Self-rated health and mortality: a follow-up study of a Spanish population

Family Support and Type 2 Diabetes Self-management Behaviors in Underserved Latino/a/x Patients

BACKGROUND

Latino/a/x families experience persistent Type 2 diabetes mellitus (T2DM) disparities, including higher rates of diagnosis and mortality due to disease complications than their non-Hispanic White counterparts. Though greater social support is associated with improved disease outcomes for Latino/a/x patients with diabetes, research has yet to identify the specific pathways through which social support, and specifically family support, influences self-management.

PURPOSE

This study tested a theoretical model highlighting the mechanisms and pathways linking social support and physical health. Specifically, self-efficacy and depression were tested as psychological pathways connecting family support to diabetes self-management behaviors and diabetes morbidity in Latino/a/x patients with T2DM.

METHODS

Data from 177 patients were analyzed using structural equation modeling. Measures included diabetes-specific family support needed and received, depressive symptoms, self-efficacy in diabetes management, diabetes self-management behaviors, health appraisal, and hemoglobin A1c.

RESULTS

Greater diabetes-specific family support was significantly associated with more frequent engagement in diabetes self-management behaviors, both directly (p < .001) and through diabetes self-efficacy's partial mediation of this relationship (p = .013). Depression was not significantly associated with either family support (support received, p = .281; support needed, p = .428) or self-management behaviors (p = .349).

CONCLUSIONS

Family support and diabetes self-efficacy may be important modifiable psychosocial factors to target via integrated care interventions aimed at supporting Latino/a/x patients with T2DM. Future research is needed to test empirically based, culturally adapted interventions to reduce T2DM-related health disparities in this population.

Determinants of self-rated health among highly educated Ukrainian women refugees in Czechia: analysis based on cross-sectional study in 2022

BACKGROUND

Russia's military aggression against Ukraine set in motion a large number of refugees. Considerable amount of them came and stayed in Czechia. Refugees represent special vulnerable individuals often affected by war physically and psychologically. Due to the national regulations not allowing most of Ukrainian men aged 18-60 to leave the country, nowadays Ukrainian forced migration is relatively young and strongly gendered. Evidence suggests the higher probability for searching the safe refuge abroad among Ukrainian women with small children as well as those with relatively higher economic and cultural capital. The aim of this study is to identify the structural features of systemic risks associated with war migration by examining determinants of self-rated health among forcibly displaced highly educated Ukrainian women of productive age residing in Czechia.

METHODS

Data from one wave of the panel survey among Ukrainian refugees in Czechia conducted in September 2022 was used. Determinants of self-rated health including self-reported diseases and healthcare factors, lifestyle, human and social capital, economic factors, and migration characteristics were analysed using binary logistic regression.

RESULTS

About 45% highly educated Ukrainian women refugees in Czechia assessed their health as poor. The poor self-rated health was mostly associated with the number of diseases and depressive symptoms, and by social capital and economic factors. Having four and more diseases (OR = 13.26; 95%-CI: 5.61-31.35), showing some severe depressive symptoms (OR = 7.20; 95%-CI: 3.95-13.13), experiencing difficulties to seek help from others (OR = 2.25; 95%-CI: 1.20-4.23), living alone in a household (OR = 2.67; 95%-CI: 1.37-5.27), having severe material deprivation (OR = 2.70; 95%-CI: 1.35-5.41) and coming originally from the eastern part of Ukraine (OR = 2.96; 95%-CI: 1.34-6.55) increased the chance of these refugees to assess their health as poor.

CONCLUSION

Social and economic determinants such as lack of social contacts for seeking help and material deprivation were found to be crucial for self-rated health and should be tackled via migration policies. Further, qualitative research is needed to better understand the mechanisms behind the factors affecting subjectively assessed health.

Health literacy: association with socioeconomic determinants and the use of health services in Spain

Background

Health literacy (HL) is the set of social and cognitive skills that determine person's level of motivation and the ability to access, understand and use information to promote and maintain good health. The aim of this study is to assess the level of health literacy, and to analyze its relationship with sociodemographic variables, state of health, and use of health services in the population aged 15 and over in the Valencian Community (Spain).

Methods

Cross-sectional study based on a sample of 5,485 subjects participating in the Health Survey of the Valencia Community. The HLS-EU-Q16 was used. As outcome variables we considered HL categorized into 2 levels: Inadequate or Problematic HL and Sufficient HL and the standardized literacy index. Prevalence rates and HL means were estimated and OR were calculated to analyze the association between variables.

Results

A total of 12.8% of the subjects surveyed presented an inadequate or problematic degree of HL. This percentage was higher in people >85 years (63.1%), with a low level of education (46.5%), in retired people (27.4%) or in other work situations (25.0%), in foreigners (18.1%), in low-income people (16.2%), with a perception of poor health status (26.9%), chronic disease (18.5%) or with activity limitations (56.4% severe, 19.7% not severe). Significant differences were found. With the exception of chronic disease, all the variables analyzed were associated with HL. Low HL was associated with a lower consumption of medicines, a greater use of health services, general medical consultations, poorer knowledge of new health technologies and fewer preventive health visits.

Conclusion

The percentage of inadequate or problematic HL was globally not very high, but certain population subgroups notably presented a high degree of inadequate or problematic HL. Raising the HL level of such groups should be regarded as a priority. HL was shown to be associated with the service use and new health technology use. Enhancing the population's HL should lead to the following: a greater probability of adopting preventive practices; improving the use of the health system; and boosting people's abilities to manage and to improve their own health.

Sleep Duration, Sleep Quality, and Insomnia in Association With Self-Rated Health: A Systematic Review and Meta-Analysis

Background and Objective This study undertook a systematic review and meta-analysis of the relationship between sleep duration, sleep quality, and insomnia in association with self-rated health.Methods Studies that had examined the relationship between sleep duration, sleep quality, and insomnia with self-rated health were eligible. PubMed and Scopus were the two main databases for searching for studies related to this meta-analysis. The Google Scholar database as a source of gray literature was also searched by hand. This search was from the beginning of the formation of databases until the end of January 2022, and the search language was limited to articles published in English. The Effective Public Health Practice Project Quality Assessment Tool was used to assess the quality of studies. For this meta-analysis, odds ratio and 95% confidence interval were extracted or calculated. The pool of studies was processed by the random effects method.Results Twenty-six studies were included in this meta-analysis. Sleep duration of ≤ 8 hours per day (h/d) (odds ratio = 1.58 and 95% confidence interval = [1.41–1.77]) and sleep duration of > 8 h/d (odds ratio = 1.32 and 95% confidence interval = [1.17–1.50]) are associated with poor self-rated health. Poor sleep quality and insomnia are associated with poor self-rated health. Conclusions Sleep problems have a negative effect on self-rated health, and therefore, effective interventions can help improve sleep.

Insomnia Symptoms Among Hospice Family Caregivers: Prevalence and Association with Caregiver Mental and Physical Health, Quality of Life, and Caregiver Burden

BACKGROUND

Poor sleep exacerbates mental health problems and reduces quality-of-life (QOL) but prevalence of insomnia symptoms among hospice family caregivers and associations of poor sleep with caregiver health and QOL outcomes are not known.

OBJECTIVE

To describe prevalence of insomnia symptoms among hospice family caregivers and compare anxiety, depression, self-rated health, QOL, and caregiver burden between hospice family caregivers with and without insomnia symptoms.

METHODS

Descriptive sub-study using data collected during baseline interviews of hospice family caregivers involved in a randomized clinical trial in Midwestern United States (xxxxxxxx). Caregivers were dichotomized based on Insomnia Severity Index (ISI) scores (8+ indicated insomnia symptoms).

RESULTS

Among 57 hospice family caregivers, the mean ISI score was 8.2; nearly half (49.1%) experienced insomnia symptoms. Compared to caregivers without insomnia symptoms, caregivers with insomnia symptoms reported 2.4 times greater mean anxiety scores (4.7 vs 11.4); 3.5 times greater mean depression scores (3.1 vs 10.7); 2.1 times greater caregiver burden scores (5.6 vs 11.8); and 1.3 times lower self-rated health (3.5 vs 2.8); 1.3 times lower total QOL scores (29.3 vs 22.6); including differences in emotional QOL (7.9 vs 2.2), social QOL (7.2 vs 3.0), and physical QOL (7.4 vs 5.3).

CONCLUSIONS

Hospice family caregivers experience high prevalence of insomnia symptoms; caregivers with insomnia symptoms report worse anxiety, depression, caregiver burden, QOL, self-rated health. Clinicians must screen hospice caregivers for poor sleep and mental health and offer supportive interventions that improve their sleep and health. Policy makers must expand hospice benefits to better support family caregivers.

Self-Rated Health as a Predictor of Mortality in Older Adults: A Systematic Review

The aim of this study was to investigate the link between self-reported health (SRH) and mortality in older adults. In total, 505 studies were found in PubMed and Scopus, of which 26 were included in this review. In total, 6 of the 26 studies included did not find any evidence of an association between SRH and mortality. Of the 21 studies that included community dwellers, 16 found a significant relationship between SRH and mortality. In total, 17 studies involved patients with no specific medical conditions; among these, 12 found a significant link between SRH and mortality. Among the studies in adults with specific medical conditions, eight showed a significant association between SRH and mortality. Among the 20 studies that definitely included people younger than 80 years, 14 found a significant association between SRH and mortality. Of the twenty-six studies, four examined short-term mortality; seven, medium-term mortality; and eighteen, long-term mortality. Among these, a significant association between SRH and mortality was found in 3, 7, and 12 studies, respectively. This study supports the existence of a significant relation between SRH and mortality. A better understanding of the components of SRH might help guide preventive health policies aimed at delaying mortality in the long term.

Health self-perception is associated with life-styles and comorbidities and its effect on mortality is confounded by age. A population based study

Background

Health self-perception (HSP) is the individual and subjective concept that a person has of their state of health. Despite its simplicity, HSP is considered a valid and relevant indicator employed in epidemiological research and in professional practice as an overall measure of health.

Objectives

(1) To describe and analyze the associations between HSP and demographic variables, lifestyle and diseases prevalent in a population and (2) to investigate the relationship between HSP and mortality.

Materials and methods

In a primary care setting, we conducted a longitudinal study of a random populational sample of a Galician municipality, stratified by decade of life. A total of 1,516 adults older than 18 years, recruited by the 2013-2015 AEGIS study, were followed-up for more than 5 years. During the clinical interview, data were collected on lifestyle and prevalent diseases. The HSP was grouped into 2 categories (good/poor). The statistical analysis consisted of a logistic regression, Kaplan-Meier curves and Cox regression.

Results

A total of 540 (35.6%) participants reported poor HSP. At the end of the follow-up, 78 participants had died (5.1%). The participants with increased age and body mass index and chronic diseases (anxiety, depression, ischemic heart disease, diabetes, and cancer) presented a poorer subjective health. A high level of physical activity and moderate alcohol consumption were associated with better HSP. A poorer HSP was associated with increased mortality, an association that disappeared after adjusting for the rest of the covariates (HR, 0.82; 95% CI 0.50-1.33).

Conclusion

(1) Health self-perception is associated with age, lifestyle, and certain prevalent diseases. (2) A poorer HSP is associated with increased mortality, but this predictive capacity disappeared after adjusting for potential confounders such as age, lifestyle, and prevalent diseases.

The Utility of Grip Strength as a Simplified Measure of Frailty in the Older Adult in the Preoperative Clinic

Objective

 The aim of this study was to compare the measure of grip strength against other validated methods of measuring frailty.

Materials and methods

This was a single-center, cross-sectional study that took place at the Westchester Medical Center Pre-Procedural Testing Clinic. The patient population included n = 73 patients ≥65 years of age evaluated for elective surgery. During the study, patients’ grip strength, CFS-I (Clinical Frailty Score of Investigator), CFS-P (Clinical Frailty Score of Participant), and FRAIL (Fatigue, Resistance, Aerobic capacity, Illnesses, and Loss of weight) scores were measured.

Results

Grip strength correlated negatively with the CFS-I, CFS-P, and FRAIL scores for females. Reduced grip strength in females correlated with higher frailty scores and vice versa. Male grip strength showed no significant relationship with the frailty scales. In addition, multivariate linear regression analysis revealed that the independent measure that demonstrated a significant inverse association with grip strength was age (β= -0.43, p = <0.001).

Conclusions

 There exists a difference in the utility of grip strength as a measure of frailty between males and females.

Predictive capacity of self-rated health on all-cause mortality in Spain: differences across sex, age and educational level

BACKGROUND

Published evidence on self-rated health's capacity to predict mortality and its variability across subpopulations lacks consistency. Our objective is to evaluate this predictive association and whether/how it varies by sex, age and educational attainment at the population level in Spain.

METHODS

Data came from a prospective longitudinal study based on 42 645 individuals aged ≥15 years who participated in the 2011-2012 and 2014 Spanish Health Surveys. Median follow-up time for mortality was 5.4 years. Cox proportional hazards models adjusted for sociodemographic, lifestyle and chronic disease variables were used to estimate the predictive capacity of self-rated health on mortality.

RESULTS

Self-rated health was associated with mortality with a dose-response effect (p value for linear trend <0.001). Compared with respondents who rated their health as very good, those rating it as very poor presented an HR of 3.33 (95% CI 2.50 to 4.44). Suboptimal self-rated health was a stronger predictor of mortality among 15-44 year-olds (HR 2.87; 95% CI 1.59 to 5.18), compared with the estimate for 45-64 year-olds (HR 1.86; 95% CI 1.45 to 2.39) (p value for interaction=0.001) and for those 65 and older (HR 1.51; 95% CI 1.36 to 1.68) (p value for interaction <0.001). Regarding educational attainment, the association was stronger for individuals with university studies (HR 2.51; 95% CI 1.67 to 3.76) than for those with only primary or no studies (HR 1.31; 95% CI 1.17 to 1.48) (p value for interaction=0.010). No statistically significant differences were observed between men and women.

CONCLUSIONS

Self-rated health may be considered a good predictor of all-cause mortality in the population of Spain, although the magnitude of this predictive association varies by age and educational level.

Self-reported health status and mortality from all-causes of death, cardiovascular disease and cancer in an older adult population in Spain

Aim

To assess the association between self-reported health (SRH) and mortality from all-causes, cardiovascular disease (CVD) and cancer, in adults 65 years and older in Spain.

Methods

We analysed data of 894 adults (504 women, 390 men) aged 65 years and above from two population-based studies, the EUREYE-Spain study and the Valencia Nutritional Survey (VNS). SRH was assessed at baseline using a single question which is widely used in epidemiological studies: “Overall, how would you consider your health at present?” and the response options were: 1. Very good, 2. Good, 3. Fair, 4. Poor, 5. Very poor. Deaths were ascertained during a 12-year follow-up period, and we used Cox proportional hazards regression models to obtain adjusted hazard ratios (HR).

Results

During the 12 years of follow-up (8566.2 person-years), we observed 400 deaths, 158 (39.5%) due to CVD and 89 (22.3%) due to cancer. Fair and poor/very poor SRH were significantly associated with higher all-cause mortality after 12-years of follow-up, HR = 1.29 (95% CI, 1.03–1.61) and HR 1.53 (95% CI, 1.09–2.15), respectively. We observed evidence of higher CVD mortality among those who reported fair and poor/very poor SRH, although the association was attenuated and lost statistical significance in the fully adjusted models.

Conclusion

This study suggests that a poor SRH status is associated with a higher all-cause mortality risk among older adults in Spain. Checking SHR status may be useful to plan health care in older adults.

What influences individual perception of health? Using machine learning to disentangle self-perceived health

Self-perceived health is a subjective health outcome that summarizes all the health conditions and is widely used in population health studies. Yet, despite its well-known relationship with survival, it is still unclear as to which health conditions are actually taken into account when making an individual assessment of one's own health. The aim of this paper is to assess the influence of four objective health conditions - IADLs, ADLs, chronic diseases, and depression - in predicting self-perceived health among Europeans by age group (50-64 and 65-79) and by sex. Classification trees (J48 algorithm), which pertains to the emerging Machine Learning techniques, were applied to predict self-perceived health according to the four abovementioned objective health conditions of European individuals in the sixth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) (n = 55,611). The four variables present different degrees of relevance in establishing predictions of self-perceived health values by age and by sex. Before the age of 65, chronic diseases have the greatest importance, while IADL limitations are more important in the 65-79 age group. Likewise, ADL limitations are more important for women free of chronic diseases in the 50-64 age group; however, these differences disappear among women in the older group. There is an evident degree of interplay between the objective health indicators of chronic diseases, ADLs, IADLs, and depression when predicting self-perceived health with a high level of accuracy. This interplay implies that self-perceived health summarizes different health conditions depending on age. Gender differences are only evident for the younger age group, whereas construction of self-perceived is the same for women and men among the older group. Therefore, none of these four indicators on its own is able to totally substitute self-perceived health.

Association of Visual Display Terminal Usage with Self-Rated Health and Psychological Distress among Japanese Office Workers during the COVID-19 Pandemic

The aim of this study was to examine the association of the duration of visual display terminal (VDT) usage for work and non-work activities with self-rated health (SRH) and psychological distress among office workers during the COVID-19 pandemic in Japan. A cross-sectional data of 7088 office workers from a web-based, self-administered survey conducted from 25 August 2020, to 30 September 2020, was used. Multiple logistic regression analysis was applied. Compared to those who used a VDT for 4–9 h for work, office workers who used a VDT for ≥10 h for work had poor SRH (odds ratio (OR): 1.65; 95% confidence interval (CI): 1.13, 2.41) and severe psychological distress (OR: 2.23; 95% CI: 1.52, 3.28). VDT usage for less than 1 h (OR: 1.37, 95% CI: 1.12, 1.67) and 1–3 h (OR: 1.42, 95% CI: 1.12, 1.80) for work were also associated with severe psychological distress. Stratification analysis by age showed a significant association of VDT usage for work with poor SRH among 30–64-year-olds, while a U-shape association was found between VDT usage for work and psychological distress with the younger age group (15–29 years old). During the COVID-19 pandemic in Japan, the prolonged usage of VDT for work can deteriorate both general and psychological health, while moderate usage of VDT for work can reduce psychological distress.

Association of self-rated health with chronic disease, mental health symptom and social relationship in older people

Chronic disease, mental health symptoms and poor social relations are reported common causes for poor self-rated health in older people. To assess the co-occurrence rate of chronic diseases, poor mental health and poor social relationships in older people, and determine their association with self-rated health. 6,551 older people in Zhongshan, China, participated a large health surveillance program were randomly selected and questioned about their SRH, chronic conditions, mental health symptoms and social relationships. The association between self-rated health and chronic conditions, poor mental health, social relationships, and their co-occurrence were analyzed. 56.4% of participants reported poor self-rated health. 39.1% experienced at least one chronic disease. 29.0% experienced one or more mental health symptoms; 19.5% experienced at least one poor social relationship. 7.8% had co-occurrence of chronic diseases, mental health problems, and poor social relationships. Logistic regressions showed that poor self-rated health was associated with chronic diseases, poor mental health, poor social relationships and their co-occurrence. The findings indicate the importance of managing chronic disease, poor mental health and poor social relationships for older people.

Impacto de la crisis económica sobre la percepción de la salud en la población española

Objetivo: analizar el impacto de la situación económica en la percepción del estado de salud y la capacidad explicativa de las características individuales en esta percepción. Método: estudio transversal con enfoque analítico. Se extrajeron datos de la Encuesta Nacional de Salud (ENSE) publicada en 2011-2012 (crisis económica) y en 2017 (recuperación). La variable dependiente fue la percepción de la salud recogida en una escala Likert de 1 (muy bueno) a 5 (muy malo). Las variables independientes fueron: el momento de recogida (crisis/recuperación), sociodemográficas, relacionadas con el estilo de vida, relativas al estado «objetivo» de salud y relacionadas con el uso de servicios. Se construyeron modelos lineales generalizados para dar respuesta a los objetivos. Para valorar la magnitud del tamaño del efecto de las asociaciones se valoró la dispersión de las distribuciones según la relación existente entre el efecto y la desviación estándar de la media (DS). Resultados: se encontró una mejoría en la percepción del estado de salud de -0,066 (intervalo de confianza [IC] 95%: entre -0,080 y -0,052) puntos en el período de recuperación. Se hallaron asociaciones de tamaño del efecto «moderado» entre una peor percepción de salud y las variables relacionadas con el estado «objetivo» de salud; y «pequeño», con las variables relacionadas con el estilo de vida poco saludable y la clase social más desfavorecida. Conclusión: los períodos de crisis económica se asocian a una peor percepción del estado de salud, impactando más en aquella población perteneciente a una categoría social baja, con hábitos de vida poco saludables y especialmente en los pacientes crónicos. Palabras clave: estado de salud, crisis económica, enfermedad crónica, España, clase social, características de la población.

The Applicability of the Poincaré Plot in the Analysis of Variability of Reaction Time during Serial Testing

(1) Background: This study aims to put into evince the relationship between the variability of the reaction time (RT) during repeated testing, expressed through indicators extracted by the Poincaré plot method, and the age of the participants, their self-reported health (SRH), and level of perceived anxiety. (2) Methods: The study was performed using computerized RT testing software. An observational cross-sectional study was performed on a group of 120 subjects (mean age 42.33 ± 21.12 years), sex ratio men to women 1.14:1. Data were processed through descriptive and inferential statistics. The Poincaré plot method was applied in the analysis of the RT series of data, by calculating the indicators SD₁, SD₂, SD₁/SD₂, and area of the fitting ellipse (AFE) (3) Results: We provided evidence of the excellent reliability of the web-based RT serial testing (Cronbach’s Alpha 0.991) with this sample group. Our results showed that age is an important predictor for mean values of RT, while SD₁, SD₂, and AFE indicators are for SRH (p < 0.01). (4) Conclusions: the variability of RT, expressed by the Poincaré plot indicators, reflects the health status rather than the aging of the subjects and is barely influenced by their level of anxiety.

The healthy aging phenotype in older people in Manizales

Introducción.

El fenotipo de envejecimiento saludable está presente en aquellos individuos que envejecen con poca morbilidad, sin deterioro funcional ni cognitivo, y con un nivel aceptable de bienestar y de participación social.

Objetivo.

Establecer la frecuencia del fenotipo de envejecimiento saludable según un modelo multidimensional, uno biomédico y uno psicosocial, y determinar los factores de predicción en cada uno de ellos.

Materiales y métodos.

Se hizo un estudio de diseño transversal, observacional y descriptivo, que incluyó a 402 personas (50,1 % mujeres) de 65 años y más (promedio de edad, 69,2) en el área urbana de Manizales. El fenotipo de envejecimiento saludable se caracterizó en cinco dimensiones: salud metabólica y fisiológica, función física, función cognitiva, bienestar psicológico y bienestar social. Los factores asociados incluyeron aspectos sociodemográficos y de salud.

Resultados.

La prevalencia de envejecimiento saludable fue de 15,5 % en el modelo multidimensional, de 12,3 % en el biomédico y de 63,3 % en el psicosocial. El tener autopercepción de buena salud fue un factor de predicción independiente de envejecimiento saludable en los tres modelos, así como la satisfacción con los ingresos económicos en el modelo biomédico y en el psicosocial. Un tercer factor de predicción fue el estar casado, aunque fue significativo solamente en el modelo psicosocial.

Conclusiones.

La prevalencia del fenotipo de envejecimiento saludable fue baja en el modelo biológico y en el multidimensional (1 de cada 10 personas), y mayor en el modelo psicosocial (6 de cada 10). A pesar de ello, los factores predictores independientes fueron los mismos: la autopercepción de buena o muy buena salud, la satisfacción con los ingresos económicos y el estar casado.

Eating Habits in Older Adults: Compliance with the Recommended Daily Intakes and Its Relationship with Sociodemographic Characteristics, Clinical Conditions, and Lifestyles

Background: Older people have different nutritional requirements from those of the general population; in particular, they need a lower energy intake, higher protein content to preserve muscle mass, and a greater supply of vitamins and minerals to maintain good bone health. The objective of this study is to evaluate the degree of compliance with nutritional recommendations, and its relationship with sociodemographic characteristics, clinical conditions, and lifestyles in older people residing in the Spanish Mediterranean.

METHODS

Cross-sectional study with 341 people over 60 years old. Participants were selected using a snowball strategy. A validated food intake frequency questionnaire for older populations was used to determine the daily food intake. This evaluation was carried out at two time points from which the average nutrient intake was obtained. Sociodemographic, clinical, and lifestyle variables were obtained from an ad hoc elaborated questionnaire.

RESULTS

Compliance with dietary intakes was low, by deficiency, such as in vitamin D, where none of the participating subjects met the requirements, and iodine, where the compliance rate did not exceed 20%, or by excess, such as with monounsaturated fatty acids, fiber, iron, B vitamins, vitamin E, and vitamin C. People with better blood pressure, cholesterol, and glucose levels observed a higher degree of compliance with the recommended intakes. Living in rural areas, being divorced, or being illiterate negatively influence meeting the recommended intakes of certain nutrients. Increased physical activity was associated with an increased compliance with Kcal recommendations, cholesterol, and vitamin B2 intake.

CONCLUSION

this study highlights the importance of accurately knowing the dietary intakes in the older population, and what factors, such as lifestyles or sociodemographic characteristics, may predispose to better or worse compliance with the recommendations.

The association between self-compassion and self-rated health in 26 samples

Background

Although there is growing evidence of the relevance of self-compassion for understanding health outcomes, few studies have examined self-compassion in relation to self-reported physical health status, also known as self-rated health (SRH). This study addressed this gap by examining the associations between self-compassion and SRH across multiple samples and after accounting for the contributions of positive and negative affect.

Methods

Data from 26 samples (total N = 6127), comprised of 6 university student, 16 community adult, and 4 chronic illness samples, were included in the current analyses. Participants in each sample completed a survey including measures of self-compassion and SRH. Thirteen samples also completed a measure of positive and negative affect. The associations between self-compassion and SRH were statistically meta-analysed. Moderator analyses were conducted to test whether the associations varied as a function of sample type, age or participant sex. Semipartial correlations were calculated controlling for positive and negative affect in 13 samples and meta-analysed.

Results

Findings indicated that self-compassion was significantly associated with higher SRH across the 26 samples (r_avg = .25; CI: .22, .28). The associations did not however vary significantly across sample types, or as a function of participant sex or age. The meta-analyses of the adjusted effects found that self-compassion remained significantly associated with higher SRH after accounting the contributions of positive (sr_avg = .11; CI: .07, .15) and negative (sr_avg = .25; CI: .06, .15) affect.

Conclusions

The current study demonstrated that self-compassion is robustly associated with higher SRH across 26 samples and that this association remained significant after adjusting for the influence of positive and negative affect in 13 samples. Further longitudinal and experimental research is needed to verify the causal direction between self-compassion and SRH suggested by theory and the current findings.

Features and impact of missing values in the association of self-rated health with mortality in care homes: a longitudinal study

Background

Self-rated health (SRH) is a health measure used in studies of older adults. The objective of this study is to analyze SRH as a predictor of mortality in the institutionalized older population and the characteristics of those who do not provide information about their SRH on health questionnaires.

Methods

This is a 15-year follow-up study of older adult residents in nursing or care homes in of Madrid, Spain. SRH was measured on a 5-point Likert type scale. The association between answering the SRH question and socio-demographic and health characteristics was evaluated through prevalence ratio (PR), estimated by Poisson regression models. Survival rates associated with SRH were studied through a multivariate Cox regression.

Results

The sample has a mean age of 83.4 (standard deviation, SD = 7.3), with 75.7% women. Twelve percent did not answer the SRH item. Those who did not answer showed a higher probability of disability (Barthel index, PR = 0.76, 95% confidence interval = 0.67–0.86) and/or dementia (PR = 8.03, 3.38–19.03). A trend for higher mortality was observed in those persons who did not respond (adjusted hazard ratio HR = 1.26, 0.75–2.11). The mortality rate was 32% higher for those who declared poor SRH in comparison with those who reported good SRH (adjusted HR = 1.32, 1.08–1.6).

Conclusions

There is an elevated number of people who do not respond to the SRH item, mainly those with disabilities and cognitive deterioration. Lack of response to SRH is a good indicator of 15-year mortality for persons institutionalized in care or nursing homes.

[Morbidity and self-perception of health, two different approaches to health status]

OBJECTIVE

To determine the degree of association between perceived health status and that obtained from information on attended morbidity.

METHOD

The population of four health areas of the Baix Empordà region (Catalonia, Spain) (N=91,067) was studied in 2016, by means of a sample of 1202 individuals. A health survey was conducted on sample individuals. At the same time, the respondents were classified by health status through the Clinical Risk Groups system. The degree of association was analysed by logistic regression.

RESULTS

27% of patients with more than two major chronic diseases or with complex health conditions stated they were in good health. An association was detected between health perception and disease burden. Sex, work situation, social class and especially age also showed association with the perception of health.

CONCLUSIONS

The inference of health status from clinical records on attended morbidity approximates to the subjective perception of health and vice versa. However, certain sociodemographic factors modulate individual perception. The results obtained are encouraging in relation to the development of new methodologies for calculating quality of life indicators.

Is the association of weight disorders with perceived health status and life satisfaction independent of physical activity in children and adolescents? The CASPIAN-IV Study

BACKGROUND

Physical activity (PA) and weight status have been suggested as predictors of life satisfaction (LS) and perceived health status (PHS). Therefore the present study aims to investigate and compare the impacts of body mass index (BMI) and PA on LS and PHS in a population of Iranian children and adolescents.

MATERIAL AND METHODS

This study was conducted in 2011-12 as a nationwide population-based study among 14 880 students of age 6-18 years. Students were selected via a multistage cluster sampling method from 30 provinces of Iran. Information on demographics, PA, PHS and LS was obtained using the World Health Organization Global School-based Student Health Survey (WHO-GSHS) questionnaire. PA values were considered as low (<2 /week), moderate (2-4 h/week) and high (>2 h/week).

RESULTS

The current study has a participation rate of 90.6% (50.8% boys). PA was significantly associated with both LS and PHS [odds ratio (OR), 1.37 in both), while in BMI, this association was significant for only PHS (in underweight: OR, 0.65; 95% CI, 0.57-0.75; in excess weight: OR, 0.82; 95% CI, 0.73-0.93). In the combined group of BMI-PA, the influence of PA prevailed over the impact of BMI on PHS and LS, and therefore, PA was found to be the stronger factor.

CONCLUSION

Although BMI and PA could both significantly impact LS and PHS, the stronger influence of PA on LS and PHS suggests that upgrading the 'activity level' of children and adolescents should be underscored and included on the agenda, rather than merely focusing on their BMI and weight status.

Correlates of quality of life in mothers of children with diagnosed epilepsy

Contrary to a plethora of studies on the quality of life (QoL) of parents caring for children with chronic conditions, information regarding parents of children with epilepsy remains limited. The main purpose of the current study was to explore associations between children's biomedical characteristics, mothers' sociodemographic characteristics, mothers' situational factors, and QoL among mothers of children with epilepsy. One hundred and fifty mothers of children with epilepsy completed valid and reliable measures. The study was conducted at a large outpatient clinic for children with epilepsy in a central hospital in southern Israel. Sense of mastery and optimism emerged as significant predictors of all four domains of QoL; self-rated health (SRH) and mothers' socioeconomic status were significant predictors of three QoL domains; mothers' sleeping disturbances and children's behavioral problems predicted one QoL component. These results highlight the pivotal role that mastery and optimism play in securing the QoL of mothers caring for children with epilepsy. Moreover, mother's socioeconomic status and SRH should also be screened to deal with possible socioeconomic deprivation. In addition, health professionals should screen mothers and children for sleeping disturbances, and provide information about sleep hygiene. Psychosocial interventions need to be developed and offered to parents, in an attempt to address the social and behavior problems of children with epilepsy.

Socioeconomic inequalities in self-rated health: role of work-to-family conflict in married Korean working women

Little evidence exists on the role of work-to-family conflict (WFC) in explaining socioeconomic inequality in self-rated health (SRH). We examined the association between socioeconomic status (SES) and SRH and tested the mediating effect of WFC in the association between SES and SRH among married Korean working women. A cross-sectional study was conducted using data from the 2014 Korean Longitudinal Survey of Women and Family. Participants were 3,226 women. Three SES indicators were used: income as measured by income-to-needs ratio; education categorized into college vs. noncollege education levels; and occupation classified by white vs. pink/blue-collar occupations. Lower levels of all the SES indicators were significantly associated with poor SRH and higher levels of WFC. The higher levels of WFC were also significantly associated with poor SRH. In the relation between SES and SRH, WFC showed a partial mediating effect for income (z = -4.13, p < .001) and full mediating effects for education (z = -3.79, p < .001) and occupation (z = -4.59, p < .001). WFC played a mediating role in explaining socioeconomic health inequality among married Korean working women. Workplace strategies focused on alleviating the WFC levels of socioeconomically disadvantaged married women may be crucial for improving their health status.

Subjective health status of multimorbidity: verifying the mediating effects of medical and assistive devices

Background

This study aimed to verify the mediating effect of using assistive devices as a factor that alleviates the relationship between multimorbidity and subjective health status.

Methods

This study used three-year data (2011–2013) from the Korea Health Panel (KHP). The data were jointly collected by the consortium of the National Health Insurance Service and Korea Institute for Health and Social Affairs.

Results

The mediating effect of using assistive devices was verified, but the direction of the effect was deteriorated subjective health. In other words, in terms of the impact of multimorbidity on subjective health, using assistive devices had a negative impact (−) on subjective health.

Conclusions

The current assessment system for medical devices, narrow scope for choice of assistive devices, and limited scope of health insurance benefits must change to ultimately lead to a positive mediating effect on using medical devices and on subjective health satisfaction of patients with chronic diseases. A system that embraces all ages and generations must be developed. To this end, it is necessary to expand the scope of medical devices and insurance payment in long-term care insurance for elderly users, as well as the active meaning of medical devices in terms of health insurance.

Successful Aging in Colombia: The Role of Disease

Objective: This study aimed to determine the prevalence of successful aging (SA) and identify its predictive factors in a cohort of older people in the Colombian Andes Mountain. Method: Data were drawn from a prospective longitudinal study of community-dwelling elderly people in Manizales. SA encompassed indicators in four domains: physical, cognitive, emotional, and social functioning. Results: The prevalence of SA was 24.4%. The independent predictors were good and very good self-rated health, middle–high/high-income level, absence of chronic conditions, married status, high educational level, and very high spirituality. Discussion: The prevalence of SA was low: One of 10 people older than 65 years showed SA when presence of diseases was included in the criteria, compared with one of four when such an item was excluded. The identification of predictive factors allows distinguishing this population in primary care services and promoting strategies that ensure high functionality levels for as long as possible.

Economic Crisis and Amenable Mortality in Spain

Background: Both overall mortality and avoidable mortality have decreased in recent years in most European countries. It has become clear that less privileged socioeconomic groups have an increased risk of death. In 2008, most countries went into a severe economic recession, whose effects on the health of the population are still ongoing. While on the one hand, some evidence associates the economic crisis with positive health outcomes (pro-cyclical effect), on the other hand, some other evidence suggests that the economic crisis may pose serious public health problems (counter-cyclical effect), which has given rise to controversy. Objectives: To describe the evolution of overall mortality and amenable mortality in Spain between 2002⁻2007 (before the economic crisis) and 2008⁻2013 (during the economic crisis), nationally and by province, as well as to analyse trends in the risks of death and their association with indicators of the impact of the crisis. Methods: Ecological study of overall mortality and amenable mortality describing the evolution of the risks of death between 2002⁻2007 and 2008⁻2013. Age Standardised Rates were calculated, as well as their percentage change between periods. The association between percentage changes and provincial indicators of the impact of the crisis was analysed. Amenable mortality was studied both overall and categorised into five groups. Results: Amenable mortality represented 8.25% of overall mortality in 2002⁻2007, and 6.93% in 2008⁻2013. Age Standardised Rates for overall mortality and global amenable mortality generally declined, with the sharpest decline in amenable mortality. Decreases in overall mortality and amenable mortality were directly related to vulnerability indicators. The most significant decreases were registered in ischaemic heart disease, cerebrovascular disease, and other amenable causes. The relationship with vulnerability indices varied from direct (cancer) to inverse (hypertensive disease). Conclusions: Amenable mortality shows a more significant decrease than overall mortality between both study periods, albeit unevenly between provinces causes of death. Higher vulnerability indicators entail greater declines, although this trend varied for different causes. Mortality trends and their relationship with socioeconomic indicators in a situation of crisis must be conducted cautiously, taking into consideration a possible pro-cyclical effect.

Relationship between Adherence to the Mediterranean Diet and Health-Related Quality of Life and Life Satisfaction among Older Adults

OBJECTIVES

Evaluate the relationship between adherence to the Mediterranean diet and health-related quality of life and degree of life satisfaction among older adults.

DESIGN AND SETTING

Cross-sectional descriptive study.

PARTICIPANTS

A total of 351 people older than 60 years participated in the study.

MEASUREMENTS

The Mediterranean Diet Score (MDS) was calculated to assess the degree of adherence to the MD. MD adherence was related to health-related quality of life using the Short Form Healthy Survey (SF-12) questionnaire, to life satisfaction using the Satisfaction with Life Scale (SWLS), and to sociodemographic, clinical and lifestyle variables. Multiple logistic regression models were used to analyse this relationship.

RESULTS

Mediterranean diet adherence was related to health- related quality of life. Participants with better adherence to the MD were more physically active (p=0.01) and had better health-related quality of life (p<0.05) and lower consumption of alcoholic beverages (p=0.04). The age-adjusted model showed a significant association between the MD and mental function for both sexes and with physical function only for men. The fully adjusted model showed a direct relationship between the MD and life satisfaction of women (p>0.05) but not for that of men (p=0.31).

CONCLUSIONS

The adherence to the MD is directly associated with the self-perceived physical and mental function of both sexes and with the life satisfaction of women. Further studies in older adult populations should be performed to obtain conclusive results on the MD effect on health-related quality of life, including wellness indicators.

Self-rated physical fitness and estimated maximal oxygen uptake in relation to all-cause and cause-specific mortality

This study investigated the longitudinal associations of self-rated physical fitness and estimated maximal oxygen uptake (VO2max) with all-cause and cause-specific mortality. A total of 59 741 participants in the Finnish National FINRISK Study Cohort had data on self-rated physical fitness and covariates. A subsample of 4823 participants had estimated VO2max data. Follow-up ranged from 3 to 38 years. Associations of self-rated physical fitness and VO2max with mortality were analyzed using multivariate Cox proportional hazard models. The study showed that poor self-rated physical fitness was related to all-cause mortality (hazard ratio [HR] 1.9; 95% confidence interval [CI] 1.8-2.0) and mortality due to cardiovascular (HR 2.0, 95% CI 1.9-2.2), cerebrovascular (HR 1.9, 95% CI 1.6-2.2) and respiratory diseases (HR 2.1, 95% CI 1.9-2.4), trauma (HR 1.7, 95% CI 1.3-2.0), infections (HR 1.8, 95% CI 1.3-2.7), dementia (HR 1.9, 95% CI 1.6-2.3), and cancer (HR 1.7, 95% CI 1.5-1.9). Coexisting higher age, physical inactivity, male gender, and severe chronic conditions further increased the risk. In men, higher VO2max was associated with a lower risk of lung cancer mortality (HR 0.8, 95% CI 0.7-0.96). Based on the results, self-rated physical fitness reflects a combination of unfavorable biological and lifestyle-related factors, which increase mortality risk. A simple question about perceived physical fitness may reveal at-risk individuals who would benefit from more intensive treatment of chronic conditions and other interventions aiming to promote better fitness and well-being.

Oral health self-perception in quilombola communities in Rio Grande do Sul: a cross-sectional exploratory study

Objective:

There's a shortage of evidence on the oral health of quilombolas. This study aims to describe oral health self-perception, as well as to verify its associated factors in quilombola communities in the state of Rio Grande do Sul.

Methods:

The data for this cross-sectional health survey were collected by application of a questionnaire. Since this study was part of a survey on nutritional security, the probabilistic cluster sample was estimated for the outcome of nutritional insecurity, comprising 583 individuals across quilombola communities in Rio Grande do Sul. The association between the outcome of negative oral health self-perception and sociodemographic, general health, and oral health variables was measured by prevalence ratios obtained through Poisson regressions with robust variance and 95% confidence intervals.

Results:

Negative self-rated oral health was reported by 313 (53.1%) of the individuals. Satisfaction with chewing ability and satisfaction with oral appearance were associated with a higher prevalence of negative perception of oral health, while there was no association between the outcome and number of teeth. Use of alcohol had a borderline association with the outcome.

Conclusion:

Satisfaction with appearance and chewing ability are factors associated with oral-health self-perception of the quilombolas in Rio Grande do Sul.

Association of passive and active smoking with self-rated health and life satisfaction in Iranian children and adolescents: the CASPIAN IV study

OBJECTIVE

To assess the joint association of passive and active smoking with self-rated health and life satisfaction among Iranian children and adolescents.

METHODS

Using a multistage random cluster sampling method, a representative sample of 14 880 school students were selected from urban and rural areas of 30 provinces of Iran. Data were gathered using a questionnaire, a weight scale and metre. Participants were classified into four groups based on their smoking patterns: 'non-smoker', 'only active smoker', 'only passive smoker' and 'active and passive smoker'. Life satisfaction (LS) and self-rated health (SRH) were assessed by self-administered validated questionnaires based on the WHO-Global School-based student Health Survey (WHO-GSHS). Data were analysed using a t-test, χ² test and multiple logistic regression.

RESULTS

A total of 13 486 individuals (6640 girls and 6846 boys) out of 14 880 invited participated in the study (response rate 90.6%). LS and good SRH showed linearly negative associations with smoking status in both sexes. The proportions of LS and SRH categories were significantly different among all subsets of smoking status. Those classified as 'non-smokers' had the highest proportions of LS and good SRH, followed by 'only passive smokers' and 'only active smokers', while those with 'active and passive smoking' had the lowest proportions of LS and good SRH. In a multivariate model, students in the 'active and passive smoking' group had lower odds of LS (OR 0.43; 95% CI 0.32 to 0.57) and good SRH (OR 0.51; 95% CI 0.38 to 0.68) than those in the 'non-smoker' group. Students in the 'only passive smoker' group also had lower odds of LS (OR 0.75; 95% CI 0.67 to 0.83) and good SRH (OR 0.72; 95% CI 0.66 to 0.80) compared with the 'non-smoker' group.

CONCLUSIONS

Adolescents with different smoking habits and exposure patterns have poorer SRH and LS than non-smokers. Both active and passive smoking status could affect LS and SRH in adolescents. Therefore, smoking prevention strategies should be considered as a health priority in school health services for promoting psychological well-being in children and adolescents.

Joint association of screen time and physical activity on self-rated health and life satisfaction in children and adolescents: the CASPIAN-IV study

BACKGROUND

Self-rated health and life satisfaction are two subjective measures for assessing overall health status. This study aims to investigate the association of self-rated health and life satisfaction with physical activity and screen time.

METHODS

As part of the fourth survey of a national surveillance program in Iran (CASPIAN-IV study), 14 880 students aged 6 to 18 years were selected via multi-stage cluster sampling from 30 provinces. Data were obtained from the WHO Global School-Based Student Health Survey questionnaire.

RESULTS

A total of 13 486 students with mean age of 12.47 (SD 3.36) completed the study. In crude model both prolonged screen time and physical activity were associated with favorable life satisfaction and self-rated health. However, in multivariate analysis only high physical activity was associated with good self-rated health (OR 1.37) and life satisfaction (OR 1.39), while prolonged screen time was not associated with good self-rated health (OR 1.02) and life satisfaction (OR 0.94). For combined screen time-physical activity variable, low screen time-high physical activity combination had the highest OR for both good self-rated health (OR 1.37) and life satisfaction (OR 1.43) in multivariate analysis.

CONCLUSIONS

Our findings suggest that increasing physical activity is more crucial than emphasizing reducing screen time in improving the well-being of children and adolescents.

Determinants of self-rated health in an Irish deprived suburban population - a cross sectional face-to-face household survey

Background

Self-rated health (SRH) is amongst the most frequently assessed health perceptions in epidemiological research. While there is a growing understanding of the role of SRH, a paradigm model has yet to be widely accepted with recent studies concluding that further work is required in determining whether there are important predictors of SRH yet to be highlighted. The aim of this paper is to determine what health and non-health related factors were associated with SRH in a suburban deprived population in Dublin, Ireland.

Methods

A cross sectional face-to-face household survey was conducted. Sampling consisted of random cluster sampling in 13 electoral divisions, with a sampling frame of 420 houses. Demographic information relating to the primary carer was collected. Health status of the primary carer was measured through SRH. Household level data included the presence or absence of persons with a chronic disease, persons who smoked, persons with a disability and healthcare utilisation of general practitioner and hospital level services. A logistic regression model was utilised in the analysis whereby the odds of primary carers with poor SRH were compared to the odds of carers with good SRH taking health and non-health related factors into account.

Results

Of the 420 households invited to participate a total of 343 were interviewed (81.6 % response rate). Nearly half of the primary carers indicated their health as being ‘good’ (n = 158/342; 46.2 %).

Adjusting for the effects of other factors, the odds of primary carers with second level education were increased for having poor SRH in comparison to the odds of those with third level education (OR 3.96, 95 % CI (1.44, 11.63)). The odds of primary carers who were renting from the Council were increased for having poor SRH compared to the odds for those who owned their own property (OR 3.09, 95 % CI (1.31, 7.62)). The odds of primary carers that were unemployed (OR 3.91, 95 % CI 1.56, 10.25)) or retired, ill or unable to work (OR 4.06, 95 % CI (1.49, 11.61)) were higher for having poor SRH than the odds of those in employment. If any resident of the household had a chronic illness then the odds of the primary carer were increased for having poor SRH compared to the odds for a primary carer in a household where no resident had a chronic illness (OR 4.78, 95 % CI (2.09, 11.64)). If any resident of the household used the local hospital, the odds of the primary carer were increased for having poor SRH compared to the odds for the primary carer in a household where no resident used the local hospital (OR 2.01, 95 % CI (1.00, 4.14)).

Conclusions

SRH is affected by both health and non-health related factors. SRH is an easy to administer question that can identify vulnerable people who are at risk of poor health.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3442-x) contains supplementary material, which is available to authorized users.

Concordance between self-reported body mass index with weight perception, self-rated health and appearance satisfaction in people living in Tehran

BACKGROUND

Obesity is investigated as a health concern due to high prevalence in the world. Nowadays, researchers are looking for an indirect method to measure weight and height. Self-reported Body Mass Index (BMI) is ever more served as an alternative method for direct weight and height measurement. Misreporting is a usual concern in self-reported BMI, thus, this study set explored the association and degree of agreement of self-reported BMI with weight perception, Self-Rated Health (SRH), and appearance satisfaction in people living in Tehran, Iran.

METHODS

722 men and women (268 men and 454 women) aged 30-64 years were selected using Cluster Multi-stage Sampling with the Probability Proportional to Size (PPS) method from each area. The questionnaire included demographic and socioeconomic variables and self-reported weight and height and questions related to weight and health perception, and appearance satisfaction. Independent samples T-test compared the mean of scales and differences in characteristics between BMI categories, analyzed using chi-square test. The Cohen's kappa coefficient examined the association between self-reported BMI and weight perception, SRH, and appearance satisfaction.

RESULTS

The mean self-reported weight was 80.79 ± 12.87 in men and 68.33 ± 11.53 in women. The results of the agreement analysis for weight perception were Kappa = 0.38 with p < 0.0001 for women and Kappa = 0.23 with p <0.0001 for men. This measure of agreement, while statistically significant, is fair agreement. SRH and appearance satisfaction were not significantly correlated with self-reported BMI.

CONCLUSION

The measurements of height and weight can cause significant imprecisions in calculation of BMI, which is used as a guide for identifying persons at risk of disease. Direct measurement of height and weight should be performed whenever possible for optimal measurements in clinical practice and clinically oriented researches.

The joint association of self-rated health and diabetes status on 14-year mortality in elderly men and women

PURPOSE

Low self-rated health (SRH) has been found to be associated with increased risk of type 2 diabetes (T2D) and with mortality. We examined the possible interaction between SRH and diabetic state on all-cause mortality in a large cohort of elderly subjects, followed for 14 years.

METHODS

During the years 2000-2004, survivors of the nationwide longitudinal Israel Study of Glucose Intolerance, Obesity and Hypertension were interviewed and examined for the third follow-up. The 1037 participants (mean age 72.4 ± 7.2 years) were asked to rate their health as: excellent, good, fair, poor, or very poor. Glucose categories were as follows: Normoglycemic, Prediabetes, T2D and Undiagnosed diabetes. Survival time was defined as the time from interview to date of death or date of last vital status follow-up (August 1, 2013). Multivariate Cox proportional hazards models were performed in order to assess whether SRH interacts with glycemic state in the association with mortality.

RESULTS

A better SRH was reported by those with undiagnosed than known diabetes, and best for normoglycemic and prediabetic individuals. While all individuals with fair or poor/very poor SRH were at increased risk of mortality compared to those with excellent/good SRH, in the known diabetic individuals a greater hazard was observed in the excellent/good SRH (HR 3.32, 95 % CI 1.71-6.47) than in those with fair or poor/very poor SRH (HR 2.19, 95 % CI 1.25-3.86), after adjusting for age, sex, ethnic origin, marital status, education, BMI, physical activity, CVD, tumors, and creatinine level (p for interaction = 0.01).

CONCLUSIONS

Self-rated health is not a sensitive tool for predicting mortality in elderly men and women with known T2D.

Trends in health indicators in the urban middle-aged population in the Czech Republic in 1998-2010

OBJECTIVES

To track the trends in general health indicators and the prevalence of cardiovascular diseases (CVD), high blood pressure and elevated blood cholesterol in the middle-aged urban population in the Czech Republic in 1998-2010.

STUDY DESIGN

Cross-sectional study.

METHODS

The following data from the three-phase HELEN (HEalth - Lifestyle - ENvironment) study, a prevalence questionnaire survey, were analysed: data collected from 8214 subjects in phase I, 6107 subjects in phase II, and 4389 subjects in phase III. The study subjects were aged 45-54 years and the study period spanned from 1998 to 2010. The differences in the indicators between phases were evaluated by binary and ordinal logistic regression models at a significance level of 0.01.

RESULTS

Over the study period, a significant increase was observed in the proportion of respondents who self-rated their health as very good or good: from 46.6% to 51.0% in males (P = 0.006) and from 45.5% to 49.9% in females (P < 0.001). At the same time, the rates of respondents under long-term medical follow-up rose significantly from 36.3% to 44.3% (P < 0.001) and from 46.4% to 56.2% (P < 0.001), respectively. CVD prevalence did not change although the percentage of males and females with high blood pressure (from 29.3% to 36.6% and from 26.0% to 31.2%, respectively) and elevated total cholesterol (from 29.0% to 36.6% and from 27.3% to 32.4%, respectively) increased significantly.

CONCLUSIONS

Self-rated health among the middle-aged population in the Czech Republic improved during the 1998-2010 period, but, at the same time, more people needed to be followed up for a disease. The proportions of respondents with hypertension and elevated blood cholesterol increased while the CVD rates did not vary significantly.

Gender gap in self-rated health in South Korea compared with the United States

Addressing the gender gap issue is a key to the reduction of the health gap between and within nations. This study aimed to describe gender differences in SRH of populations in South Korea and the United States (U.S.). Data on 33,240 eligible participants from the KNHNES and 39,646 participants from the NHNES was included in the study. Multiple logistic regression analysis was performed to identify gender differences in SRH. SRH was rated as poor in 18.8% and 16.3% of the participants in South Korea and in the U.S. The results of this study indicated that South Korean women had a higher risk of poor SRH, differed from women in the U.S. The 20-39 age group had a higher risk for poor SRH in both South Korea and the U.S. It suggested that South Korea's traditional gender roles negatively affect women. Thus, the welfare of South Korean should be improved to reduce these between-country health gaps by applying health-related laws to differentiation of beneficiaries' gender and age group.

Self-rated health and hospital services use in the Spanish National Health System: a longitudinal study

Background

Self-rated health is a subjective measure that has been related to indicators such as mortality, morbidity, functional capacity, and the use of health services. In Spain, there are few longitudinal studies associating self-rated health with hospital services use. The purpose of this study is to analyze the association between self-rated health and socioeconomic, demographic, and health variables, and the use of hospital services among the general population in the Region of Valencia, Spain.

Methods

Longitudinal study of 5,275 adults who were included in the 2005 Region of Valencia Health Survey and linked to the Minimum Hospital Data Set between 2006 and 2009. Logistic regression models were used to calculate the odds ratios between use of hospital services and self-rated health, sex, age, educational level, employment status, income, country of birth, chronic conditions, disability and previous use of hospital services.

Results

By the end of a 4-year follow-up period, 1,184 participants (22.4 %) had used hospital services. Use of hospital services was associated with poor self-rated health among both men and women. In men, it was also associated with unemployment, low income, and the presence of a chronic disease. In women, it was associated with low educational level, the presence of a disability, previous hospital services use, and the presence of chronic disease. Interactions were detected between self-rated health and chronic disease in men and between self-rated health and educational level in women.

Conclusions

Self-rated health acts as a predictor of hospital services use. Various health and socioeconomic variables provide additional predictive capacity. Interactions were detected between self-rated health and other variables that may reflect different complex predictive models, by gender.

Self-Rated Health and Associated Factors in Older Turkish Adults With Type 2 Diabetes: A Pilot Study

PURPOSE

To evaluate self-rated health (SRH) and determine its associations with participant characteristics, glycemic control, family support, and health-related quality of life in older Turkish adults with type 2 diabetes.

METHOD

This cross-sectional study included 113 adults aged 60 years or older with type 2 diabetes. Data were collected by using an information form, the Perceived Social Support From Family Scale, and the Nottingham Health Profile. SRH was assessed by a single-item question. Glycemic control was measured by glycosylated hemoglobin levels.

RESULTS

Ninety-seven patients (85.8%) evaluated their health as fair or poor. The glycemic target level (glycosylated hemoglobin <7.5%) was achieved in 47.8% of the patients. Female gender, a low or moderate family income, and lower levels of family support were associated with poorer SRH.

CONCLUSIONS/IMPLICATIONS

The majority of the participants considered their health to be fair or poor. Better understanding of risk factors associated with SRH may provide more effective interventions to improve health outcomes.

Associations of a Short Sleep Duration, Insufficient Sleep, and Insomnia with Self-Rated Health among Nurses

Epidemiological evidence suggests that sleep duration and poor sleep are associated with mortality, as well as with a wide range of negative health outcomes. However, few studies have examined the association between sleep and self-rated health, particularly through the combination of sleep complaints. The objective of this study was to examine whether self-rated health is associated with sleep complaints, considering the combination of sleep duration, insomnia, and sleep sufficiency. This cross-sectional study was performed in the 18 largest public hospitals in the city of Rio de Janeiro, Brazil. A total of 2518 female nurses answered a self-filled multidimensional questionnaire. The adjusted odds ratios and 95% confidence intervals (CIs) estimated the chance of poor self-rated health in the presence of different combinations of sleep duration and quality. Compared with women who reported adequate sleep duration with no sleep quality complaints (reference group), the odds ratios (95% CI) for poor self-rated health were 1.79 (1.27–2.24) for those who reported only insufficient sleep, 1.85 (0.94–3.66) for only a short sleep duration, and 3.12 (1.94–5.01) for only insomnia. Compared with those who expressed all three complaints (short sleep duration, insomnia, and insufficient sleep), the odds ratio for poor self-rated health was 4.49 (3.25–6.22). Differences in the magnitude of the associations were observed, depending on the combination of sleep complaints. Because self-rated health is a consistent predictor of morbidity, these results reinforce the increasing awareness of the role of sleep in health and disease. Our findings contribute to the recognition of sleep as a public health matter that deserves to be better understood and addressed by policymakers.

Who Looks Forward to Better Health? Personality Factors and Future Self-Rated Health in the Context of Chronic Illness

BACKGROUND

Self-rated health (SRH) is an important predictor of objective health-related outcomes that, according to the Cognitive Process Model of SRH, is influenced by contextual factors (symptoms and personality). Although research indicates that personality contours SRH, less attention has been given to understanding the contributions of personality to future self-rated health (FSRH) or the contextual factors that play a role in shaping these effects.

PURPOSE

The aim of the present study was to extend the theory and research on FSRH by exploring the contributions of personality, current SRH, and fatigue to FSRH in the context of chronic illness, and to test the potential mediating role of optimism for explaining these effects.

METHOD

Two chronic illness samples (arthritis, N = 365, and inflammatory bowel disease, IBD; N = 290) completed identical surveys. A hierarchical regression model with age, education, and current health, and fatigue entered in the first two steps and traits entered in the last step, tested the effects of personality on FSRH. Mediation analyses controlling for contextual variables tested the explanatory role of optimism.

RESULTS

Fatigue was a significant contributor to FSRH accounting for 11 % of the variance in the arthritis sample and 17 % in the IBD sample over the demographic variables. Both Agreeableness and Neuroticism accounted for additional significant but modest variance in FSRH (4 %); Agreeableness was associated with higher FSRH, whereas Neuroticism was associated with lower FSRH. For both traits, optimism fully explained the associations with FSRH.

CONCLUSION

After accounting for the influence of fatigue and other variables, the contributions of high Agreeableness and low Neuroticism to FSRH are modest in the context of chronic illness, and these associations may be explained by optimism.

What does Self Rated Mental Health Represent

BACKGROUND

Unlike the widely used self rated health, the self rated mental health was found unsuitable as a proxy for mental illness. This paper analyses the relationships between the self ratings of physical health, mental health and overall health, and their association of with the objective indicators for physical and mental health.

DESIGN AND METHODS

The study is a secondary analysis of data from a nationwide representative sample of the non-institutionalized adult residents of Israel in 2003 that was collected via computer-assisted personal interview methods [n=4859].

RESULTS

The self rated physical health and the self rated mental health were strongly related to each other yet the self rated mental health was not related to chronic physical conditions and the self rated physical health was not related to mental disorders. In a multiple logistic regression analysis, those with positive self rated mental health had 93 times the odds of reporting positive overall health whereas those with positive self rated physical health had 40 times the odds of reporting positive overall health.

CONCLUSIONS

The self rating of mental health presents a qualitatively different dimension from mental illness. The self rated mental health is two times more important than the self rated physical health in predicting the self rated overall health Significance for public healthThe present study is an original study on the self rated physical, mental and overall health measures. Because of the wide range of associations with other health indicators, and the simplicity with which they are collected, self-rated health measures are widely used in large population surveys.The present study questions the automatic assumption that the self rated mental health functions as a proxy measure of psychiatric morbidity, and suggests that the self rated mental health is more closely related to subjective well-being. The results show that self rated mental health predicts self rated general health better than self rated physical health.