Predictive Strength of Self-Rated Health for Mortality Risk Among Older Adults in the United States: Does It Differ by Race and Ethnicity?

Self-rated health (SRH) is widely used to capture racial and ethnic disparities in health. It is therefore critical to understand whether individuals with different racial and ethnic backgrounds assess their SRH differently. Despite the high overall predictive validity of SRH for subsequent mortality, few studies paid attention to potential variations by race and ethnicity. This study examines racial and ethnic differences in the predictive validity of SRH for subsequent mortality risk among older adults (55-84) by estimating Cox Proportional Hazard models using data from the National Health Interview Surveys Linked Mortality Files (1989-2006; N = 289,432). Results indicate that SRH predicts mortality risk less well for non-Hispanic Blacks and Hispanics than non-Hispanic Whites. Three proposed mechanisms-socioeconomic status, immigration status, and cause of death-explain only a modest proportion of the variation. These results suggest that individuals from different racial and ethnic groups may evaluate their heath differently, and thus caution is necessary when using SRH to estimate racial and ethnic health disparities.