Self-Rated Health and Mortality Among Older Adults in Israel: A Comparison Between Jewish and Arab Populations

Background: Self-rated health (SRH) has been shown to predict mortality across a lifespan. However, its predictive value might differ between populations. We compared the association between SRH and mortality in Israeli Jewish and Arab older adults (65+). Methods: A prospective cohort study was conducted among Jewish (n = 1463) and Arab (n = 298) participants in the first National Health and Nutrition Survey of Older Adults (2005-2006). SRH was measured on a four-point scale. Mortality data were available from baseline (2005-2006) through 2019. A survival analysis was performed using Cox models. Results: Mean baseline age (SD) was 75 (6) years among Jewish participants (54% women) and 72 (5) years among Arab participants (50% women). Jewish participants were more likely to rate their health as not good (35% vs. 29%) or poor (11% vs. 8%) than Arab participants (p = 0.01). During a median follow-up of 13.3 years, 896 deaths occurred; 744 in the Jewish group (mean age [SD] 77.8 [6.6] years) and 152 in the Arab group (mean age [SD] 74.0 [5.2] years). The age- and sex-adjusted hazard ratio (HR) for mortality in the Arab vs. Jewish participants was 1.33 (95% CI: 1.12-1.60). Mortality risk increased with declining SRH, with multivariable-adjusted HRs in the lowest vs. most-favorable SRH categories of 2.46 (95% CI: 1.66-3.63) in the Jewish sample and 2.60 (95% CI: 0.98-6.93) in the Arab sample. Conclusions: Although Jewish participants reported poorer SRH, their survival rate was better than Arab participants. Lower SRH was consistently and strongly associated with higher mortality in both groups in a dose-response manner.