Self-rated health and mortality risk in relation to gender and education: a time-dependent covariate analysis.
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ABSTRACT:
SUBMITTER: Sanchez-Santos MT
PROVIDER: S-EPMC5547358 | biostudies-other | 2011 Dec
REPOSITORIES: biostudies-other
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Project description:BackgroundSelf-rated health and the factors that influence it have never been described in Singapore before. This paper presents a descriptive study of self-rated health in a nationally representative cross-sectional survey of 6236 persons.MethodsAs part of the National Health Surveillance Survey 2001, 6236 subjects aged 18 years and above were interviewed in the homes of participants by trained interviewers. The subjects were asked "In general, how would you rate your health today?", and given 5 possible responses. These were then categorized as "Good" (very good and good) and "Poor" (moderate, bad and very bad) self-rated health. The association of socio-economic and health behaviour risk factors with good self-rated health was studied using univariate and multivariate logistic regression analysis.ResultsUnivariate analyses suggest that gender, ethnicity, marital status, education, household income, age, self-reported doctor-diagnosed illnesses, alcohol intake, exercise and BMI are all associated with poor self-rated health. In multivariate regression analyses, gender, ethnicity, household income, age, self-reported illness and current smoking and BMI were associated with poor self-rated health. There are gender differences in the association of various factors such as household income, smoking and BMI to self-rated health.ConclusionSocioeconomic factors and health behaviours are significantly associated with self-rated health, and gender differences are striking. We discuss why these factors may impact self-rated health and why gender differences may have been observed, propose directions for further research and comment on the public policy implications of our findings.
| S-EPMC1976324 | biostudies-literature
Project description:This study aimed to examine the association between preschool education experiences and adulthood self-rated health using representative data from a national population-based survey.Data from the Korean Labor and Income Panel Study in 2006 and 2012 were used. A total of 2391 men and women 21-41 years of age were analyzed. Log-binomial regression analyses were conducted to examine the associations between preschool education experience and self-rated health in adulthood. Parental socioeconomic position (SEP) indicators were considered as confounders of the association between preschool education experience and adulthood subjective health, while current SEP indicators were analyzed as mediators. Age-adjusted prevalence ratios (PRs) and the associated 95% confidence intervals (CIs) were estimated.Compared with men without any experience of preschool education, those with both kindergarten and other preschool education experiences showed a lower prevalence of self-rated poor health (PR, 0.65; 95% CI, 0.47 to 0.89). In women, however, such an association was not evident. The relationship of preschool education experiences with self-rated poor health in adulthood among men was confounded by parental SEP indicators and was also mediated by current SEP indicators. After adjustment for parental and current SEP indicators, the magnitude of the associations between preschool education experiences and adulthood subjective health was attenuated in men.Preschool education experience was associated with adulthood self-rated health in men. However, this association was explained by parental and current SEP indicators. Further investigations employing a larger sample size and objective health outcomes are warranted in the future.
| S-EPMC5541274 | biostudies-other
Project description:ObjectivesThis study examines the potential use of interviewer-rated health (IRH) as a complementary measure of self-rated health (SRH) through a systematic comparison of their components and mortality-predictive powers in the Chinese elderly population.MethodsThis study used a nationwide dataset with more than 12,000 adults aged 65 or older drawn from the 2005 and 2008 waves of the Chinese Longitudinal Health Longevity Survey (CLHLS).ResultsDisability, cognitive function, chronic disease conditions, psychological well-being, and health behaviors influenced both the SRH and IRH of Chinese older adults; these factors, especially disabilities, explained a large portion of the association between SRH and mortality. However, the impact of these factors on the association between IRH and mortality was limited. Furthermore, when both SRH and IRH were included in the analytical models, the association between SRH and mortality disappeared, while the association between IRH and mortality still persisted.DiscussionAlthough there is some difference between IRH and SRH, IRH captures similar health information as SRH and is strongly predictive of mortality independent of SRH; thus, IRH could be a good supplementary measurement for well-adopted SRH.
| S-EPMC6366535 | biostudies-literature
Project description:BackgroundThe extant literature on gender differentials in health in developed countries suggests that women outlive men at all ages, but women report poorer health than men. It is well established that Indian women live longer than men, but few studies have been conducted to understand the gender dimension in self-rated health and self-reported disability. The present study investigates gender differentials in self-rated health (SRH) and self-reported disability (SRD) among adults in India, using a nationally representative data.MethodsUsing data on 10,736 respondents aged 18 and older in the 2007 WHO Study on Global Ageing and Adult Health in India, prevalence estimates of SRH are calculated separately for men and women by socio-economic and demographic characteristics. The association of SRH with gender is tested using a multinomial logistic regression method. SRD is assessed using 20 activities of daily living (ADL). Further, gender differences in total life expectancy (TLE), disability life expectancy (DLE) and the proportion of life spent with a disability at various adult ages are measured.ResultsThe relative risk of reporting poor health by women was significantly higher than men (relative risk ratio: 1.660; 95% confidence Interval (CI): 1.430-1.927) after adjusting for socio-economic and demographic characteristics. Women reported higher prevalence of severe and extreme disability than men in 14 measures out of a total20 ADL measures. Women aged less than 60 years reported two times more than men in SRD ? 5 ADLs. Finally, both DLE and proportion of life spent with a disability were substantially higher for women irrespective of their ages.ConclusionIndian women live longer but report poorer health than men. A substantial gender differential is found in self-reported disability. This makes for an urgent call to health researchers and policy makers for gender-sensitive programs.
| S-EPMC4633186 | biostudies-literature
Project description:Theoretical approaches suggest that gender inequity increases men's health risks. Previous findings from the United States support this contention, however only a small number of health outcomes have been explored. This study extends the range of health outcomes examined by using a cross-sectional, multilevel analysis to investigate whether measures of state-level gender inequity are predictors of men's self-rated health. Data were derived primarily from the Behavioral Risk Factor Surveillance System and the full-case data set included 116,594 individuals nested within 50 states. Gender inequity was measured with nine variables: higher education, women's reproductive rights, abortion provider access, elected office, management, business ownership, labour force participation, earnings and relative poverty. Covariates at the individual level were age, income, education, race/ethnicity, marital status and employment status. Covariates at the state level were income inequality and gross domestic product per capita. In fully adjusted models for all-age men the reproductive rights (OR 1.06 95% CI 1.01-1.11), abortion provider access (OR 1.11 95% CI 1.05-1.16) and earnings (OR 1.06 95% CI 1.02-1.12) measures all predicted an increased risk of men reporting poorer self-rated health for each 1 standard deviation increase in the gender inequity z-score. The most consistent effect was seen for the 65+ age group where the reproductive rights (OR 1.09 95% CI 1.03-1.16), abortion provider access (OR 1.15 95% CI 1.09-1.21), elected office (OR 1.06 95% CI 1.01-1.11) and earnings (OR 1.10 95% CI 1.04-1.16) measures all showed a significant effect. These findings provide evidence that some aspects of gender inequity increase the risk of poorer self-rated health in men. The study contributes to a growing body of literature implicating gender inequity in men's health patterns.
| S-EPMC6049919 | biostudies-literature
Project description:Previous research has documented changes in health differentials by marital status over time. However, recent shifts in family patterns and continuing socioeconomic changes necessitate analyses of more recent changes in union status and self-rated health. Using pooled data from the 2000-2018 National Health Interview Survey (n = 788,829), this study examines educational differences in trends in self-rated health among married, cohabiting, previously-married, and never-married adults. The results of a series of logistic regression models show increasing divergence in self-rated health by union status and by education, driven mostly by declining self-assessed health in middle educational strata (high school graduate and some college), and among single adults, particularly never-married adults. The findings add to the growing evidence of increasing social class divide in family and health outcomes. Evolving trends in self-rated health by union status and education have important implications for programs promoting health and wellbeing across families.
| S-EPMC7327840 | biostudies-literature
Project description:To determine a) proportions of behavior related health risk factors among job-seekers and b) to what extend these are related to self-rated health.Over 12 months, job-seekers were recruited at three job-agencies in northeastern Germany. Among all individuals eligible for study inclusion, 7,906 (79.8%) provided information on smoking, risky drinking, overweight/obesity (body mass index), fruit and vegetable intake, physical inactivity, illicit drug use, and self-rated health. Proportions and 95% confidence intervals stratified by gender, age and duration of unemployment were calculated. Multivariate logistic regression analyses predicting self-rated health were conducted.The proportions of each health-risk factor were high, and 52.4% of the sample (53.4% male, 33.5 years mean age) had 3 or more health risk factors. Mostly, the proportions were particularly high among men and long-term unemployed individuals; e.g. 84.8% of the 18-24 year old long-term unemployed men were current smokers. Proportions of substance use related health risk factors were highest among the 18-24 year olds (e.g. risky drinking 28.7%), and proportions of health risk factors related to nutrition and physical inactivity were highest among the 40-64 year olds (e.g. overweight/obesity 65.4%). Depending on gender, all health risk factors and having 3 or more health risk factors were associated with lower self-rated health; odd ratios ranged between 1.2 for smoking (95% CI: 1.0-1.3) and 1.7 for overweight and physical inactivity (95% CI: 1.5-1.9).Prevention efforts to reduce health risk factors and to increase health among job-seekers are needed, and job agencies appear a feasible setting for their implementation.
| S-EPMC3223919 | biostudies-literature
Project description:BACKGROUND: Poor self-rated health (SRH) is associated with increased mortality. However, most studies only adjust for few health risk factors and/or do not analyse whether this association is consistent also for intermediate categories of SRH and for follow-up periods exceeding 5-10 years. This study examined whether the SRH-mortality association remained significant 30 years after assessment when adjusting for a wide range of known clinical, behavioural and socio-demographic risk factors. METHODS: We followed-up 8,251 men and women aged ? 16 years who participated 1977-79 in a community based health study and were anonymously linked with the Swiss National Cohort (SNC) until the end of 2008. Covariates were measured at baseline and included education, marital status, smoking, medical history, medication, blood glucose and pressure. RESULTS: 92.8% of the original study participants could be linked to a census, mortality or emigration record of the SNC. Loss to follow-up 1980-2000 was 5.8%. Even after 30 years of follow-up and after adjustment for all covariates, the association between SRH and all-cause mortality remained strong and estimates almost linearly increased from "excellent" (reference: hazard ratio, HR 1) to "good" (men: HR 1.07 95% confidence interval 0.92-1.24, women: 1.22, 1.01-1.46) to "fair" (1.41, 1.18-1.68; 1.39, 1.14-1.70) to "poor"(1.61, 1.15-2.25; 1.49, 1.07-2.06) to "very poor" (2.85, 1.25-6.51; 1.30, 0.18-9.35). Persons answering the SRH question with "don't know" (1.87, 1.21-2.88; 1.26, 0.87-1.83) had also an increased mortality risk; this was pronounced in men and in the first years of follow-up. CONCLUSIONS: SRH is a strong and "dose-dependent" predictor of mortality. The association was largely independent from covariates and remained significant after decades. This suggests that SRH provides relevant and sustained health information beyond classical risk factors or medical history and reflects salutogenetic rather than pathogenetic pathways.
| S-EPMC3276505 | biostudies-literature
Project description:Introduction:Although education is among the major socioeconomic status (SES) resources that influence populations' and individuals' health, social marginalization may reduce the health gain that follows access to SES indicators such as education, a pattern called marginalization-related diminished return (MDR). The literature on MDRs, however, has been mainly derived from studies that have defined marginalization based on race, ethnicity, and sexual orientation. Thus, more research is needed on MDRs that may follow as a result of immigration. To extend what is known on immigration status related MDRs, this study compared a national sample of immigrants and non-immigrants for the effect of education on the poor self-rated health (SRH) of adults in the United States. Methods:With a cross-sectional design, this study employed data from the 2015 National Health Interview Survey (NHIS), a survey that had enrolled 33,654 adults who were either immigrants (n = 6225; 18.5%) or non-immigrants (n = 27 429; 81.5%). The independent variable was education level, treated as a categorical variable. The dependent variable was SRH treated as a dichotomous variable. Race, ethnicity, age, gender, marital status, and region were the confounders. Immigration (nativity) was the moderator. Logistic regression was used for data analysis. Results:Higher education credentials were associated with better SRH in the pooled sample; however, immigration showed a significant statistical interaction with education level (college graduation) on the outcome. This interaction was indicative of a smaller protective effect of college graduation on poor SRH among immigrants than non-immigrant adults. Conclusion:In line with the MDRs framework, the effect of education on SRH is weaker for immigrants than for non-immigrant adults. There is a need to help highly educated immigrants to mobilize their human capital to secure their best health outcomes, similar to non-immigrants. Such strategies may require bold and innovative policy solutions to reduce discrimination against immigrants, so they can more effectively translate their education and human capital into tangible outcomes such as health.
| S-EPMC7470225 | biostudies-literature
Project description:Despite the serious biases that characterize self-rated health, researchers rely heavily on these ratings to predict mortality. Using newly collected survey data, we examine whether simple ratings of participants' health provided by interviewers and physicians can markedly improve mortality prediction.We use data from a prospective cohort study based on a nationally representative sample of older adults in Taiwan. We estimate proportional-hazard models of all-cause mortality between the 2006 interview and 30 June 2011 (mean 4.7 years' follow-up).Interviewer ratings were more strongly associated with mortality than physician or self-ratings, even after controlling for a wide range of covariates. Neither respondent nor physician ratings substantially improve mortality prediction in models that include interviewer ratings. The predictive power of interviewer ratings likely arises in part from interviewers' incorporation of information about the respondents' physical and mental health into their assessments.The findings of this study support the routine inclusion of a simple question at the end of face-to-face interviews, comparable to self-rated health, asking interviewers to provide an assessment of respondents' overall health. The costs of such an undertaking are minimal and the potential gains substantial for demographic and health researchers. Future work should explore the strength of the link between interviewer ratings and mortality in other countries and in surveys that collect less detailed information on respondent health, functioning, and well-being.
| S-EPMC3968811 | biostudies-literature