department of Epidemiology and Health Promotion, National Public Health Institute Helsinki, Finland.

BACKGROUND: Previous studies have reported an increased risk of death in those who report their is poor, however the role of underlying and subclinical disease in this association has not been carefully studied.

METHODS: The assoclations between perceived health status and mortality from all causes and cardiovascular disease, incidence of myocardial infarction, carotid atherosclerosis, forced expiratory volume, and maximal exercise capacity were studied in the kuopio Ischaemic Heart Disease Risk Factor Study, a population-based of 2682 men, aged 42–60, in eastern Finland.

RESULTS: There were strong, statistically significant, age-adjusted associations between level of perceived health and mortality from all causes (RHbad versus good= 3.67), cardiovascular causes (RHbad verses good = 6.64), and Incidence of myocardial inferction (RHbad verses good = 3.67). Perceived health levels were strongly associated with risk factors and diseases Indicators The associations with mortality and myocardial infarctlon outcomes were considerably weakened with prograssive adjustment for eight risk factors and prevalent disease. Higher levels of percaived health were associated with less carotid atheroscierosis, and greater forced explatory volume and maximal exercise capacity. Associations between level of perceived health and these Indicators were considerably stronger in those with prevalent diseases than in those who were healthy.

CONCLUSIONS: The overall pattern of results suggests that perceived health levels mainly reflect underlying disease burden.

Keywords perceived health, morbidlty, mortality, cardiovascular disease

Revised 1 August 1995


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