Zusammenfassung
Subjektive Gesundheit gewann während der letzten zwei Dekaden besonderes Interesse
in der internationalen Forschung, da sie sich als konsistenter Prädiktor für die Mortalität
zeigte. Für die Bestätigung eines langfristigen und von objektiven Gesundheitsindikatoren
unabhängigen Effektes subjektiver Gesundheit auf die Mortalität anhand eines Follow-up-Vergleichs
liegt in Deutschland noch keine Studie vor. Mit den Daten des Lebenserwartungssurveys
des Bundesinstituts für Bevölkerungsforschung steht ein Mortalitäts-Follow-up für
den Zeitraum 1984/86 - 1998 zur Verfügung, das nachfolgend genutzt wird, um den Zusammenhang
zwischen subjektiver Gesundheit und Mortalität in Abhängigkeit von der Beobachtungsdauer
zu analysieren. Die stärkere Prädiktion schlechter subjektiver Gesundheit in einem
kurzfristigen gegenüber einem langfristigen Beobachtungsmodell lässt auf einen stärkeren
Zusammenhang zu objektiven Gesundheitsindikatoren schließen. Die Signifikanz des Zusammenhangs
im langfristigen Follow-up, welches die früh verstorbenen Risikopersonen nicht berücksichtigt
und für weitere gesundheitsrelevante Kovariaten kontrolliert, zeigt aber, dass die
subjektive Gesundheit einen über den aktuellen objektiven Gesundheitszustand hinausgehenden
Einfluss auf Mortalität hat.
Abstract
In the last two decades self-rated health has received growing interest in international
studies because of its consistent prediction for mortality. However, for Germany there
are no studies confirming a long-term effect independent from objective health indicators
in comparison of different follow-up. On the basis of the Life-Expectancy-Study (1984/86
- 1998) from the Federal Institute for Population Research it was possible to analyze
the association between subjective health and mortality in relation to the length
of observation. A stronger correlation between bad self-rated health and objective
health status could be indicated because of a better prediction for mortality in a
short-term follow-up. The evidence of a significant effect between self-rated health
and mortality in the long-term follow-up not including the deaths from the short-term
follow-up indicates that the mechanisms between subjective health and mortality are
more complex than those between objective health status and death.
Schlüsselwörter
Subjektive Gesundheit - Mortalität - Lebenserwartungssurvey
Key words
Self-rated health - mortality - Life-Expectancy-Survey
Literatur
- 1
Idler E L, Benyamini Y.
Self-rated health and mortality: A review of twenty-seven community studies.
Journal of Health and Social Behavior.
1997;
38
21-37
- 2
Benyamini Y, Idler E L.
Communitiy studies reporting association between self-rated health and mortality.
Research on Aging.
1999;
21
392-401
- 3 Lundberg O, Manderbacka K, Martikainen P. Health measures in a comparative perspective. Nilsson
P, Orth-Gomér K Uppsala; FRN 2000: 103-109
- 4
Heidrich J, Liese A, Löwel H.
Self-rated health and its relation to all cause and cardiovaskular mortality in Southern
Germany. Results from the MONICA Augsburg Cohort Study 1984 - 95.
Annals of Epidemiology.
2002;
12
338-345
- 5
Larsson D, Hemmingsson T, Allebeck P. et al .
Self-rated health and mortality among young men: what is the relation and how may
it be explained?.
Scandinavian Journal of Public Health.
2002;
30
259-266
- 6
Schwarze J, Andersen H H, Anger S.
Self-rated health and changes in self-rated health as predictors of mortality - First
evidence from German panel data.
DIW Discussion Papers.
2002;
- 7
Bath P A.
Differences between older men and women in the self-rated health - mortality relationship.
The Gerontologist.
2003;
43
387-395
- 8
Benyamini Y, Blumstein T, Lusky A. et al .
Gender differences in the self-rated health-mortality association: Is it poor self-rated
health that predicts mortality or excellent self-rated health that predicts survival?.
The Gerontologist.
2003;
43
396-405
- 9
Deeg D JH, Kriegsman D MW.
Concepts of self-rated health: specifying the gender difference in mortality risk.
The Gerontologist.
2003;
43
376-386
- 10
Helmert U.
Subjektive Einschätzung der Gesundheit und Mortalitätsentwicklung.
Das Gesundheitswesen.
2003;
65
47-54
- 11
Idler E L.
Discussion: gender differences in self-rated health, in mortality, and in the relationship
between the two.
The Gerontologist.
2003;
43
372-375
- 12
Manderbacka K, Kårehold I, Martikainen P. et al .
The effect of point of reference on the association between self-rated health and
mortality.
Social Science and Medicine.
2003;
56
1447-1452
- 13
Van Doorslaer E, Gerdtham U G.
Does inequality in self-assessed health predict inequality in survival by income?
Evidence from Swedish data.
Social Science and Medicine.
2003;
57
1621-1629
- 14
Baron-Epel O, Shemy G, Carmel S.
Prediction of survival: A comparison between two subjective health measures in an
elderly population.
Social Science & Medicine.
2004;
58
2035-2043
- 15
Benjamins M R, Hummer R A, Eberstein I W. et al .
Self-reported health and adult mortality risk: An analysis of cause-specific mortality.
Social Science & Medicine.
2004;
59
1297-1306
- 16
Mossey J M, Shapiro E.
Self-rated health: A predictor of mortality among the elderly.
American Journal of Public Health.
1982;
72
800-808
- 17 De Bruin A, Picavet H SJ. Health interview surveys: Towards international harmonization
of methods and instruments. Nossikov A Copenhagen; WHO Regional Office for Europe
1996
- 18
Robine J M, Jagger C. Euro-Reves Group .
Creating a coherent set of indicators to monitor health across Europe. The Euro-REVES
2 project.
European Journal of Public Health.
2003;
13
6-14
- 19 Bjorner J B, Kirstensen T S, Orth-Gomér K. et al .Self-rated health a useful concept
in research, prevention and clinical medicine. Uppsala; Ord & Form AB 1996
- 20 Nilsson P. Self-rated health in a European perspective. Orth-Gomér K Uppsala; FRN
2000
- 21
Idler E L, Angel R.
Self-rated health and mortality in the NHANES-I Epidemiologic Follow-up Study.
American Journal of Public Health.
1990;
80
446-452
- 22 Blossfeld H P. Ereignisanalyse: statistische Theorie und Anwendung in den Wirtschafts-
und Sozialwissenschaften. Frankfurt/Main; Campus 1986
- 23 Kleinbaum D G. Survival Analysis. A self-learning text. New York; Springer 1996
- 24 Burger M, Mensink G. Beiträge zur Gesundheitsberichterstattung des Bundes. Bundes-Gesundheitssurvey:
Alkohol. Konsumverhalten in Deutschland. Berlin; Robert Koch-Institut 2003
Stephan Müters
Technische Universität Berlin, Institut für Gesundheitswissenschaften, Fachbereich
Gesundheitssoziologie
Ernst-Reuter-Platz
10587 Berlin
Email: mueters@ifg.tu-berlin.de