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Association between self-rated health and depressive symptoms in rural Chinese adults: a cohort study based on propensity score matchingHealth status is widely regarded as a correlate of depressive symptoms. However, health assessments based on clinical diagnosis in rural areas with poor medical conditions are very limited. Self-rated health (SRH) serves as a simple and convenient evaluation indicator, which may be used as an independent predictor of depressive symptoms. To confirm the relationship between SRH and depressive symptoms in rural adults, a longitudinal survey of rural households in China was conducted using the China Family Panel Studies (CFPS) from 2012 to 2016. Propensity score matching and logistic regression analysis were used to explore the association. After data cleansing, 3,127 pairs (6,254 participants) aged 16 and older followed for 4 years were enrolled, of which the average age was (50.02 ± 14.19) years old, and the proportions of male and female were 48.64% and 51.36%, respectively. The incidence rate of depressive symptoms within 4 years was 30.86% (95%CI: 29.24–32.48) in the group with fair or poor SRH, and 21.59% (95%CI: 20.14–23.03) in the group with good SRH. The difference between the two groups was statistically significant (χ2 = 69.51, P < 0.001). The results of univariate unconditional logistic regression analysis showed that there was a correlation between SRH and depressive symptoms in rural adults aged 30 and above (OR = 1.65, 95%CI: 1.46–1.85, P < 0.001). Thus, a simple and practical assessment tool based on SRH and other indicators should be established for early prevention and intervention in rural primary mental health care.