Focusing neighborhood context and self-rated health in the Pró-Saúde Study

Built environment and its association with self-rated health in Brazilian elderly: National Health Survey 2013

The present study aims to investigate the association between the built environment and positive self-rated health among older adults from Brazilian capitals. It is a cross-sectional population-based study, which collected data from the National Health Survey 2013 and the Observatório das Metrópoles. The outcome was a positive self-rated health. The built environment was investigated by the Urban Wellbeing Index (IBEU, in Portuguese). Analyses were performed by multilevel logistic regression (95%CI). Among the 4,643 elderly individuals evaluated in this study, 51.5% reported a positive self-rated health (95%CI: 50.0-52.9). Elderly people living in capitals with higher IBEU terciles were more likely to have a positive self-rated health (OR: 1.42; 95%CI: 1.08-1.86 (T2); OR: 1.78; 95%CI: 1.35-2.33 (T3)). As for the dimensions of the IBEU, the following were associated with the outcome: urban infrastructure (OR: 1.56; 95%CI: 1.13-2.16), urban environmental conditions (OR: 1.49; 95%CI: 1.10-2.04), urban housing conditions (OR: 1.45; 95%CI: 1.05-1.99), and urban collective services (OR: 1.72; 95%CI: 1.30-2.27). A positive association was found between better conditions of the built environment and one's perception of health, regardless of individual characteristics. Promoting changes in the built environment can be effective in improving health levels, thus favoring healthy aging.

Social environment characteristics are related to self-rated health in four Latin America countries: Evidence from the SALURBAL Project

We investigated the associations of social and built environment and demographic features of urban areas with self-rated health among adults living in four Latin American countries. We estimated multilevel models with harmonized data from 69,840 adults, nested in 262 sub-cities and 112 cities, obtained from the Salud Urbana en América Latina project. Poor self-rated health was inversely associated with services provision score at the sub-city-level and with social environment index at the city-level. We did not identify associations of built environment and demographic features with self-rated health. Approaches and policies to improve health in Latin American should be urban context-sensitive.

Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) participant's profile regarding self-rated health: a multiple correspondence analysis

BACKGROUND

Self-rated health (SRH) - one of the most common health indicators used to verify health conditions - can be influenced by several types of socioeconomic conditions, thereby reflecting health inequalities. This study aimed to evaluate the participant profiles regarding the association between self-rated health and social and occupational characteristics of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

METHODS

Cross-sectional design, including 11,305 individuals. Self-rated health was categorized as good, fair, and poor. The relationship between socio-demographic, psychosocial work environment, health-related variables, and self-rated health was analyzed by multiple correspondence analysis (stratified by age: up to 49 years old and 50 years old or more).

RESULTS

For both age strata, group composition was influenced by socioeconomic conditions. Poor SRH was related to lower socioeconomic conditions, being women, black self-declared race/ethnicity, being non-married/non-united, low decision authority, low skill discretion, and obesity.

CONCLUSION

To promote health, interventions should focus on reducing existing socioeconomic, race, and gender inequalities in Brazil.

Physical Disorders and Poor Self-Rated Health in Adults Living in Four Latin American Cities: A Multilevel Approach

Considering that urban environments may affect self-rated health through behavioral and psychosocial mechanisms, the aim of this study was to investigate the association between self-rated health and perceived urban environment characteristics among adults living in four Latin American cities. Data is from a population-based survey by Development Bank of Latin America, encompassing adults between 20 and 60 years old in Buenos Aires, Lima, Mexico City, and Panama City. Self-rated health was measured using a single question and the response options were categorized as poor and good. The explanatory variables were empirical Bayes estimates of self-reported area physical disorder, social disorder, access to services, and access to leisure spaces derived from the survey. The covariates were: individual age, sex, education, wealth index, and length of residency in the neighborhood; and an area social environment index. Multilevel logistic regressions with two levels (individual and sub-city areas) were fitted. Poor self-rated health was reported by 34.73% (95% CI: 33.17 to 36.29) of the participants and was associated with physical disorder (OR = 1.16 per SD; 95% CI: 1.02 to 1.32). Our findings suggest that public policies to promote population health should consider area urban environment factors, especially those associated with disorder.

The neighborhood effect of cognitive function on self-rated health: A population-based observational study

This study investigates the interaction between the neighborhood effect of cognitive function on self-rated health among middle aged and older adults. Data from the Korean Longitudinal Study on Aging (KLoSA) were analyzed. A total of 9,998 participants were selected for biennial follow-ups from 2006 to 2018 to estimate the probability of change in cognitive function according to individual, regional and dependent variables. A generalized estimating equation (GEE) model and chi-square test were used. The odds ratio (OR) of underestimation, when an individual's cognitive function is lower than his/her regional average of cognitive function, was 1.173 times higher (95 % Confidence Interval [CI]: 1.108-1.241, p-value: <.0001) compared to accurate, when an individual's cognitive function is equal to his/her regional average of cognitive function. The OR of individuals with low cognitive function in regions with low cognitive function levels had the highest probability of poor SRH (self-rated health) (OR: 3.525; 95 % CI: 3.182-3.905, p-value: <.0001) compared to individuals with high cognitive function in regions with high cognitive function levels. Findings speak of the importance of the neighborhood effect of cognitive function on self-rated health among Korean middle aged and older adults. Further research is needed to investigate the potential mediation of pleasurable mechanisms in the rapidly aging population of Korea.