The most valuable part of a physical, as far as predicting a patient's mortality within the next 10 years, is one simple question: "Is your health excellent, good, fair, or poor?"
Several recent research studies examined in the New York Times have discovered that patients tend to be better predictors of their own mortality than physicians, laboratory tests, and physicals. This trend was strongest among men between the ages of 45 and 64.
Although a physical examination may indicate that they are in good health, elderly people who describe their health as "poor" are seven times more likely to die within the next 1 2 years as compared with those who say they are in "good" health.
These findings have been supported by six studies involving thousands of people. Researchers have no explanation for the results; however, there are several possibilities.
When people assess their health, they most likely consider the health histories of their relatives, including the life spans of their parents and grandparents, and their own health habits. Thus, their response becomes more of a summation of their health history rather than a simple statement about how they feel at that moment.
Personal health assessments may become self-fulfilling prophecies, influencing health-care routines. Another possibility may be that people evaluate their health according their perceived vulnerability to illness. These estimates would take into account a person's feelings of energy and vitality.
A person's assessment of health may also be related to mood, say researchers. Someone who is depressed will rate his health as worse than someone who is in a more positive mood.
The researchers are careful to note that this subjective assessment does not replace regular physical examinations.