1. Nahal Mavaddat GP and Primary Care Research Unit School for Primary Care Research Self-Rated Health: Determinants and Outcomes

2. Research Questions How are subjective perceptions of health and wellbeing created? How do these influence morbidity and mortality outcomes among healthy subjects and patients with chronic disease?

3. In general, how do you rate your health? Self-Rated Health Question:

4. Self-Rated Health and Cardiovascular Outcome Hospitalisation and mortality from IHD or stroke in those not previously diagnosed with stroke, heart attack or angina n=7279 men aged 39-79 in EPIC-Norfolk Cohort (1992-2007)

5. Determinants of Self-Rated Health: Proposed Model Physical Physical activity Symptoms Disease or treatment Pre-clinical disease Mental Thoughts and feelings Resilience and optimism Coping strategies Sense of coherence Mental ill health Social Social class Social deprivation Social networks ENVIRONMENT/ EXTERNAL Subjective Assessment of Health (SRH) INPUTS ORGANISM/ INTERNAL

6. Determinants of Self-Rated Health: Publications What determines self-rated health (SRH)? A cross-sectional study of functional status in the EPIC-Norfolk population. Mavaddat et al. J Epid Comm Health doi: 10.1136/jech2009.090845 Patient-centred assessment of the burden of multiple chronic conditions in primary care: a study of self rated health in the EPIC- Norfolk cohort Mavaddat et al. (in submission JECH) Social inequalities in self-rated health by age: cross-sectional study of 22,357 middle-aged men and women. Mcfadden et al. BMC Public Health 2008;8(230):1471-2458 Self-rated health does not explain the socioeconomic differential in mortality: a prospective study in the EPIC-Norfolk cohort. Mcfadden et al. J Epid Comm Health 2009;63 (4),329-31 Combined impact of health-related behaviours on self-rated health in men and women: The EPIC-Norfolk prospective population study. Van der Wilde et al. (for submission Eu J Epidemiol)

7. Collaborators GP and Primary Care Research Unit Ann Louise Kinmonth, Simon Sanderson, Nahal Mavaddat, Rianne van der Wilde, Sonya Smith, Simon Cohn, Jonathan Mant, Stephen Sutton, Lisa Lim Clinical Gerontology Unit Emily Mcfadden, Kay-Tee Khaw Public Health Carol Brayne