Health self-perception is associated with life-styles and comorbidities and its effect on mortality is confounded by age. A population based study

Oscar Rañó-Santamaría; Carmen Fernandez-Merino; Ana Isabel Castaño-Carou; Óscar Lado-Baleato; María José Fernández-Domínguez; Juan Jose Sanchez-Castro; Francisco Gude

doi:10.3389/fmed.2022.1015195

Health self-perception is associated with life-styles and comorbidities and its effect on mortality is confounded by age. A population based study

Front Med (Lausanne). 2022 Nov 23:9:1015195. doi: 10.3389/fmed.2022.1015195. eCollection 2022.

Authors

Oscar Rañó-Santamaría¹, Carmen Fernandez-Merino², Ana Isabel Castaño-Carou³, Óscar Lado-Baleato^{4

5}, María José Fernández-Domínguez⁶, Juan Jose Sanchez-Castro², Francisco Gude^{7

8}

Affiliations

¹ Faculty of Medicine, Santiago de Compostela, Spain.
² A Estrada Primary Care Center, A Estrada, Spain.
³ Bertamiráns Primary Care Center, Ames, Spain.
⁴ Research Methods Group (RESMET), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
⁵ ISCIII Support Platforms for Clinical Research, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
⁶ Leiro Primary Care Center, Leiro, Spain.
⁷ Health Research Institute (IDIS), Santiago de Compostela, Spain.
⁸ Clinical Epidemiology Unit, University Clinic Hospital, Santiago de Compostela, Spain.

Abstract

Background: Health self-perception (HSP) is the individual and subjective concept that a person has of their state of health. Despite its simplicity, HSP is considered a valid and relevant indicator employed in epidemiological research and in professional practice as an overall measure of health.

Objectives: (1) To describe and analyze the associations between HSP and demographic variables, lifestyle and diseases prevalent in a population and (2) to investigate the relationship between HSP and mortality.

Materials and methods: In a primary care setting, we conducted a longitudinal study of a random populational sample of a Galician municipality, stratified by decade of life. A total of 1,516 adults older than 18 years, recruited by the 2013-2015 AEGIS study, were followed-up for more than 5 years. During the clinical interview, data were collected on lifestyle and prevalent diseases. The HSP was grouped into 2 categories (good/poor). The statistical analysis consisted of a logistic regression, Kaplan-Meier curves and Cox regression.

Results: A total of 540 (35.6%) participants reported poor HSP. At the end of the follow-up, 78 participants had died (5.1%). The participants with increased age and body mass index and chronic diseases (anxiety, depression, ischemic heart disease, diabetes, and cancer) presented a poorer subjective health. A high level of physical activity and moderate alcohol consumption were associated with better HSP. A poorer HSP was associated with increased mortality, an association that disappeared after adjusting for the rest of the covariates (HR, 0.82; 95% CI 0.50-1.33).

Conclusion: (1) Health self-perception is associated with age, lifestyle, and certain prevalent diseases. (2) A poorer HSP is associated with increased mortality, but this predictive capacity disappeared after adjusting for potential confounders such as age, lifestyle, and prevalent diseases.

Keywords: chronic diseases; health self-perception (HSP); lifestyles; mortality; primary care.