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  • 1.
    Reile, Rainer
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). University of Tartu, Tartu, Estonia.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia.
    Ethnic variation in self-rated health–mortality association: Results from a 17-year follow-up study in Estonia2017In: Medicina (Kaunas), ISSN 1010-660X, E-ISSN 1648-9144, Vol. 53, no 2, p. 114-121Article in journal (Refereed)
    Abstract [en]

    Previous research has highlighted the role of self-rated health (SRH) as an important predictor of mortality. With substantial ethnic differences in SRH and mortality reported in Estonia, this study aims to examine the ethnic variation in SRH–mortality association in this setting. Materials and methods The baseline data come from nationally representative 1996 Estonian Health Interview Survey. Individual records of 3983 respondents in the 25–79 age group were linked with mortality data with 17 years follow-up time. The association between SRH and all-cause mortality was analysed using the Cox regression for two ethnic groups and separately for men and women. Results Among ethnic Estonians, both men and women with bad or very bad SRH had about 60% higher mortality compared to those with good or very good SRH even after adjustment for age, socioeconomic and health-related variables. In contrast, SRH did not predict mortality among non-Estonian men and women. A strong and universal inverse association with mortality was found for personal income. Education (among men) and occupation (among women) predicted mortality only among non-Estonians, whereas ever smoking was associated with mortality in Estonian men and women. Overweight women had lower mortality risk compared to women in normal weight category. Conclusions We found considerable ethnic variation in SRH–mortality association and in socioeconomic predictors of mortality. Further research, preferably focusing on cause-specific mortality and reporting heterogeneity of SRH could potentially shed further light on ethnic differences in SRH–mortality association in Estonia and more generally on socioeconomic inequalities in mortality in Eastern Europe.

  • 2.
    Reile, Rainer
    et al.
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). University of Tartu, Tartu, Estonia.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia.
    Large variation in predictors of mortality by levels of self-rated health: Results from an 18-year follow-up study2017In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 145, p. 59-66Article in journal (Refereed)
    Abstract [en]

    Objectives: To analyze the variation in factors associated with mortality risk at different levels of self-rated health (SRH).

    Study design: Retrospective cohort study.

    Methods: Cox regression analysis was used to examine the association between mortality and demographic, socioeconomic and health-related predictors for respondents with good, average, and poor SRH in a longitudinal data set from Estonia with up to 18 years of follow-up time.

    Results: In respondents with good SRH, male sex, older age, lower income, manual occupation, ever smoking, and heavy alcohol consumption predicted higher mortality. These covariates, together with marital status, illness-related limitations, and underweight predicted mortality in respondents with average SRH. For poor SRH, only being never married and having illness-related limitations predicted mortality risk in addition to older age and male sex.

    Conclusions: The predictors of all-cause mortality are not universal but depend on the level of SRH. The higher mortality of respondents with poor SRH could to a large extent be attributed to health problems, whereas in the case of average or good SRH, factors other than the presence of illness explained outcome mortality.

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