Using data from the linked National Health Interview Survey National Death Index (NHIS‐NDI), a new and unique data set, we examine the interaction of age and self‐rated health as a predictor of overall and cause‐specific mortality. Proponents of wear and tear theories argue that as the body ages, it begins to degenerate, leaving the aged in poor health and vulnerable to their ultimate mortality. We find that although the majority of the elderly rate their health as good or better, low levels of education and income contribute to poor perceived health, and the effect of age on mortality varies by level of perceived health. While the oldest old who report the poorest health experience greater risks of mortality, elders who report good health experience much lower risks. As a larger share of our population survives into old age, it is important to emphasize preventive health care policy, as well as strong economic and health care safety nets, not only to promote health but also to lengthen life.