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      How the economic recession has changed the likelihood of reporting poor self-rated health in Spain

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          Abstract

          Background

          Between 2006 and 2011 self-rated health (SRH) (the subjective report of an individual’s health status) actually improved in Spain despite its being in the grips of a serious economic recession. This study examines whether the likelihood of reporting poor health has changed because of the global financial crisis. It also attempts to estimate the differences between SRH and other self-perceived measures of health among groups before and during the current economic crisis in Spain.

          Methods

          Cross-sectional population-based surveys were conducted in Spain (ENSE 2006 and ENSE 2011) and in Catalonia (ESCA 2006 and ESCA 2011) in 2006 and again in 2011. In this research work we have used random effects logistic models (dependent variable SRH 1 Poor, 0 Good) and exact matching and propensity score-matching.

          Results

          The results of the ENSE explanatory variables are the same in both 2006 and 2011. In other words, all diseases negatively affect SRH, whereas alcohol habits positively affect SRH and obesity is the only disease unrelated to SRH. ESCA explanatory variables’ results show that in 2006 all diseases are significant and have large odds ratio (OR) and consequently those individuals suffering from any of these diseases are more likely to report poor health. In 2011 the same pattern follows with the exception of allergies, obesity, high cholesterol and hypertension, albeit they are not statistically significant. Drinking habits had a positive effect on SRH in 2006 and 2011, whereas smoking is considered as unrelated to SRH. The likelihood of reporting poor health in 2006 is added as a variable in with the logistic regression of 2011 and is not, in either the ENSE data or the ESCA data, significant. Furthermore, neither is it significant when controlling by age, gender, employment status or education.

          Conclusions

          The results of our analysis show that the financial crisis did not alter the likelihood of reporting poor health in 2011. Therefore, there are no differences between our perceived health in either 2006 or in 2011.

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          Most cited references26

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          Self-rated health and mortality: a review of twenty-seven community studies.

          We examine the growing number of studies of survey respondents' global self-ratings of health as predictors of mortality in longitudinal studies of representative community samples. Twenty-seven studies in U.S. and international journals show impressively consistent findings. Global self-rated health is an independent predictor of mortality in nearly all of the studies, despite the inclusion of numerous specific health status indicators and other relevant covariates known to predict mortality. We summarize and review these studies, consider various interpretations which could account for the association, and suggest several approaches to the next stage of research in this field.
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            A Language and Environment for Statistical Computing

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              Perceived health and mortality: a nine-year follow-up of the human population laboratory cohort.

              The association between perceived health ratings ("excellent," "good," "fair," and "poor") and mortality was assessed using the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, California, and a subsequent nine-year follow-up. Risk of death during this period was significantly associated with perceived health rating in 1965. The age-adjusted relative risk for mortality from all causes for those who perceived their health as poor as compared to excellent was 2.33 for men and 5.10 for women. The association between level of perceived health and mortality persisted in multiple logistic analyses with controls for age, sex, 1965 physical health status, health practices, social network participation, income, education, health relative to age peers, anomy, morale, depression, and happiness.
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                Author and article information

                Contributors
                34-972418040 , elena.arroyo@udg.edu
                34-972418781 , gemma.renart@udg.edu
                34-972418338 , marc.saez@udg.edu
                Journal
                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                1475-9276
                18 December 2015
                18 December 2015
                2015
                : 14
                : 149
                Affiliations
                [ ]Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Spain, Carrer de la Universitat de Girona 10, Campus Montilivi, 17071 Girona, Spain
                [ ]CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
                Article
                285
                10.1186/s12939-015-0285-5
                4683862
                921ee912-058b-40ae-b5b8-611b159343f0
                © Arroyo et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 28 July 2015
                : 11 December 2015
                Funding
                Funded by: CIBERESP
                Award ID: strategic subprograms 'Crisis and Health'
                Funded by: AGAUR
                Award ID: 2014SGR551
                Categories
                Research
                Custom metadata
                © The Author(s) 2015

                Health & Social care
                self-rated health,chronic conditions,health econometrics,economic downturn,health surveys

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