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      Self-rated health and socio-economic status among older adults in Northern Iceland

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          ABSTRACT

          Little is known about self-rated health (SRH) of older people living in more remote and Arctic areas. Iceland is a high-income country with one of the lowest rates of income inequality in the world, which may influence SRH. The research aim was to study factors affecting SRH, in such a population living in Northern Iceland. Stratified random sample according to the place of residency, age and gender was used and data collected via face-to-face interviews. Inclusion criteria included community-dwelling adults ≥65 years of age. Response rate was 57.9% (N = 175), average age 74.2 (sd 6.3) years, range 65–92 years and 57% were men. The average number of diagnosed diseases was 1.5 (sd 1.3) and prescribed medications 3.0 (sd 1.7). SRH ranged from 5 (excellent) to 1 (bad), with an average of 3.26 (sd 1.0) and no difference between the place of residency. Lower SRH was independently explained by depressed mood (OR = 0.88, 95% CI = 0.80–0.96), higher body mass index (OR = 0.93, 95% CI = 0.87–0.99), number of prescribed medications (OR = 0.88, 95% CI = 0.78–1.00) and perception of inadequate income (OR = 0.45, 95% CI = 0.21–0.98). The results highlight the importance of physical and mental health promotion for general health and for ageing in place and significance of economic factors as predictors of SRH.

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          SF-36 Health Survey Update

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            What is self-rated health and why does it predict mortality? Towards a unified conceptual model.

            The association of self-rated health with mortality is well established but poorly understood. This paper provides new insights into self-rated health that help integrate information from different disciplines, both social and biological, into one unified conceptual framework. It proposes, first, a model describing the health assessment process to show how self-rated health can reflect the states of the human body and mind. Here, an analytic distinction is made between the different types of information on which people base their health assessments and the contextual frameworks in which this information is evaluated and summarized. The model helps us understand why self-ratings of health may be modified by age or culture, but still be a valid measure of health status. Second, based on the proposed model, the paper examines the association of self-rated health with mortality. The key question is, what do people know and how do they know what they know that makes self-rated health such an inclusive and universal predictor of the most absolute biological event, death. The focus is on the social and biological pathways that mediate information from the human organism to individual consciousness, thus incorporating that information into self-ratings of health. A unique source of information is provided by the bodily sensations that are directly available only to the individual him- or herself. According to recent findings in human biology, these sensations may reflect important physiological dysregulations, such as inflammatory processes. Third, the paper discusses the advantages and limitations of self-rated health as a measure of health in research and clinical practice. Future research should investigate both the logics that govern people's reasoning about their health and the physiological processes that underlie bodily feelings and sensations. Self-rated health lies at the cross-roads of culture and biology, therefore a collaborative effort between different disciplines can only improve our understanding of this key measure of health status.
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              Neighborhood environment in studies of health of older adults: a systematic review.

              Epidemiologists and public health researchers are studying neighborhood's effect on individual health. The health of older adults may be more influenced by their neighborhoods as a result of decreased mobility. However, research on neighborhood's influence on older adults' health, specifically, is limited. Recent studies on neighborhood and health for older adults were identified. Studies were identified through searches of databases including PsycINFO, CINAHL, PubMed, Academic Search Premier, Ageline, Social Science Citation Index, and Health Source. Criteria for inclusion were as follows: human studies; English language; study sample included adults aged > or =55 years; health outcomes, including mental health, health behaviors, morbidity, and mortality; neighborhood as the primary exposure variable of interest; empirical research; and studies that included > or =10 neighborhoods. Air pollution studies were excluded. Five hundred thirty-eight relevant articles were published during 1997-2007; a total of 33 of these articles met inclusion criteria. The measures of objective and perceived aspects of neighborhood were summarized. Neighborhood was primarily operationalized using census-defined boundaries. Measures of neighborhood were principally derived from objective sources of data; eight studies assessed perceived neighborhood alone or in combination with objective measures. Six categories of neighborhood characteristics were socioeconomic composition, racial composition, demographics, perceived resources and/or problems, physical environment, and social environment. The studies are primarily cross-sectional and use administrative data to characterize neighborhood. These studies suggest that neighborhood environment is important for older adults' health and functioning.
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                Author and article information

                Journal
                Int J Circumpolar Health
                Int J Circumpolar Health
                International Journal of Circumpolar Health
                Taylor & Francis
                1239-9736
                2242-3982
                29 November 2019
                2019
                : 78
                : 1
                : 1697476
                Affiliations
                [a ]School of Health Sciences, University of Akureyri, Solborg v/Nordursloð; , Akureyri, Iceland
                [b ]Department of Education and science, Akureyri Hospital Eyrarlandsvegi; , Akureyri, Iceland
                [c ]Department of Physical Therapy, School of Health Sciences, University of Iceland; , Reykjavik, Iceland
                [d ]Department of Biostatistics, Brown University; , Providence, RI, USA
                [e ]School of Humanities and Social Sciences, University of Akureyri; , Akureyri, Iceland
                Author notes
                CONTACT Arun K. Sigurdardottir arun@ 123456unak.is School of Health Sciences, University of Akureyri; , Solborg v/Nordursloð, Akureyri600, Iceland
                Author information
                https://orcid.org/0000-0002-4287-5409
                https://orcid.org/0000-0002-5102-4569
                https://orcid.org/0000-0002-1790-4554
                https://orcid.org/0000-0003-1036-2008
                https://orcid.org/0000-0002-3017-113X
                https://orcid.org/0000-0003-2116-9377
                Article
                1697476
                10.1080/22423982.2019.1697476
                6896473
                31783724
                6a39ba58-3b24-4f34-a9ee-ffb106d8be24
                © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 1, Tables: 3, References: 39, Pages: 1
                Categories
                Research Article
                Original Research Article

                Medicine
                older people,rural health,community dwelling,arctic areas
                Medicine
                older people, rural health, community dwelling, arctic areas

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