OBJECTIVES: Although average life expectancy has increased considerably in Sweden, there is less evidence for improved self-rated health (SRH). We analyzed longitudinal trends in SRH between 1980/1981 and 2004/2005 in age and birth cohort subgroups. METHODS: 2,728 males and 2,770 females, aged 16-71 years, were interviewed every eighth year. Mixed models with random intercepts were used to estimate changes in SRH within different age groups and birth cohorts, adjusting for potential confounders. RESULTS: During the 25-year follow-up, SRH improved in individuals aged ≥48 years, but became poorer or was unchanged in those aged 16-47 years. All birth cohorts showed poorer SRH with increasing age, with an adjusted odds ratio (95% confidence interval) of 0.94 (0.93-0.95) in males and 0.92 (0.91-0.93) in females. CONCLUSIONS: While SRH in the older age groups improved, SRH became poorer in the youngest. Poorer SRH is deeply worrying for the affected individuals, and may also have a negative impact on the health care system. Although mental illness, socioeconomic factors, and lifestyle may be potential mechanisms, future studies are needed to investigate the reasons behind this trend.
OBJECTIVES: Although average life expectancy has increased considerably in Sweden, there is less evidence for improved self-rated health (SRH). We analyzed longitudinal trends in SRH between 1980/1981 and 2004/2005 in age and birth cohort subgroups. METHODS: 2,728 males and 2,770 females, aged 16-71 years, were interviewed every eighth year. Mixed models with random intercepts were used to estimate changes in SRH within different age groups and birth cohorts, adjusting for potential confounders. RESULTS: During the 25-year follow-up, SRH improved in individuals aged ≥48 years, but became poorer or was unchanged in those aged 16-47 years. All birth cohorts showed poorer SRH with increasing age, with an adjusted odds ratio (95% confidence interval) of 0.94 (0.93-0.95) in males and 0.92 (0.91-0.93) in females. CONCLUSIONS: While SRH in the older age groups improved, SRH became poorer in the youngest. Poorer SRH is deeply worrying for the affected individuals, and may also have a negative impact on the health care system. Although mental illness, socioeconomic factors, and lifestyle may be potential mechanisms, future studies are needed to investigate the reasons behind this trend.
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