Predictive Strength of Self-Rated Health on Mortality Risk: Does It Differ by Race and Ethnicity?

Hyeyoung Woo, Portland State University

Self-rated health (SRH) has been widely used as a measure of population health. In order to accurately measure trends and differentials across subpopulations, it is critical to understand the predictive validity of SRH for subsequent mortality. We address a gap in the literature by examining race/ethnic differences in the predictive strength of SRH on mortality, an important dimension of health inequalities. Cox proportional hazard models are used to analyze data from the National Health Interview Study Linked Mortality Files (1989-2006). Our results confirm that SRH serves as a reliable predictor of subsequent mortality. We also find significant race/ethnic variation: black and Hispanic adults have a weaker link between SRH and mortality. Three potential explanations for these patterns --different cause-of-death patterns, socioeconomic status, and acculturation-- explain only a portion of the overall differences. The findings indicate caution in using SRH for measuring race/ethnic health disparities.