Abstract
Over the past half century, research on self-rated health (SRH) revealed that SRH is a strong independent predictor of mortality. However, research investigating the mechanisms of this association has not been fully developed. The aim of this report is to highlight a study that had investigated the relationship between SRH and immune indices in healthy Japanese employees (which received the 13th Araki award for the best paper in Int J Behav Med) as well as to provide a systematic review on the link between SRH and immunity searched by PubMed. Overall, 15 studies fulfilled the inclusion criteria. Based on the current literature search, poor SRH was associated with increased inflammatory markers such as interleukin-6, tumor necrosis factor-α, C reactive protein, and total leukocyte count, as well as activated humoral immune functioning in various populations. This association was stronger among women than men, and more robust among elderly than younger population. In conclusion, in this review, immune disruption was found to be a candidate pathway for the association between poor SRH and mortality (especially by cardiovascular disorder) but the causality is inconclusive since most studies were based on cross-sectional design. Longitudinal studies are needed to provide cause-and-effect relationship to clarify the role of immune system in the linkage of SRH and mortality.
