Self-rated health and mortality among young men: what is the relation and how may it be explained?

Aims: This study examined the relation between self-rated health (SRH) and mortality among young men, and factors in youth and adolescence that could explain the relation. Methods: Using logistic regression relative risks of mortality between various levels of self-rated health were compared in a longitudinal study of 49,321 men born in 1949-51, participating in a nationwide military conscription survey in 1969-70. Results: Poor self-rated health at conscription was associated with increased mortality during 27 years of follow up for those stating Rather poor or Very poor compared with those stating Very good SRH. SRH was most strongly related to alcohol- and drug-related mortality. Three psychological factors (low emotional control, psychiatric diagnosis at conscription, and self-reported medication for nervous problems) were found to account for 84% of the increased mortality in the group stating Rather poor or Very poor SRH (remaining RR = 1.1). However, the explanatory power of the psychological factors was widely different for different diagnoses of death. Conclusions: Poor self-rated health among young men is a predictor of future mortality. Psychological factors seem to be important explanatory variables.