Epidemiology of self-rated health in rural China: a population-based cross-sectional study.
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ABSTRACT:
SUBMITTER: Liu F
PROVIDER: S-EPMC5493681 | biostudies-other | 2017 Jun
REPOSITORIES: biostudies-other
Publications
Epidemiology of self-rated health in rural China: a population-based cross-sectional study.
Liu Fangfang F Zhang Chaoting C Liang Yongmei Y Deng Qiuju Q Hang Dong D Pan Yaqi Y Li Xiang X He Zhonghu Z Liu Mengfei M Liu Ying Y Li Jingjing J Ning Tao T Guo Chuanhai C Xu Ruiping R Zhang Lixin L Cai Hong H Ke Yang Y
Scientific reports 20170630 1
Self-rated health (SRH) has been shown to be a good predictor of mortality. Data on SRH and its associated factors in the Chinese general population are limited. This study aims to assess the epidemiology of SRH in rural Anyang, China. SRH (categorized as "healthy", "fair" or "unhealthy") was measured in a population-based study of 2,814 adults (including 697 couples) aged 25 to 69 who were recruited from rural Anyang in 2014. Of 2,814 subjects, 63.1% rated their health as "healthy", whereas 28. ...[more]
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Project description:ObjectivesThis study aims to examine the association between self-rated health (SRH) and levels of C-reactive protein (CRP) among adults aged 45 to 101 years old in rural areas of China, and to explore the role of education in the association.DesignCross-sectional study.SettingThe study population was derived from two databases in China: Nanping project (NP) and the China Health and Retirement Longitudinal Study (CHARLS).ParticipantsThere were 646 participants from a rural area of Nanping (NP) and 8555 rural participants from a national representative sample of China (CHARLS).MethodsCRP was measured using a high sensitivity sandwich enzyme immunoassay in the NP and immunoturbidimetric assay in the CHARLS. SRH was assessed by SRH questionnaires and categorised into good and poor. Education was measured by the maximum years of schooling and dichotomised into illiterate and literate. Multivariate linear regression models were used to study the associations.ResultsCompared to people with good SRH, those with poor SRH had higher levels of CRP in NP (?=0.16, 95%?CI -0.02 to 0.34) and in CHARLS (?=0.07, 95%?CI 0.02 to 0.11) after adjusting for potential confounders. Similar findings were observed in the pooled population (?=0.08, 95%?CI 0.03 to 0.12), especially in men (?=0.13, 95%?CI 0.06 to 0.20) and in literate people (?=0.12, 95%?CI 0.06 to 0.18).ConclusionPoor SRH may be a predicator of elevated levels of CRP among middle-aged and older people in rural areas, especially in men and literate people.
| S-EPMC6887060 | biostudies-literature
Project description:ObjectivesWe used nationally representative samples of China and the US older population to investigate (1) whether factors influencing self-rated health among older Chinese were similar to those among older Americans; and (2) whether there was a significant cross-national difference in self-rated health between China and the USA after controlling those available influencing factors.DesignA cross-sectional study. Data came from the 2014 Health and Retirement Study and China Health and Retirement Longitudinal Study conducted from 2014 to 2015.ParticipantsOur final sample size totaled 8905 older adults in the USA and 4442 older adults in China.OutcomeThe response variable was self-rated health. Ordered logistic regression models were conducted to investigate factors influencing self-rated health among older adults.ResultsMore than three-fourths (78%) of older adults in China reported fair or poor health status, while almost 74% of older adults in the USA reported excellent, very good or good health status. In the overall ordered logistic regression model, when controlling statistically for sociodemographics, family structure, functional limitations, cognition, chronic conditions, mental health and health-related behaviours, the Chinese survey respondents were much more likely to rate their health as being poorer than the US respondents. The odds of having better versus poorer health was almost five times greater in American older adults than those in China (OR=4.88, 95% CI 4.06 to 5.86). Older adults in China living alone rated their health better than those living with spouse/partner; however, no significant difference was found between these two living arrangements in older Americans. In contrast, older adults in the USA living with others rated their health worse compared with those living with spouse/partner. In addition, older adults who had more activities of daily living limitations, poorer self-reported memory, worse mental health and chronic health conditions had lower self-rated health in both countries.ConclusionsWe found a striking difference in self-rated health between China and the USA even after controlling for measures of disease, functional status and other influencing factors. Relative to their American counterparts, Chinese elders were much more likely to report worse health.
| S-EPMC6677996 | biostudies-literature
Project description:ObjectivesTo assess the prevalence of wheeze and factors associated with its severity among 3-6 years old children.MethodologyDESIGN: A population-based, cross-sectional study using the WHO 30 cluster methodology with probability proportionate to size sampling.Setting36 preschools registered at the divisional secretariat offices of Anuradhapura district, Sri Lanka.ParticipantsWe recruited 1060 preschool children from 36 preschools aged 3-6 years.Main outcome measurementsWe used the International Study of Asthma and Allergy in Childhood questionnaire to assess the prevalence, symptomatology and associated factors of wheeze.ResultsThe study sample consisted of 548 (51.70%) male and 512 (48.30%) female children with a mean age of 4.41 (±0.66) years. At least one wheezing episode ever was reported in 323 (30.47%; 95% CI 27.71% to 33.34%) children and 247 (23.30%; 95% CI 20.79% to 25.97%) children had a wheezing attack in the preceding year. Severe episodes of wheezing were reported in 76 (7.17%; 95% CI 5.69% to 8.89%) participants. However, only 27 (35.53%; 95% CI 24.88% to 47.34%) children with severe wheezing had been diagnosed as asthmatics by a clinician. The identified independent risk factors for severe wheeze were allergic rhinitis (OR 6.90; 95% CI 3.84 to 12.40), domestic dog(s) (OR 2.34; 95% CI 1.01 to 5.40), frequent consumption of skipjack tuna (OR 1.94; 95% CI 1.11 to 3.39) and passive smoking (OR 1.70; 95% CI 0.93 to 3.11) while living in a house with a cement floor is a protective factor (OR 0.41; 95% CI 0.21 to 0.80).ConclusionWheezing commonly affects one-fourth of preschool children in rural Sri Lanka. Severe wheezing is often not diagnosed as asthma despite frequent symptoms, probably due to hesitancy in labelling preschool children as asthmatics. Allergic rhinitis, domestic dogs, frequent consumption of Skipjack tuna fish and exposure to passive smoking were independent risk factors for severe wheeze.
| S-EPMC8264903 | biostudies-literature
Project description:ObjectiveTo determine the prevalence, degree of trust and usefulness of the online health information seeking source and identify associated factors in the adult population from the rural region of China.DesignA cross-sectional population-based study.SettingA self-designed questionnaire study was conducted between May and June 2015 in four districts of Zhejiang Province.Participants652 adults aged ≥18 years (response rate: 82.8%).Primary outcome measuresThe prevalence, degree of trust and usefulness of online health information was the primary outcome. The associated factors were investigated by χ2 test.ResultsOnly 34.8% of participants had faith in online health information; they still tended to select and trust a doctor which is the first choice for sources of health information. 36.7% of participants, being called 'Internet users', indicated that they had ever used the internet during the last 1 year. Among 239 internet users, 40.6% of them reported having sought health information via the internet. And 103 internet users responded that online health information was useful. Inferential analysis demonstrated that younger adults, individuals with higher education, people with a service-based tertiary industry career and excellent health status used online health information more often and had more faith in it (p<0.001).ConclusionsUsing the internet to access health information is uncommon in the rural residential adult population in Zhejiang, China. They still tend to seek and trust health information from a doctor. Internet as a source of health information should be encouraged.
| S-EPMC6502021 | biostudies-literature
Project description:Background: Substantial evidence indicated that absolute income is directly associated with health. Few studies have, however, examined if relative income may be equally associated with health. This study aimed to investigate the association between absolute income/relative deprivation (RD) and self-rated health (SRH). We also investigated whether the urban-rural difference was existing in these associations. Methods: Using cross-sectional data of 7,070 participants in the Shandong Family Health Service Survey of older people, this study applied binary logistic model and semi-parametric model to estimate the effect of absolute income and relative deprivation on SRH of older people. The Kakwani Index was used as a measure of relative deprivation at the individual level. Results: Absolute income has a significant positive effect on the SRH among both urban and rural older people. When considered RD as a variable, both absolute income and RD have negative significant effects on SRH among all older people. In addition, the negative effect of RD on rural elderly is more pronounced than that of urban older populations. Semi-parametric regression results show that there was a complex non-linear relationship between income and SRH. Psychological distress substantially attenuated the association between relative deprivation and SRH. Conclusions: Relative deprivation is negatively associated with self-rated health in both urban and rural older people after controlling the absolute income. RD may partly explain the association between income inequality and worse health status. Compared with the urban elderly, the effect of income-based relative deprivation on SRH was more pronounced among the rural elderly, and more care should be given to the lower income and rural older populations.
| S-EPMC8291363 | biostudies-literature
Project description:BackgroundSeveral studies have reported that individualized residential place-based discrimination (PBD) affects residents' health. However, studies exploring the association between institutionalized PBD and health are scarce, especially in Asian countries including Japan.MethodsA cross-sectional study was conducted with random two-stage sampling of 6191 adults aged 25-64 years in 100 census tracts across Osaka city in 2011. Of 3244 respondents (response rate 52.4%), 2963 were analyzed using multilevel logistic regression to examine the association of both individualized and institutionalized PBD with self-rated health (SRH) after adjustment for individual-level factors such as socioeconomic status (SES). An area-level PBD indicator was created by aggregating individual-level PBD responses in each tract, representing a proxy for institutionalized PBD, i.e., the concept that living in a stigmatized neighborhood affects neighborhood health. 100 tracts were divided into quartiles in order. The health impact of area-level PBD was compared with that of area-level SES indicators (quartile) such as deprivation.ResultsAfter adjustment for individual-level PBD, the highest and third area-level PBD quartiles showed odds ratio (OR) 1.57 (95% credible interval: 1.13-2.18) and 1.38 (0.99-1.92), respectively, for poor SRH compared with the lowest area-level PBD quartile. In a further SES-adjusted model, ORs of area-level PBD (highest and third quartile) were attenuated to 1.32 and 1.31, respectively, but remained marginally significant, although those of the highest area-level not-home-owner (census-based indicator) and deprivation index quartiles were attenuated to 1.26 and 1.21, respectively, and not significant. Individual-level PBD showed significant OR 1.89 (1.33-2.81) for poor SRH in an age, sex, PBD and SES-adjusted model.ConclusionInstitutionalized PBD may be a more important environmental determinant of SRH than other area-level SES indicators such as deprivation. Although it may have a smaller health impact than individualized PBD, attention should be paid to invisible and unconscious aspects of institutionalized PBD to improve residents' health.
| S-EPMC4046154 | biostudies-literature
Project description:ObjectivesThe population of Estonia has one of the lowest life expectancies and health statuses in Europe. This is reflected in a lower perception of health among older adults. This study focuses on the role of health behaviour (smoking, alcohol consumption, physical activity and nutrition) in self-rated health, accounting for sociodemographic characteristics, activity limitations and long-term illnesses as well as satisfaction with life of older Estonian men and women.DesignWe use representative cross-sectional data from Wave 4 of the Estonian Survey of Health, Ageing and Retirement in Europe, conducted mainly in 2011.ParticipantsFrequencies, ?2 tests and logistic regression models include respondents aged 50 years and older, with no upper age limit (n=6660).ResultsMen have 20% higher odds (CI 1.02 to 1.43) of poor self-rated health. Being of foreign origin (OR 1.48; CI 1.24 to 1.77), having a basic (2.50; CI 2.06 to 3.00) or secondary (1.71; CI 1.43 to 2.04) education, being retired (2.00; CI 1.65 to 2.44) or staying at home (1.49; CI 1.16 to 1.93) and having activity limitations (3.25; CI 2.77 to 3.80) or long-term illnesses (4.78; CI 4.08 to 5.60) are related to poor self-rated health. Never being involved in vigorous (2.30; CI 1.90 to 2.79) or moderate physical activity (1.41; CI 1.02 to 1.94), and consuming legumes and eggs less frequently (1.25; CI 1.08 to 1.45) is associated with poorer self-rated health. Lower satisfaction with life accounts for some of the variation (2.28; CI 1.92 to 2.71).ConclusionsThere is a strong cumulative effect of one's previous life course on the self-rated health of older adults in Estonia, suggesting that public health policies have long-term consequences rather than immediate consequences. Health services supporting health behaviours and targeting vulnerable population groups with specific sociodemographic characteristics and health problems may influence self-rated health for some. Public health services emphasising social activities or psychological aspects may be most successful in improving self-rated health of older Estonians through satisfaction with life.
| S-EPMC5734211 | biostudies-literature
Project description:BackgroundFollowing health insurance reforms, China's health care system has made great progress. However, there are still huge differences between the urban and rural health insurance systems. For rural-to-urban migrant workers, there may be differences in the use of urban and rural health insurance to improve their health status. This study aimed to determine whether any disparities exist in the relationship between urban and rural health insurance and the self-rated health (SRH) of migrant workers in Southwest China from the perspective of urban and rural segmentation.MethodsUsing cross-sectional survey data on Southwest China in 2016, a representative data sample drawn from 8507 migrant workers was analysed. An ordinary least squares (OLS) model and instrumental variable (IV) estimation were used to analyse the relationship between urban and rural health insurance and the SRH of migrant workers.ResultsUsing the IV method to control the endogeneity problems associated with health insurance, this study found that there are differences in the relationship between urban and rural health insurance and the SRH of migrant workers. Urban health insurance is associated with significant improvements in the SRH of migrant workers. Compared with the NRCMS, participating in urban health insurance, including urban employee basic medical insurance (UEBMI) and urban resident basic medical insurance (URBMI), increases the likelihood of migrant workers having better SRH.ConclusionsThere are disparities in the relationship between urban and rural health insurance and the SRH of migrant workers in China. Compared to rural health insurance, urban health insurance has a more positive correlation with the health of migrant workers. Our study shows that it is necessary to integrate urban and rural health insurance to promote social equity.
| S-EPMC8240306 | biostudies-literature
Project description:Self-rated health (SRH) is an independent determinant for all-cause mortality. We aimed to examine the independent and combined associations of components of physical fitness with SRH at baseline (cross-sectional) and two years later (longitudinal) in children and adolescents. Spanish youth (N = 1378) aged 8 to 17.9 years participated at baseline. The dropout rate at 2-year follow-up was 19.5% (n = 270). Participants were categorized as either children (8 to 11.9 years age) or adolescents (12 to 17.9 years age). The ALPHA health- related fitness test battery for youth was used to assess physical fitness, and SRH was measured by a single-item question. Cumulative link, ANOVA and ANCOVA models were fitted to analyze the data. Cardiorespiratory fitness, relative upper body isometric muscular strength, muscular strength score, and global physical fitness were positively associated with SRH in children (OR, 1.048; 95% CI, 1.020-1.076; OR, 18.921; 95% CI, 3.47-104.355; OR, 1.213; 95% CI, 1.117-1.319, and OR, 1.170; 95% CI, 1.081-1.266, respectively; all p < 0.001) and adolescents (OR, 1.057; 95% CI, 1.037-1.076; OR, 5.707; 95% CI, 1.122-29.205; OR, 1.169; 95% CI, 1.070-1.278, and OR, 1.154 95% CI, 1.100-1.210, respectively; all p < 0.001); and motor fitness was positively associated with SRH only in adolescents at baseline (OR, 1.192; 95% CI, 1.066-1.309; p < 0.01). Cardiorespiratory fitness and global physical fitness were positively associated with SRH in children two years later (OR, 1.056; 95% CI, 1.023-1.091; p < 0.001; and OR, 1.082; 95% CI, 1.031-1.136; p < 0.01; respectively). Only cardiorespiratory fitness was independently associated with SRH in children and adolescents at baseline (OR, 1.059; 95% CI, 1.029-1.090; and OR, 1.073; 95% CI, 1.050-1.097, respectively; both p < 0.001) and two years later (OR, 1.075; 95% CI, 1.040-1.112; p < 0.001; and OR, 1.043; 95% CI, 1.014-1.074; p < 0.01, respectively). A high level of cardiorespiratory fitness at baseline or maintaining high levels of cardiorespiratory fitness from the baseline to 2-year follow-up were associated with a higher level of SRH at 2-year follow-up in children (p < 0.01) and adolescents (p < 0.05). These findings emphasize the importance of cardiorespiratory fitness as strong predictor of present and future SRH in youth. Intervention programs to enhance cardiorespiratory fitness level of the youth population are urgently needed for present and future youth's health.
| S-EPMC7177446 | biostudies-literature
Project description:BackgroundIn Europe, knowledge about the social determinants of health among undocumented migrants is scarce. The canton of Geneva, Switzerland, implemented in 2017-2018 a pilot public policy aiming at regularizing undocumented migrants. We sought to test for associations between self-rated health, proven eligibility for residence status regularization and social and economic integration.MethodsThis paper reports data from the first wave of the Parchemins Study, a prospective study whose aim is to investigate the effect of residence status regularization on undocumented migrants' living conditions and health. The convenience sample included undocumented migrants living in Geneva for at least 3 years. We categorized them into those who were in the process of receiving or had just been granted a residence permit (eligible or newly regularized) and those who had not applied or were ineligible for regularization (undocumented). We conducted multivariate regression analyses to determine factors associated with better self-rated health, i.e., with excellent/very good vs. good/fair/poor self-rated health. Among these factors, measures of integration, social support and economic resources were included.ResultsOf the 437 participants, 202 (46%) belonged to the eligible or newly regularized group. This group reported better health more frequently than the undocumented group (44.6% versus 28.9%, p-value < .001), but the association was no longer significant after adjustment for social support and economic factors (odds ratio (OR): 1.12; 95% confidence interval (CI): 0.67-1.87). Overall, better health was associated with larger social networks (OR: 1.66; 95% CI: 1.04-2.64). This association remained significant even after adjusting for health-related variables.ConclusionAt the onset of the regularization program, access to regularization was not associated with better self-rated health. Policies aiming at favouring undocumented migrants' inclusion and engagement in social networks may promote better health. Future research should investigate long-term effects of residence status regularization on self-rated health.
| S-EPMC8220781 | biostudies-literature