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Cross-classification between self-rated health and health status: longitudinal analyses of all-cause mortality and leading causes of death in the UK

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Article number459
JournalScientific Reports
Volume12
Issue number1
Early online date10 Jan 2022
DOIs
Accepted/In press13 Dec 2021
E-pub ahead of print10 Jan 2022
Published10 Jan 2022

Bibliographical note

Funding Information: JM receives studentship funding from the Biotechnology and Biological Sciences Research Council (BBSRC) and Eli Lilly and Company Limited. CML is a member of the Scientific Advisory Board of Myriad Neuroscience. Funding Information: This research has been conducted using data from UK Biobank, a major biomedical database. This project made use of time on Rosalind HPC, funded by Guy’s & St Thomas’ Hospital NHS Trust Biomedical Research Centre (GSTT-BRC), South London & Maudsley NHS Trust Biomedical Research Centre (SLAM-BRC), and Faculty of Natural Mathematics & Science (NMS) at King’s College London. Funding Information: This work was supported by studentship funding to JM from the Biotechnology and Biological Sciences Research Council (BBSRC) [grant number 2050702] and Eli Lilly and Company Limited. CML is part-funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Publisher Copyright: © 2022, The Author(s).

King's Authors

Abstract

Risk stratification is an important public health priority that is central to clinical decision making and resource allocation. The aim of this study was to examine how different combinations of self-rated and objective health status predict all-cause mortality and leading causes of death in the UK. The UK Biobank study recruited > 500,000 participants between 2006 and 2010. Self-rated health was assessed using a single-item question and health status was derived from medical history, including data on 81 cancer and 443 non-cancer illnesses. Analyses included > 370,000 middle-aged and older adults with a median follow-up of 11.75 (IQR = 1.4) years, yielding 4,320,270 person-years of follow-up. Compared to individuals with excellent self-rated health and favourable health status, individuals with other combinations of self-rated and objective health status had a greater mortality risk, with hazard ratios ranging from HR = 1.22 (95% CI 1.15–1.29, P Bonf. < 0.001) for individuals with good self-rated health and favourable health status to HR = 7.14 (95% CI 6.70–7.60, P Bonf. < 0.001) for individuals with poor self-rated health and unfavourable health status. Our findings highlight that self-rated health captures additional health-related information and should be more widely assessed. The cross-classification between self-rated health and health status represents a straightforward metric for risk stratification, with applications to population health, clinical decision making and resource allocation.

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