Is inflammation related to self-rated health and mortality in men?

Abstract: Self-rated health is a powerful predictor of long-term health, but relatively little is known about what determines an individual’s rating of her perceived health status. Psychoneuroimmunological research has found links between immune activity and behaviour, and a relation between low-grade inflammation and poor self-rated health, primarily in women. The principal aim of this paper was to examine the relation between self-rated health and inflammation, measured by erythrocyte sedimentation rate (ESR), in young men. A secondary objective was to investigate whether self-rated health and ESR may be associated to mortality. Pearson correlation and Cox regression analyses were used to examine data collected in 1969-70 when 49,321 men underwent military conscription, together with information from the national cause of death register in 2006. Background factors (BMI, emotional control, psychiatric diagnosis and smoking) were included in multivariate analyses. The results show that self-rated health was significantly related to ESR (r=0.08, p<0.001), also after control for background factors. Furthermore, subjects with poor self-rated health had a near two-fold increased risk of mortality during 37 years of follow-up. In addition, ESR was a significant predictor of mortality (beta=0.051, p<0.002). To conclude, in this cohort of young, healthy men, the association between self-rated health and inflammation was significant but modest. Instead, low emotional control showed a stronger independent correlation to poor self-rated health (r=-0.284, p<0.001). Moreover, adding to a growing body of evidence, poor self-rated health was a strong predictor of mortality.