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Self-Rated Health in Healthy Adults and Susceptibility to the Common Cold

Cohen, Sheldon PhD; Janicki-Deverts, Denise PhD; Doyle, William J. PhD

doi: 10.1097/PSY.0000000000000232

Objectives To explore the association of self-rated health (SRH) with host resistance to illness after exposure to a common cold virus and identify mechanisms linking SRH to future health status.

Methods We analyzed archival data from 360 healthy adults (mean [standard deviation] age = 33.07 [10.69] years, 45.6% women). Each person completed validated questionnaires that assessed SRH (excellent, very good, good, fair, poor), socioemotional factors, and health practices and was subsequently exposed to a common cold virus and monitored for 5 days for clinical illness (infection and objective signs of illness).

Results Poorer SRH was associated in a graded fashion with greater susceptibility to developing clinical illness (good/fair versus excellent: odds ratio = 3.21, 95% confidence interval = 1.47–6.99; very good versus excellent: odds ratio = 2.60, 95% confidence interval = 1.27–5.32), independent of age, sex, race, prechallenge immunity (specific antibody), body mass, season, education, and income. Greater illness risk was not attributable to infection, but to increased likelihood of developing objective signs of illness once infected. Poorer SRH also correlated with poorer health practices, increased stress, lower positive emotions, and other socioemotional factors. However, none of these (alone or together) accounted for the association between SRH and host resistance. Additional data (separate study) indicated that history of having colds was unrelated to susceptibility and hence also did not account for the SRH link with immunocompetence.

Conclusions Poorer SRH is associated with poorer immunocompetence, possibly reflecting sensitivity to sensations associated with premorbid immune dysfunction. In turn, poorer immune function may be a major contributing mechanism linking SRH to future health.

From the Department of Psychology (Cohen and Janicki-Deverts), Carnegie Mellon University, Pittsburgh, Pennsylvania; and Department of Otolaryngology/ENT (Doyle), Children's Hospital of Pittsburgh and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Address correspondence and reprint requests to Sheldon Cohen, PhD, Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213. E-mail:

Received for publication March 24, 2015; revision received June 29, 2015.

Copyright © 2015 by American Psychosomatic Society
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