Self-rated health, physician-rated health and associated factors among elderly men: the Finnish cohorts of the Seven Countries Study

Objectives: to study self-rated and physician-rated health, to analyse concordance of the two methods and to examine factors explaining differences between self-rated and physician-rated health. Design: population-based cross-sectional study. Setting: Finnish cohorts of the Seven Countries Study. Subjects: 470 men aged 70–89 years. Main outcome measures: self-administered questionnaire and clinical examination. Results: general health status estimated by doctors correlated weakly with self-rated health. The strongest determinants of self-rated health were depression (P< 0.0001), coronary heart disease (P = 0.0112) and dysuria (P =0.0238). Activity of daily living (P < 0.0001), age (P = 0.0001), coronary heart disease (P = 0.0005) and chronic lung disease (P = 0.0064) were independently related to physician-rated health. Conclusion: the discrepancy found in ratings of health between physicians and the subjects themselves can be explained by different appreciation of ageing in the assessment of health status. After adjustment for medical conditions, age did not relate to self-perceived health, whereas there was a significant association between age and doctors' ratings. Depression and symptoms which explained self-ratings were not related to physicians' assessments.