Determinants of Self-Rated Health and Self-Rated Physical Fitness in Middle and Old Age

Poor Self-Rated Health and Associated Factors among Older Persons in Malaysia: A Population-Based Study

OBJECTIVE

This study aims to determine the prevalence of poor self-rated health (SRH) in Malaysia and its association with sociodemographic characteristics, lifestyle behavior, chronic diseases, depression, and functional limitations in activities of daily living (ADLs) among older persons.

DESIGN

Cross-sectional. Setting, participants, and outcome measures: We used data from the National Health and Morbidity Survey 2018, a nationwide community-based study. This study was conducted using a two-stage stratified cluster sampling design. Older persons were defined as persons aged 60 years and above. SRH was assessed using the question "How do you rate your general health?" and the answers were "very good", "good", "moderate", "not good", and "very bad". SRH was then grouped into two categories; "Good" (very good and good) and "Poor" (moderate, not good, and very bad). Descriptive and logistic regression analyses were conducted using SPSS version 25.0.

RESULTS

The prevalence of poor SRH among older persons was 32.6%. Poor SRH was significantly related to physical inactivity, depression, and limitations in activities of daily living (ADLs). Multiple logistic regression revealed that poor SRH was positively associated with those who had depression (aOR 2.92, 95% CI:2.01,4.24), limitations in ADLs (aOR 1.82, 95% CI: 1.31, 2.54), low individual income (aOR 1.66, 95% CI:1.22, 2.26), physical inactivity (aOR 1.40, 95% CI:1.08, 1.82), and hypertension (aOR 1.23, 95% CI:1.02, 1.49).

CONCLUSIONS

Older persons with depression, limitations in ADLs, low income, physical inactivity, and hypertension were significantly associated with poor SRH. These findings provide information to aid health personnel and policymakers in the development and implementation of health promotion and disease prevention programs, as well as adequate evidence in planning different levels of care for the older population.

Daily moderate-intensity physical activities and optimism promote healthy ageing in rural northern Sweden: a cross-sectional study

The aim of our study was to explore the association between self-reported health factors and self-rated health (SRH) among an older rural population in northern Sweden and whether confounders optimistic outlook or daily moderate-intensity physical activity could moderate the association between self-reported health factors and SRH, controlling for age. The study is based on a sample (N = 1946) from the “Health on Equal Terms” Västernorrland survey 2018 aged 65–84. Prevalence and multivariate logistic regression analyses were performed. The results indicated most rural older people perceived very good or good SRH, though physical and mental health issues and impaired mobility increased with advanced age. Mental well-being exhibited a stronger association with poor SRH than physical health or impaired mobility. In addition, confounders optimistic outlook and daily moderate-intensity physical activity, separately and together could moderate the association between health factors and poor SRH. In conclusion, older people in a rural setting perceived good health, despite common physical and mental health issues. Promoting daily moderate-intensity physical activity and activities contributing to an optimistic outlook can protect against poor SRH in old age.

The Effects of Hopelessness on Chronic Disease Among African Americans and Caribbean Blacks: Findings from the National Survey of American Life (NSAL)

This paper examines the relationship between hopelessness on chronic disease in a national sample of African Americans (3570) and Caribbean Blacks (1438) Using the National Survey of American Life. A multivariate negative binomial regression examined whether chronic disease is associated with hopelessness, controlling for sociodemographic characteristics. Overall, 13.14% of the sample reported they were highly hopeless, and 31.5% indicated they were moderately hopeless. About 19% of respondents experienced chronic disease. Bivariate associations showed that those who have ever had chronic disease significantly differed from those who did not in regard to age, gender and spirituality. Multivariate results showed that respondents who ever have had chronic disease reported significantly higher hopelessness scores than those with no chronic disease. The study findings contribute to the current body of literature by supporting findings from smaller studies on the relationship between depression and hopelessness in African Americans and Caribbean Blacks.

How do combinations of unhealthy behaviors relate to attitudinal factors and subjective health among the adult population in the Netherlands?

Background

Health behaviours like smoking, nutrition, alcohol consumption and physical activity (SNAP) are often studied separately, while combinations can be particularly harmful. This study aims to contribute to a better understanding of lifestyle choices by studying the prevalence of (combinations of) unhealthy SNAP behaviours in relation to attitudinal factors (time orientation, risk attitude) and subjective health (self-rated health, life expectancy) among the adult Dutch population.

Methods

In total 1006 respondents, representative of the Dutch adult population (18–75 years) in terms of sex, age, and education, were drawn from a panel in 2016. They completed an online questionnaire. Groups comparisons and logistic regression analyses (crude and adjusted) were applied to analyse (combinations of) SNAP behaviours in relation to time orientation (using the Consideration of Future Consequences scale comprising Immediate (CFC-I) and Future (CFC-F) scales) and risk attitude (Health-Risk Attitude Scale; HRAS-6), as well as subjective health (visual analogue scale and subjective life expectancy).

Results

In the analyses, 989 respondents (51% men, average 52 years, 22% low, 48% middle, and 30% high educated) were included. About 8% of respondents engaged in four unhealthy SNAP behaviours and 18% in none. Self-rated health varied from 5.5 to 7.6 in these groups, whilst subjective life expectancy ranged between 73.7 and 85.5 years. Logistic regression analyses, adjusted for socio-demographic variables, showed that smoking, excessive drinking and combining two or more unhealthy SNAP behaviours were significantly associated with CFC-I scores, which increased the odds by 30%, 18% and 19%, respectively. Only physical inactivity was significantly associated with CFC-F scores, which increased the odds by 20%. Three out of the four SNAP behaviours were significantly associated with HRAS-6, which increased the odds between 6% and 12%. An unhealthy diet, excessive drinking, and physical inactivity were significantly associated with SRH, which decreased the odds by 11%. Only smoking was significantly associated with subjective life expectancy, which decreased the odds by 3%.

Conclusion

Our findings suggest that attitudinal factors and subjective health are relevant in the context of understanding unhealthy SNAP behaviours and their clustering. This emphasizes the relevance of a holistic approach to health prevention rather than focusing on a single unhealthy SNAP behaviour.

Determinants of self-rated health among shanghai elders: a cross-sectional study

BACKGROUND

As the most populous nation in the world, China has now becoming an emerging ageing society. Shanghai is the first city facing the challenge of ageing demographics. Against this background, a study that employs self-rated health (SRH) assessment system was designed to explore the health status of Shanghai elders, and learn their attitudes toward health issues; as well as to investigate the determinants of SRH among Shanghai elders. Understanding SRH is crucial for finding appropriate solutions that could effectively tackle the increasing eldercare demand.

METHODS

This study adopted a quantitative research strategy. Using a multistage stratified cluster sampling method, we conducted a questionnaire survey in August 2011 in Shanghai, which collected 2001 valid survey responses. SRH assessments were categorized by five levels: very good, fairly good, average, fairly poor, or poor. The respondents' functional status was evaluated using the Barthel index of activities for daily living. In the data analysis, we used chi-squared test to determine differences in socio-demographic characteristics among various groups. Along with statistics, several logistic regression models were designed to determine the associations between internal influence factors and SRH.

RESULTS

Younger age (χ2 = 27.5, p < 0.05), male sex (χ2 = 11.5, p < 0.1), and living in the suburbs (χ2 = 55.1, p < 0.05) were associated with better SRH scores. Higher SRH scores were also linked with health behaviour of the respondents; namely, do not smoke (χ2 = 18.0, p < 0.1), do not drink (χ2 = 18.6, p < 0.1), or engage in regular outdoor activities (χ2 = 69.3, p < 0.05). The respondents with better social support report higher SRH scores than those without. Respondents' ability to hear (χ2 = 38.7, p < 0.05), speak (χ2 = 16.1, p < 0.05) and see (χ2 = 78.3, p < 0.05) impacted their SRH scores as well. Meanwhile, chronic illness except asthma was a major influence factor in low SRH score. Applying multiple regression models, a series of determinants were analysed to establish the extent to which they contribute to SRH. The impact of these variables on SRH scores were 6.6% from socio-demographic and health risk behaviours, 2.4% from social support, 8.5% from mental health, 20% from physical conditions, and13% from chronic diseases.

CONCLUSIONS

This is the first study that examines the determinants of SRH among Shanghai elders. Nearly 40% of our study's respondents reported their health status as "good". The main determinants of SRH among elders include living condition, health risk behaviour, social support, health status, and the economic status of the neighbourhood.