Objectives. To study the independent and combined effects of self-rated health (SRH), self-rated physical activity (SRPA) and self-rated fitness (SRF) as predictors of all-cause mortality. Moreover, we also examined whether any protective effect of SRH on premature mortality was mediated by SRPA, SRF.
Methods. SRH, SRPA and SRF were self-reported in 7111 participants, aged 16 to 96 years, by asking their perceptions of health, PA and fitness, respectively, in comparison with their age peers. Based on their ratings participants were categorised in 3 incremental groups. Cox proportional hazards regression was used to examine associations between SRH, SRPA, SRF and all-cause mortality.
Results. During a median follow-up of 23 years, 1850 deaths occurred. SRH, SRPA and SRF were inversely and independently associated with mortality (P < 0.05) after adjustment for sex, age, socio-economic and marital status, body mass index, baseline medical conditions, parental history of chronic disease, fruit, vegetable and alcohol intake, and smoking habits. The association between SRH and mortality remained significant following additional adjustment for SRPA, SRF. Self-rated factors combined were associated with a more than 50% reduced hazard for premature mortality when comparing extreme categories.
Conclusion. SRH, SRPA and SRF are independent predictors of mortality. Perceptions of health, physical activity and fitness may be valuable additional tools in epidemiological studies, health surveillance and the clinical setting.
