Nishi, AkihiroKawachi, IchiroShirai, KokoroHirai, HiroshiJeong, SeungwonKondo, Katsunori2012-04-192012Nishi, Akihiro, Ichiro Kawachi, Kokoro Shirai, Hiroshi Hirai, Seungwon Jeong, and Katsunori Kondo. 2012. Sex/gender and socioeconomic differences in the predictive ability of self-rated health for mortality. PLoS ONE 7(1): e30179.1932-6203http://nrs.harvard.edu/urn-3:HUL.InstRepos:8605253Background: Studies have reported that the predictive ability of self-rated health (SRH) for mortality varies by sex/gender and socioeconomic group. The purpose of this study is to evaluate this relationship in Japan and explore the potential reasons for differences between the groups. Methodology/Principal Findings: The analyses in the study were based on the Aichi Gerontological Evaluation Study's (AGES) 2003 Cohort Study in Chita Peninsula, Japan, which followed the four-year survival status of 14,668 community-dwelling people who were at least 65 years old at the start of the study. We first examined sex/gender and education-level differences in association with fair/poor SRH. We then estimated the sex/gender- and education-specific hazard ratios (HRs) of mortality associated with lower SRH using Cox models. Control variables, including health behaviors (smoking and drinking), symptoms of depression, and chronic co-morbid conditions, were added to sequential regression models. The results showed men and women reported a similar prevalence of lower SRH. However, lower SRH was a stronger predictor of mortality in men (HR = 2.44 [95% confidence interval (CI): 2.14–2.80]) than in women (HR = 1.88 [95% CI: 1.44–2.47]; p for sex/gender interaction = 0.018). The sex/gender difference in the predictive ability of SRH was progressively attenuated with the additional introduction of other co-morbid conditions. The predictive ability among individuals with high school education (HR = 2.39 [95% CI: 1.74–3.30]) was similar to that among individuals with less than a high school education (HR = 2.14 [95% CI: 1.83–2.50]; p for education interaction = 0.549). Conclusions: The sex/gender difference in the predictive ability of SRH for mortality among this elderly Japanese population may be explained by male/female differences in what goes into an individual's assessment of their SRH, with males apparently weighting depressive symptoms more than females.en-USbiologypopulation biologyepidemiologymedicineclinical research designglobal healthnon-clinical medicinehealth care policypublic healthsocial and behavior sciencesociologyJournal Article2012-04-1910.1371/journal.pone.0030179