Self-rated health showed a graded association with frequently used biomarkers in a large population sample

J Clin Epidemiol. 2006 May;59(5):465-71. doi: 10.1016/j.jclinepi.2005.12.004. Epub 2006 Mar 15.


Background and objectives: Self-rated health is a widely used measure of health status, but its biologic foundations are poorly understood. We investigated the association of frequently used biomarkers with self-rated health, and the role of these biomarkers in the association of self-rated health with mortality.

Methods: The relation of self-rated health to blood levels of albumin, white blood cell count, hemoglobin, HDL cholesterol, and creatinine was examined in a population-based sample of 4,065 men and women aged 71 years or older. A Cox proportional hazards model was used to determine the association of self-rated health with mortality during 4.9 years. Sociodemographic factors, diagnosed chronic conditions, and activities of daily living disability were controlled for in these analyses.

Results: All the biomarkers showed a graded relationship with self-rated health. After adjusting for other indicators, hemoglobin and white cell count were significantly associated with fair or poor self-rated health. When biomarkers and other indicators were adjusted for, self-rated health still was a significant predictor of mortality.

Conclusion: Self-rated health has a biologic basis, and it can be a sensitive barometer of physiologic states. Self-rated health is likely to predict mortality because it covers the spectrum of health conditions better than the variables measured in the study.

MeSH terms

  • Activities of Daily Living
  • Age Factors
  • Aged
  • Biomarkers / blood*
  • Blood Cell Count
  • Blood Pressure / physiology
  • Cholesterol, HDL / blood
  • Chronic Disease
  • Creatinine / blood
  • Female
  • Health Status*
  • Hemoglobins / analysis
  • Humans
  • Male
  • Mortality
  • Proportional Hazards Models
  • Prospective Studies
  • Serum Albumin / analysis
  • Sex Factors


  • Biomarkers
  • Cholesterol, HDL
  • Hemoglobins
  • Serum Albumin
  • Creatinine