Self-Rated Health: Inequalities and Potential Determinants

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Abstract

Understanding social inequalities in health is of great importance; it provides the conceptual frame for investigating the social factors that affect health, together with empirical evidence for improving population health. Individual and socioeconomic data, disease related conditions and self rated health (SRH) ratings were collected from a representative sample of 1,000 participants in order to study health inequalities in Greece. 20.8% of men and 37.2% of women reported poor health status. Significant inequalities in SRH were observed. Strong associations of poor SRH with gender, age, insurance coverage and chronic diseases were identified. Social insurance scheme captured partly the effects of educational level, income and residence area in SRH in multivariate analysis. Respondents under chronic treatment and those suffering from cardiovascular, musculoskeletal and neurological/psychiatric disorders exhibited the highest risk of reporting poor SRH. Our findings provide decision-makers with insights into how to manage health inequalities by prioritizing preventive measures and consequently, progress towards the fair distribution of healthcare resources.

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Most cited references 25

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

E. L. Idler, Y Benyamini (1997)

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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The association of social relationships and activities with mortality: prospective evidence from the Tecumseh Community Health Study.

J. House, C. Robbins, H L Metzner (1982)

The prospective association of social relationships and activities reported during a round of interviews and medical examinations in 1967-1969 with mortality over the succeeding nine to 12 years was examined for a cohort of 2754 adult (aged 35-69 years as of 1967-1969) men and women in the Tecumseh Community Health Study. After adjustments for age and a variety of risk factors for mortality, men reporting a higher levels of social relationships and activities in 1967-1969 were significantly less likely to die during the follow-up period. Trends for women were similar, but generally nonsignificant once age and other risk factors were controlled. These results were invariant across age, occupational, and health status groups. No association was observed between mortality and satisfaction with social relationships or activities. How and why social relationships and activities predict mortality are discussed and identified as important foci for future research.

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Trends in socioeconomic inequalities in self-assessed health in 10 European countries.

Vivian Bos, Willibald Stronegger, Enrique Regidor … (2005)

Changes over time in inequalities in self-reported health are studied for increasingly more countries, but a comprehensive overview encompassing several countries is still lacking. The general aim of this article is to determine whether inequalities in self-assessed health in 10 European countries showed a general tendency either to increase or to decrease between the 1980s and the 1990s and whether trends varied among countries. Data were obtained from nationally representative interview surveys held in Finland, Sweden, Norway, Denmark, England, The Netherlands, West Germany, Austria, Italy, and Spain. The proportion of respondents with self-assessed health less than 'good' was measured in relation to educational level and income level. Inequalities were measured by means of age-standardized prevalence rates and odds ratios (ORs). Socioeconomic inequalities in self-assessed health showed a high degree of stability in European countries. For all countries together, the ORs comparing low with high educational levels remained stable for men (2.61 in the 1980s and 2.54 in the 1990s) but increased slightly for women (from 2.48 to 2.70). The ORs comparing extreme income quintiles increased from 3.13 to 3.37 for men and from 2.43 to 2.86 for women. Increases could be demonstrated most clearly for Italian and Spanish men and women, and for Dutch women, whereas inequalities in health in the Nordic countries showed no tendency to increase. The results underscore the persistent nature of socioeconomic inequalities in health in modern societies. The relatively favourable trends in the Nordic countries suggest that these countries' welfare states were able to buffer many of the adverse effects of economic crises on the health of disadvantaged groups.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Environ Res Public Health

Journal ID (publisher-id): 101238455

Title: International Journal of Environmental Research and Public Health

Publisher: Molecular Diversity Preservation International (MDPI)

ISSN (Print): 1661-7827

ISSN (Electronic): 1660-4601

Publication date (Print): September 2009

Publication date (Electronic): 15 September 2009

Volume: 6

Issue: 9

Pages: 2456-2469

Affiliations

[1 ] Department of Public Health, Medical School, University of Patras, 26500 Rio Patras, Greece; E-Mail: ecalexop@ 123456upatras.gr

[2 ] Department of Economics, University of Thessaly, 38221 Volos, Greece

Author notes

* Author to whom correspondence should be addressed; E-Mail: geitona@ 123456econ.uth.gr ; Tel.: +30-210-6211591; Fax: +30-210-6030571.

Article

Publisher ID: ijerph-06-02456

DOI: 10.3390/ijerph6092456

PMC ID: 2760422

PubMed ID: 19826556

SO-VID: a9598767-94c2-4dbf-9ba0-21eff4536d50

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This article is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

Self-Rated Health: Inequalities and Potential Determinants

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Emerald: Healthier Lives

Most cited references 25

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

The association of social relationships and activities with mortality: prospective evidence from the Tecumseh Community Health Study.

Trends in socioeconomic inequalities in self-assessed health in 10 European countries.

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