Associations Between Self-Rated Health and Mortality in the Norwegian Women and Cancer (NOWAC) Study,2025, Killie et al

[Midnattsol]

Abstract
Purpose
We investigated the association between self-rated health (SRH) and cancer incidence and SRH and all-cause mortality among Norwegian women.

Population and Methods
We used data from 110,104 women in the Norwegian Women and Cancer (NOWAC) cohort aged 41–70 years at baseline. We used flexible parametric survival analysis with restricted cubic splines to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between SRH and mortality in the entire cohort. We employed the same method in a multistate design to assess associations between baseline SRH and 1) cancer incidence, and 2) all-cause mortality in subgroups of women who did and did not receive a cancer diagnosis during follow-up.

Results
With very good SRH as reference category for all associations and median age at end of follow-up, lower SRH was associated with increased mortality (HRgood SRH 1.19, 95% CI 1.12–1.26) and HRpoor SRH 1.81, 95% CI 1.66–1.97). Lower SRH at baseline was associated with cancer incidence (HRgood SRH 1.14, 95% CI 1.08–1.20 and HRpoor SRH 1.44, 95% CI: 1.32–1.58). Poor baseline SRH was associated with increased mortality for women who received a cancer diagnosis (HRpoor SRH 1.20, 95% CI 1.04–1.39), and SRH showed a strong association with increased mortality for women who stayed cancer free (HRgood SRH 1.59, 95% CI 1.44–1.77 and HRpoor SRH 3.34, 95% CI 2.91–3.84).

Conclusion
Lower SRH at baseline predicted increased cancer risk and all-cause mortality in middle-aged to older women. Poor SRH at baseline predicted all-cause mortality in women who later received a cancer diagnosis. Both good and poor SRH at baseline predicted all-cause mortality in women who stayed cancer-free, and the association was stronger for these women compared to both the entire cohort and to women who were subsequently diagnosed with cancer.

LINK

 

[Midnattsol]

People who self report poor health likely have poor health. Shocking to some, apparently

Forskning.no has an article about this study, where one of the take-aways is that patients who self report poor health may be noticing early signs of illness or have a high risk of illness.

"This insicates than when you report poor health, it can be an early sign of illness or high risk of bad health."

Loren says this challenges traditional ways to assess health risk.

"If patients say they have poor health, it should be taken seriously - even if tests don't show significant problems".

LINK (In Norwegian, google translate won't let me create an already translated version)

The article also has links to studies with similar findings that self reported health is associated with illness and/or mortality later.

 

[Sean]

Of course a bajillion years of evolution has prepared us for the early intuitive, less overt and specific, warning signs of approaching health trouble.

It is bizarre to me that anybody would think otherwise, and devote their time to boldly declaring these alerts to be both a false foreboding, and yet somehow also the cause of the health troubles.

This is what happens when you don't discriminate adequately between correlation and causation, and reject falsification.

 

[Utsikt]

Of course a bajillion years of evolution has prepared us for the early intuitive, less overt and specific, warning signs of approaching health trouble.

It is bizarre to me that anybody would think otherwise, and devote their time to boldly declaring these alerts to be both a false foreboding, and yet somehow also the cause of the health troubles.

Surely being able to cause illness through beliefs would have been negatively selected into oblivion through evolution.

 

[Arnie Pye]

Both good and poor SRH at baseline predicted all-cause mortality in women who stayed cancer-free

I don't understand that bit I've quoted at all. It seems to be suggesting that a random SRH will still predict all-cause mortality. How can a random number predict anything?

 

[Utsikt]

I don't understand that bit I've quoted at all. It seems to be suggesting that a random SRH will still predict all-cause mortality. How can a random number predict anything?

Predictions are essentially forecasts, not self-fulfilling prophecies.

And SRH isn’t a ‘random number’, it’s a number with a specific and limited meaning - namely how good/bad you rate your own health.

What this study shows, is that women that rate their health as worse, are more likely to die sooner. The opposite is true for good health.

This doesn’t mean that a bad self-reported health in itself causes early death. It’s much more likely and logical that the thing that makes you rate your health as worse, also makes you die sooner (on average).

 

[Arnie Pye]

And SRH isn’t a ‘random number’, it’s a number with a specific and limited meaning

Yes, I know. But the statement I quoted was saying that good and poor SRH at baseline predicted all-cause mortality. I think it was poorly worded.

 

[forestglip]

Yes, I know. But the statement I quoted was saying that good and poor SRH at baseline predicted all-cause mortality. I think it was poorly worded.

It's because they're comparing both groups to "very good" SRH.

"Good" was worse mortality. "Poor" was even worse.

With very good SRH as reference category for all associations and median age at end of follow-up, lower SRH was associated with increased mortality (HRgood SRH 1.19, 95% CI 1.12–1.26) and HRpoor SRH 1.81, 95% CI 1.66–1.97).

 

[Utsikt]

It's because they're comparing both groups to "very good" SRH.

That should probably have been mentioned in the conclusion, even though I see they mention it in the results section.

 

[rvallee]

That's quite a different interpretation from the exact same findings in discriminated illnesses where it's instead concluded, asserted, that it must be the negative feelings that create bad outcomes.

No matter what can be said about modern medicine, it's still just as firmly stuck in a battle between science and religion as ever, and the religious side has never fared better.