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Brückner RM, Schönenberg A, Wientzek R, Schreiber M, Prell T. Exploring factors associated with self-rated health in individuals with diabetes and its impact on quality of life: Evidence from the Survey of Health, Ageing, and Retirement in Europe. J Diabetes 2024; 16:e13522. [PMID: 38168898 DOI: 10.1111/1753-0407.13522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/13/2023] [Accepted: 12/03/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Self-rated health (SRH), a measure of self-reported general health, is a robust predictor of morbidity and mortality in various populations, including people with diabetes. Diabetes is negatively associated with SRH and quality of life (QoL). Little is known about how people with diabetes rate their health and which aspects influence the rating. Also, the predictive value of SRH on future QoL has not yet been evaluated. METHODS We analyzed data from 46 592 participants of the Survey of Health, Ageing and Retirement in Europe (SHARE). Using linear regression, we aimed to determine which sociodemographic, socioeconomic, medical, social, mental, and health behavior factors determine SRH in people with diabetes. In addition, we analyzed the predictive value of SRH on future QoL using the generalized estimating equations procedure. RESULTS We determined that country, current job situation, hospitalization, pain, polypharmacy, memory, eyesight, activities of daily living, number of chronic diseases, and depression are all linked to SRH. Together these variables explained 38% of the SRH's variance, whereas depression, pain, and memory had the greatest influence on SRH of people with diabetes. We also found that SRH independently predicted future QoL, supported by a regression coefficient of β = -1.261 (Wald chi-square test, χ2 = 22.097, df = 1, p < .05). CONCLUSIONS As SRH is linked to future QoL, we conclude that incorporating SRH assessment into medical evaluations can help health care professionals gaining a more comprehensive understanding of an individual's health trajectory and supporting patients to enhance their QoL.
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Affiliation(s)
| | | | - Rebecca Wientzek
- Department of Geriatrics, Halle University Hospital, Halle, Germany
| | - Mandy Schreiber
- Department of Internal Medicine II, Halle University Hospital, Halle, Germany
| | - Tino Prell
- Department of Geriatrics, Halle University Hospital, Halle, Germany
- Department of Neurology, Jena University Hospital, Jena, Germany
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Groves J, Wilcox V. The impact of overweight and obesity on unemployment duration among young American workers. ECONOMICS AND HUMAN BIOLOGY 2023; 51:101280. [PMID: 37542787 DOI: 10.1016/j.ehb.2023.101280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 08/07/2023]
Abstract
Obesity has a profound effect on the working careers of Americans. Prior studies pertaining to workers in other countries report that obese women experienced longer spells of unemployment than normal weight peers. However, the effect of obesity on unemployment duration has not been studied for American workers. To address this gap in the literature, we report estimates of the effects of overweight and obesity from a proportional hazards model of unemployment duration that controls for unobserved individual characteristics. Using a data sample of young workers drawn from the National Longitudinal Survey of Youth (1997), our findings indicate that, on average, overweight and obese job seekers experienced significantly longer spells of unemployment. The effects differed by race, sex, and ethnicity: Overweight and obese White and Black women experienced significantly longer spells than White women with normal body mass index (BMI) levels. Although overweight White and Black men had longer unemployment spells compared to White men with normal BMI levels, the magnitudes were smaller than those for White and Black women. In contrast, overweight Hispanic women had shorter duration of unemployment spells compared to White women with normal BMI levels.
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Affiliation(s)
- Jeremy Groves
- Department of Economics, Northern Illinois University, 1425 West Lincoln Hwy, DeKalb, IL 60115, USA
| | - Virginia Wilcox
- Department of Economics, Northern Illinois University, 1425 West Lincoln Hwy, DeKalb, IL 60115, USA.
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Coustaury C, Jeannot E, Moreau A, Nietge C, Maharani A, Richards L, Präg P. Subjective socioeconomic status and self-rated health in the English Longitudinal Study of Aging: A fixed-effects analysis. Soc Sci Med 2023; 336:116235. [PMID: 37757700 DOI: 10.1016/j.socscimed.2023.116235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/02/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023]
Abstract
Higher subjective socio-economic status (SES) goes along with better self-rated health: This finding is well-established in the literature, yet the majority of studies it is based on only rely on cross-sectional analyses and only account for few potential confounders of the association. Particularly wealth, which is increasingly thought of as an important dimension of accumulated advantage, is only rarely examined as a confounder. Using eight waves of panel data from the English Longitudinal Study of Aging (ELSA, 2002-19), we investigate the association between subjective SES and self-rated health. We use random effects models that account for theoretically important time-constant (such as education and social class) and time-varying confounders (such as income and wealth) as well as fixed-effects models, that in addition control for all time-constant confounders, whether observed or unobserved. The fully adjusted fixed-effects model reveals a statistically significant association between subjective SES and self-rated health. Yet, a one-point increase on the subjective SES ladder goes along with a two per cent of a standard deviation increase in self-rated health, only around a quarter of the size of the random-effects estimate. The role of wealth for the subjective SES-self-rated health association is negligible in the fixed-effects specifications. Smoking, drinking, and physical activity do not appear to mediate the association. A substantial part, though not all, of the observed association between subjective SES and self-rated health is due to unobserved confounding rather than a causal effect. Reducing health inequalities based on objective SES is likely more effective than based on subjective SES.
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Affiliation(s)
- Camille Coustaury
- École Nationale de la Statistique et de l'Administration Économique (ENSAE), Institut Polytechnique de Paris, 5 avenue Le Chatelier, 91764, Palaiseau, France.
| | - Elias Jeannot
- École Nationale de la Statistique et de l'Administration Économique (ENSAE), Institut Polytechnique de Paris, 5 avenue Le Chatelier, 91764, Palaiseau, France.
| | - Adele Moreau
- École Nationale de la Statistique et de l'Administration Économique (ENSAE), Institut Polytechnique de Paris, 5 avenue Le Chatelier, 91764, Palaiseau, France.
| | - Clotilde Nietge
- École Nationale de la Statistique et de l'Administration Économique (ENSAE), Institut Polytechnique de Paris, 5 avenue Le Chatelier, 91764, Palaiseau, France.
| | - Asri Maharani
- University of Manchester, 176 Oxford Road, Manchester, M13 9PY, United Kingdom.
| | - Lindsay Richards
- University of Oxford, 42-3 Park End Street, Oxford, OX1 1JD, United Kingdom.
| | - Patrick Präg
- Center for Research in Economics and Statistics (CREST), École Nationale de la Statistique et de l'Administration Économique (ENSAE), Institut Polytechnique de Paris, 5 avenue Le Chatelier, 91764, Palaiseau, France.
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Kang W. Diabetes Moderates the Link between Personality Traits and Self-Rated Health (SRH). Healthcare (Basel) 2023; 11:2149. [PMID: 37570389 PMCID: PMC10418877 DOI: 10.3390/healthcare11152149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/15/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVES The primary objective of this study is to explore the relationship between personality traits and self-rated health (SRH) in individuals with diabetes, while also comparing these associations with a group of healthy controls. METHODS The data for this study were obtained from the UK Household Longitudinal Study (UKHLS), comprising a sample of 1860 diabetes patients and 12,915 healthy controls who were matched in terms of age and sex. Hierarchical linear regression was utilized to analyze the data. The analysis included demographic variables such as age, sex, monthly income, highest educational qualification, marital status, and psychological distress assessed through the GHQ-12, personality traits, including Neuroticism, Agreeableness, Openness, Conscientiousness, and Extraversion, and diabetes status (0 for diabetes patients, 1 for healthy controls) as predictors. Interactions between personality traits and diabetes status were also included as predictors, with SRH serving as the dependent variable. Additionally, separate multiple regression analyses were conducted for diabetes patients and healthy controls, incorporating demographic variables, psychological distress, and personality traits as predictors, while SRH remained the dependent variable. RESULTS The findings of this study indicate that diabetes significantly moderates the association between Neuroticism and SRH. Specifically, both Neuroticism and Extraversion were negatively associated with SRH, whereas Openness and Conscientiousness exhibited a positive association with SRH in healthy controls. However, among diabetes patients, only Conscientiousness showed a positive association with SRH. CONCLUSION Personality traits predict SRH in people with and without diabetes differently. Healthcare professionals and clinicians should try to come up with ways that improve SRH and thus better outcomes in diabetes patients based on the findings from the current study.
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Affiliation(s)
- Weixi Kang
- Department of Brain Sciences, Imperial College London, London W12 0BZ, UK
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Louis MH, Berquin A, Steyaert A. Do lifestyle factors influence pain prognosis? A 1-year follow-up study. Br J Pain 2023; 17:293-305. [PMID: 37342394 PMCID: PMC10278450 DOI: 10.1177/20494637231152975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
Objective The aim of this observational longitudinal study was to investigate the impact of lifestyle factors on the prognosis of patients with pain. Methods This study was part of a large prospective longitudinal study conducted in general practice (GP). Participants completed questionnaires at baseline (T0) and one year later (T1). Outcomes analysed were the EQ-5D index, presence of pain and the ability to perform a light work for 1 hour without difficulty. Results Among 377 individuals with pain at T0, 294 still reported pain at T1. This subgroup had a significantly higher BMI, more painful sites, higher pain intensity, more sleep problems, poorer general self-rated health (GSRH) and higher Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) score at T0 than pain-free individuals at T1. There were no differences in age, sex, physical activity and smoking. In multivariable analyses, the number of painful sites, GSRH, sleep problems, pain duration, pain intensity and 2 short-form 10-item Örebro musculoskeletal pain questionnaire (SF-ÖMPSQ) items were independently associated with at least one outcome 1 year later. Only GSRH was strongly associated with all outcomes. The accuracy of GSRH at T0 to classify participants according to dichotomous outcomes was overall moderate (0.7 < AUC <0.8). Conclusions Lifestyle factors appear to have little influence on the outcome of patients with pain in GP. Conversely, poorer GSRH - which probably integrates the subjects' perception of several factors - could be considered a negative prognostic factor in patients with pain.
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Affiliation(s)
- Marc-Henri Louis
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Anne Berquin
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- Department of Physical and Rehabilitation Medicine, Cliniques Universitaires UCL Saint-Luc, Brussels, Belgium
| | - Arnaud Steyaert
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- Department of Anaesthesiology, Cliniques Universitaires UCL Saint-Luc, Brussels, Belgium
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Kang W, Malvaso A. People with Diabetes Have Poorer Self-Rated Health (SRH) and Diabetes Moderates the Association between Age and SRH. Diseases 2023; 11:diseases11020073. [PMID: 37218886 DOI: 10.3390/diseases11020073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/24/2023] Open
Abstract
Diabetes is a severe chronic condition that is related to decreased physical functioning. Recently, there has been growing interest in understanding how a brief report on health such as self-rated health (SRH) could be used to track changes in health status and service needs in people with diabetes. The current research aims to investigate how SRH is affected by diabetes and how diabetes could moderate the association between age and SRH. By analyzing data from 47,507 participants, with 2869 of them clinically diagnosed with diabetes, the current study found that people with diabetes had significantly poorer SRH than people without diabetes after controlling for demographic covariates (t(2868) = -45.73, p < 0.001, 95% C.I. (-0.92, -0.85), Cohen's d = -0.85). In addition, diabetes was a significant moderator of the relationship between age and SRH (b = 0.01, p < 0.001, 95% C.I. (0.01, 0.01)). Specifically, age was more strongly related to SRH in people without diabetes (b = -0.015, p < 0.001, 95% C.I. (-0.016, -0.015)) than in people with diabetes (b = -0.007, p < 0.001, 95% C.I. (-0.010, -0.004)). Health professionals should aim to improve SRH in people with diabetes given that SRH is related to various outcomes.
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Affiliation(s)
- Weixi Kang
- UK DRI Care Research and Technology Centre, Department of Brain Sciences, Imperial College London, London W12 0BZ, UK
| | - Antonio Malvaso
- IRCCS "C. Mondino" Foundation, National Neurological Institute, Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy
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Mortimer JT, Staff J. Agency and Subjective Health from Early Adulthood to Mid-Life: Evidence from the Prospective Youth Development Study. DISCOVER SOCIAL SCIENCE AND HEALTH 2022; 2:2. [PMID: 35464883 PMCID: PMC9022047 DOI: 10.1007/s44155-022-00006-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 02/09/2022] [Indexed: 01/03/2023]
Abstract
Understanding the determinants of subjective or self-rated health (SRH) is of central importance because SRH is a significant correlate of actual health as well as mortality. A large body of research has examined the correlates, antecedents, or presumed determinants of SRH, usually measured at a given time or endpoint. In the present study, we investigate whether individual mastery, a prominent indicator of agency, has a positive effect on SRH over a broad span of the life course. Drawing on longitudinal data from the Youth Development Study (n=741), we examine the impacts of mastery on SRH over a 24-year period (from ages 21-22 to 45-46). The findings of a fixed effects analysis, controlling time-varying educational attainment, unemployment, age, obesity, serious health diagnoses, and time-constant individual differences, lead us to conclude that mastery is a stable predictor of SRH from early adulthood to mid-life. This study provides evidence that psychological resources influence individuals' subjective assessment of their health, even when objective physical health variables and socioeconomic indicators are taken into account.
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Affiliation(s)
- Jeylan T Mortimer
- Life Course Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jeremy Staff
- Department of Sociology and Criminology, Pennsylvania State University, University Park, Pennsylvania, USA
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Lopes de Oliveira T, Oliveira RVCD, Griep RH, Moreno AB, Almeida MDCCD, Almquist YB, Fonseca MDJMD. Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) participant's profile regarding self-rated health: a multiple correspondence analysis. BMC Public Health 2021; 21:1761. [PMID: 34579683 PMCID: PMC8474707 DOI: 10.1186/s12889-021-11760-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 09/09/2021] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Thaís Lopes de Oliveira
- Department of Epidemiology and Quantitative Methods in health. National School of Public Health, Oswaldo Cruz Foundation, 1480, Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil
| | | | - Rosane Harter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Arlinda B Moreno
- Department of Epidemiology and Quantitative Methods in health. National School of Public Health, Oswaldo Cruz Foundation, 1480, Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil
| | | | - Ylva Brännström Almquist
- Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, Stockholm, Sweden
| | - Maria de Jesus Mendes da Fonseca
- Department of Epidemiology and Quantitative Methods in health. National School of Public Health, Oswaldo Cruz Foundation, 1480, Manguinhos, Rio de Janeiro, RJ, 21041-210, Brazil.
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Keramat SA, Alam K, Ahinkorah BO, Islam MS, Islam MI, Hossain MZ, Ahmed S, Gow J, Biddle SJH. Obesity, Disability and Self-Perceived Health Outcomes in Australian Adults: A Longitudinal Analysis Using 14 Annual Waves of the HILDA Cohort. CLINICOECONOMICS AND OUTCOMES RESEARCH 2021; 13:777-788. [PMID: 34522108 PMCID: PMC8434893 DOI: 10.2147/ceor.s318094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/07/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Both obesity and disability have been widely recognised as major public health challenges because they play significant roles in determining self-perceived general and mental health. Longitudinal studies of the relationship between obesity and disability with self-reported health outcomes are scarce. Therefore, the objective of the present study is to examine the relationship between obesity and disability with self-perceived general and mental health among Australian adults aged 15 years and above. METHODS Data were extracted from the most recent 14 waves (waves 6 through 19) of the annual individual person dataset of the Household, Income and Labour Dynamics in Australia (HILDA) survey. The longitudinal random-effects logistic regression model was adopted to investigate the relationships between obesity and disability with self-reported health outcomes. RESULTS The results revealed that obese individuals and adults with some form of disability are more likely to report poor or fair general and mental health. The odds of self-reporting poor or fair general health were 2.40 and 6.07 times higher among obese (aOR: 2.40, 95% CI: 2.22-2.58) and adults with some form of disability (aOR: 6.07, 95% CI: 5.77-6.39), respectively, relative to adults with healthy weight and those without disability . The results also showed that self-rated poor or fair mental health were 1.22 and 2.40 times higher among obese adults (aOR: 1.22, 95% CI: 1.15-1.30) and adults with disability (aOR: 2.40, 95% CI: 2.30-2.51), respectively, compared to their healthy weight peers and peers without disability. CONCLUSION As governmental and non-governmental organisations seek to improve the community's physical and mental well-being, these organisations need to pay particular attention to routine health care prevention, specific interventions, and treatment practices, especially for obese and/or people with disabilities.
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Affiliation(s)
- Syed Afroz Keramat
- School of Business, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
- Economics Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
| | - Khorshed Alam
- School of Business, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
| | | | - Md Sariful Islam
- Economics Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh
| | - Md Irteja Islam
- School of Business, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
| | - Md Zobayer Hossain
- Development Studies Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh
| | - Sazia Ahmed
- Economics Discipline, Social Science School, Khulna University, Khulna, 9208, Bangladesh
| | - Jeff Gow
- School of Business, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
- School of Accounting, Economics, and Finance, University of KwaZulu-Natal, Durban, 4000, South Africa
| | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
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Chang Y, Noh JW, Cheon JY, Kim Y, Kwon YD, Ryu S. Self-rated health and risk of incident non-alcoholic fatty liver disease: A cohort study. Sci Rep 2020; 10:3826. [PMID: 32123241 PMCID: PMC7052149 DOI: 10.1038/s41598-020-60823-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 02/18/2020] [Indexed: 11/28/2022] Open
Abstract
Although self-rated health (SRH), a subjective measure of overall health status, associates with metabolic abnormalities, studies on the relationship between SRH and non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of metabolic syndrome, are limited. In this study, we evaluated whether or not SRH predicts the risk of incident NAFLD. This cohort study was performed in a sample of 148,313 Korean adults free of ultrasound-diagnosed NAFLD at baseline with annual or biennial follow-up for a median of 3.7 years. SRH and NAFLD were measured at baseline and follow-up visits. NAFLD was determined based on the ultrasound-diagnosed fatty liver without excessive alcohol consumption or any other cause. Hazard ratios with 95% confidence intervals were estimated via a parametric proportional hazards model. During 522,696.1 person-years of follow-up, 23,855 individuals with new-onset NAFLD were identified (incidence rate, 45.6 per 1,000 person-years). After adjustments for possible confounders including total calorie intake, sleep duration, and depressive symptoms, the multivariate-adjusted hazard ratios (95% confidence intervals) for incident NAFLD comparing good, fair, and poor or very poor SRH to very good SRH were 1.06 (0.97-1.14), 1.18 (1.09-1.27), and 1.24 (1.13-1.37), respectively. This association of SRH with incident NAFLD remained significant after accounting for changes in SRH and confounders during follow-up and was similar across clinically relevant subgroups. In a large-scale cohort study of apparently healthy Korean adults, poor SRH was independently and positively associated with incident NAFLD risk, indicating a predictive role of SRH as a health measure in NAFLD.
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Affiliation(s)
- Yoosoo Chang
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul, Seoul, Republic of Korea
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jin-Won Noh
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Republic of Korea
- Institute of Health Promotion and Policy, Dankook University, Cheonan, Republic of Korea
- Global Health Unit, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Joo Young Cheon
- Department of Nursing Science, Sungshin University, Seoul, Republic of Korea
| | - Yejin Kim
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul, Seoul, Republic of Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seungho Ryu
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul, Seoul, Republic of Korea.
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.
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Lopes de Oliveira T, Griep RH, Guimarães JN, Giatti L, Chor D, Mendes da Fonseca MDJ. Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): socio-occupational class as an effect modifier for the relationship between adiposity measures and self-rated health. BMC Public Health 2019; 19:734. [PMID: 31185963 PMCID: PMC6560819 DOI: 10.1186/s12889-019-7072-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/29/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Little is known about the role of social class in the association between adiposity measures and self-rated health, and several studies have evaluated its influence as a confounder. The aim of the study is to investigate whether social class is an effect modifier in the association between adiposity measures and self-rated health in participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHOD Cross-sectional design, including 6453 men and 7686 women. Body mass index (kg/m2) and waist circumference (cms) were assessed. Self-rated health was categorized as good, fair and poor. Socio-occupational class was based on the participants' occupation, education and per capita income. Multicovariate ordinal logistic model was used to evaluate the association between adiposity measures and self-rated health. RESULTS For women, the low and medium socio-occupational class effects were higher for those with waist circumference between 80 and 88 cm or overweight. For men, the low and medium socio-occupational class effects were higher for those with adequate waist circumference or normal body mass index. CONCLUSIONS Social class is an effect modifier in the association between body mass index or waist circumference and self-rated health.
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Affiliation(s)
- Thaís Lopes de Oliveira
- National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ 21041-210 Brazil
| | - Rosane Harter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, RJ 21040-360 Brazil
| | - Joanna Nery Guimarães
- National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ 21041-210 Brazil
| | - Luana Giatti
- Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, 30310-100 Brazil
| | - Dóra Chor
- National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ 21041-210 Brazil
| | - Maria de Jesus Mendes da Fonseca
- National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ 21041-210 Brazil
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12
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Self-rated health and the risk of incident type 2 diabetes mellitus: A cohort study. Sci Rep 2019; 9:3697. [PMID: 30842537 PMCID: PMC6403398 DOI: 10.1038/s41598-019-40090-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 02/08/2019] [Indexed: 12/15/2022] Open
Abstract
We aimed to evaluate the association between self-rated health (SRH) and the risk of incident type 2 diabetes mellitus (T2D). This cohort study consisted of 250,805 Korean men and women without T2D at baseline. SRH was assessed at baseline with a self-administered structured questionnaire. Incident T2D was defined as fasting serum glucose ≥126 mg/dL, HbA1C ≥6.5%, or use of medication for T2D during follow-up. After adjustment for possible confounders including age, center, year of screening exam, smoking status, alcohol intake, physical activity, education level, total calorie intake, body mass index, sleep duration, depressive symptoms, family history of diabetes, history of hypertension, and history of cardiovascular disease, the multivariable-adjusted hazard ratios (95% confidence intervals) for incident T2D comparing good, fair, and poor or very poor SRH to very good SRH were 1.20 (0.98-1.48), 1.63 (1.33-1.98), and 1.83 (1.47-2.27), respectively. These associations were consistently observed in clinically relevant subgroups. Fair or poorer SRH was independently and positively associated with the development of T2D in a large-scale cohort study of apparently healthy Korean adults, indicating that SRH is a predictor of metabolic health. Physicians involved in diabetes screening and management should routinely consider SRH when evaluating T2D risk as well as overall health.
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Abstract
Work-related stress is increasing in prevalence, with important consequences for employees, employers, the economy, and wider society. While previous research has identified a link between work-related stress and bullying, gaps remain in our understanding of the nature of the relationship. This article uses ordered logistic regression and nationally representative data on 5110 employees from Ireland to empirically analyse the distribution of subjective work-related stress and its relationship with bullying (self-reported). We also consider the role and importance of gender and the presence of a formal policy on respect and dignity at work, as well as the degree to which relationships between management and staff and between staff themselves are related to work-related stress. Amongst the main findings are that employees who reported that they were bullied were considerably more likely to report that they were often or always stressed, while bad and very bad relationships between management and staff were also significantly associated with greater stress, particularly for female employees. Overall, our findings have a range of implications for employees, employers, and policymakers.
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Li S, Chen Y, He G. Laugh and grow fat: Happiness affects body mass index among Urban Chinese adults. Soc Sci Med 2018; 208:55-63. [PMID: 29763787 DOI: 10.1016/j.socscimed.2018.05.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 02/14/2018] [Accepted: 05/03/2018] [Indexed: 01/22/2023]
Abstract
Previous studies have extensively examined the relationship between body mass index (BMI) and subjective well-being (SWB) but have mainly focused on the effects of BMI on SWB, leaving the question of whether BMI can be influenced by SWB largely neglected. In this study, we present the first empirical evidence on the effects of SWB on BMI among adults, using data combined from four waves of the Chinese General Social Survey (CGSS) (2010-2013). We find that, among urban Chinese adults, those who have a higher level of happiness tend to have higher BMI, after extensively controlling for a constellation of individual sociodemographic and health attributes. Further analyses using the instrumental variable method and propensity score matching provided similar results.
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Affiliation(s)
- Shuanglong Li
- Department of Sociology, School of Public Administration, Guangzhou University, Guangzhou, Guangdong Province, 510006, PR China
| | - Yunsong Chen
- Hopkins-Nanjing Center, Nanjing University, 162 Shanghai Road, Nanjing, Jiangsu Province, 210008, PR China; Department of Sociology, School of Social and Behavioral Sciences, Nanjing University, 163 Xianlin Road, Nanjing, Jiangsu Province, 210023, PR China.
| | - Guangye He
- Department of Sociology, School of Social and Behavioral Sciences, Nanjing University, 163 Xianlin Road, Nanjing, Jiangsu Province, 210023, PR China.
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Doherty E, Queally M, Cullinan J, Gillespie P. The impact of childhood overweight and obesity on healthcare utilisation. ECONOMICS AND HUMAN BIOLOGY 2017; 27:84-92. [PMID: 28550809 DOI: 10.1016/j.ehb.2017.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 03/23/2017] [Accepted: 05/10/2017] [Indexed: 06/07/2023]
Abstract
Rising levels of childhood overweight and obesity represent a major global public health challenge. A number of studies have explored the association between childhood overweight and obesity and healthcare utilisation and costs. This paper adds to the literature by estimating the causal effect of child overweight and obesity status on use of general practitioner (GP) and hospital inpatient stays at two time points using instrumental variable (IV) methods The paper uses data from two waves of the Growing Up in Ireland survey of children when they are 9 and 13 years respectively and uses the biological mother's body mass index (BMI) as an instrument for the child's BMI. Our results demonstrate that child overweight and obesity status do not have a significant effect on healthcare utilisation for children when they are 9 years, but do have a large and significant effect at 13 years. Across all our models, the effects on both GP and hospital inpatient stays are found to be larger when endogeneity in childhood BMI status is addressed. Previous studies that did not address endogeneity concerns are likely to have significantly underestimated the impact of child overweight and obesity status on healthcare utilisation.
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Affiliation(s)
- Edel Doherty
- Health Economics and Policy Analysis Centre, J.E. Cairnes School of Business and Economics, NUI Galway, Ireland.
| | - Michelle Queally
- Health Economics and Policy Analysis Centre, J.E. Cairnes School of Business and Economics, NUI Galway, Ireland
| | - John Cullinan
- Health Economics and Policy Analysis Centre, J.E. Cairnes School of Business and Economics, NUI Galway, Ireland
| | - Paddy Gillespie
- Health Economics and Policy Analysis Centre, J.E. Cairnes School of Business and Economics, NUI Galway, Ireland
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Busutil R, Espallardo O, Torres A, Martínez-Galdeano L, Zozaya N, Hidalgo-Vega Á. The impact of obesity on health-related quality of life in Spain. Health Qual Life Outcomes 2017; 15:197. [PMID: 29017494 PMCID: PMC5634835 DOI: 10.1186/s12955-017-0773-y] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 09/28/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND It is well documented that obesity is strongly associated with mortality and morbidity, but less is known about its impact on functional status and health-related quality of life (HRQOL). The purpose of this study was to calculate the impact of the Body Mass Index (BMI) on the HRQOL of the Spanish adult population, with special emphasis on BMI ≥ 35. METHODS We used the Spanish National Health Survey (SNHS) 2011-2012 to assess the statistical association between HRQOL, measured through the EuroQol-5D-5L questionnaire, and the BMI. We conducted linear regression analysis for the EuroQol-5D-5L Visual Analogue Scale (VAS) and probit regressions for each of the five dimensions of the EuroQol-5D-5L. RESULTS Self-perceived problems in the five dimensions of the EuroQol-5D-5L increased along the BMI, especially in the mobility and pain/discomfort dimensions. Having a BMI ≥ 35 reduced HRQOL even in the absence of chronic diseases. After controlling for comorbidities, severe obesity decreased the VAS score by an average of 1.9 points and increased the probability of reporting any HRQOL problem in mobility (11.8%), self-care (2.2%), usual activities (4.3%) and pain/discomfort (7.4%). No association was found between obesity and mental problems. All the parameters analysed suggest that HRQOL in women and people aged 65 years and over was significantly worse than average. CONCLUSIONS BMI is an explanatory factor of self-perceived quality of life. Obesity is associated with a worse HRQOL, especially in women and people aged over 64 years. These results may be useful for designing prevention or treatment health policies to target obesity among the Spanish population.
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Affiliation(s)
- Rafael Busutil
- Seminario de Investigación en Economía y Salud, University of Castilla-La Mancha, Toledo, Spain
| | - Olga Espallardo
- Seminario de Investigación en Economía y Salud, University of Castilla-La Mancha, Toledo, Spain
| | | | | | - Néboa Zozaya
- Instituto Max Weber, c/ Norias 123, 28221 Majadahonda, Madrid Spain
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Arsenijevic J, Groot W. Lifestyle differences between older migrants and non-migrants in 14 European countries using propensity score matching method. Int J Public Health 2017; 63:337-347. [PMID: 28707008 PMCID: PMC5978913 DOI: 10.1007/s00038-017-1010-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 06/27/2017] [Accepted: 06/28/2017] [Indexed: 11/30/2022] Open
Abstract
Objectives We examine the differences in lifestyle between four groups of migrants—first generation of older migrants originating from one of the EU countries, Africa or the Middle East and second-generation older EU migrants—with non-migrants in their country of destination. Methods We use wave 5 of the SHARE data. To control for differences in socio-demographic characteristics, cultural factors and duration of stay in country of destination between migrants and non-migrants, we use propensity matching score analysis. Results Older migrants from Southern European countries are more likely to smoke than non-migrants in their country of origin. Older migrants originating from Africa and the Middle East are more likely to smoke than non-migrants in their country of destination. Some groups of second-generation older migrants are more likely to consume alcohol and to have lower levels of physical activity than non-migrants in their country of destination. Conclusions Our results show that differences in lifestyle between migrants and non-migrants exist, but they are not solely related to their migrant status. Cultural and socio-demographic characteristics also play a role.
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Affiliation(s)
- Jelena Arsenijevic
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI, Maastricht University Medical Center, Maastricht University, PO Box 616, 6200, Maastricht, The Netherlands. .,Faculty of Law, Economics and Governance, Utrecht University, Utrecht, The Netherlands.
| | - Wim Groot
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI, Maastricht University Medical Center, Maastricht University, PO Box 616, 6200, Maastricht, The Netherlands.,Top Institute Evidence-Based Education Research (TIER), Maastricht University, Maastricht, The Netherlands
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Bärnighausen T, Røttingen JA, Rockers P, Shemilt I, Tugwell P. Quasi-experimental study designs series-paper 1: introduction: two historical lineages. J Clin Epidemiol 2017; 89:4-11. [PMID: 28694121 DOI: 10.1016/j.jclinepi.2017.02.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 02/06/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The objective of this study was to contrast the historical development of experiments and quasi-experiments and provide the motivation for a journal series on quasi-experimental designs in health research. STUDY DESIGN AND SETTING A short historical narrative, with concrete examples, and arguments based on an understanding of the practice of health research and evidence synthesis. RESULTS Health research has played a key role in developing today's gold standard for causal inference-the randomized controlled multiply blinded trial. Historically, allocation approaches developed from convenience and purposive allocation to alternate and, finally, to random allocation. This development was motivated both by concerns for manipulation in allocation as well as statistical and theoretical developments demonstrating the power of randomization in creating counterfactuals for causal inference. In contrast to the sequential development of experiments, quasi-experiments originated at very different points in time, from very different scientific perspectives, and with frequent and long interruptions in their methodological development. Health researchers have only recently started to recognize the value of quasi-experiments for generating novel insights on causal relationships. CONCLUSION While quasi-experiments are unlikely to replace experiments in generating the efficacy and safety evidence required for clinical guidelines and regulatory approval of medical technologies, quasi-experiments can play an important role in establishing the effectiveness of health care practice, programs, and policies. The papers in this series describe and discuss a range of important issues in utilizing quasi-experimental designs for primary research and quasi-experimental results for evidence synthesis.
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Affiliation(s)
- Till Bärnighausen
- Heidelberg Institute of Public Health, Heidelberg University, Heidelberg, Germany; Harvard T.H. Chan School of Public Health, Boston, USA; Africa Health Research Institute, KwaZulu-Natal, South Africa.
| | - John-Arne Røttingen
- Harvard T.H. Chan School of Public Health, Boston, USA; Norwegian Institute of Public Health, Oslo, Norway
| | | | - Ian Shemilt
- University College London (UCL), London, USA
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, Canada
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Kinge JM. Waist circumference, body mass index, and employment outcomes. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2017; 18:787-799. [PMID: 27730443 DOI: 10.1007/s10198-016-0833-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 09/20/2016] [Indexed: 06/06/2023]
Abstract
Body mass index (BMI) is an imperfect measure of body fat. Recent studies provide evidence in favor of replacing BMI with waist circumference (WC). Hence, I investigated whether or not the association between fat mass and employment status vary by anthropometric measures. I used 15 rounds of the Health Survey for England (1998-2013), which has measures of employment status in addition to measured height, weight, and WC. WC and BMI were entered as continuous variables and obesity as binary variables defined using both WC and BMI. I used multivariate models controlling for a set of covariates. The association of WC with employment was of greater magnitude than the association between BMI and employment. I reran the analysis using conventional instrumental variables methods. The IV models showed significant impacts of obesity on employment; however, they were not more pronounced when WC was used to measure obesity, compared to BMI. This means that, in the IV models, the impact of fat mass on employment did not depend on the measure of fat mass.
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Affiliation(s)
- Jonas Minet Kinge
- Department of Health and Inequality, Norwegian Institute of Public Health, Pb 4404 Nydalen, 0403, Oslo, Norway.
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway.
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Tang K, Zhao Y, Li C. The association between self-rated health and different anthropometric and body composition measures in the Chinese population. BMC Public Health 2017; 17:317. [PMID: 28407795 PMCID: PMC5390392 DOI: 10.1186/s12889-017-4249-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 04/08/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To analyze the strength of association between self-rated health and six anthropometric and body composition measures to explore the best indicator. METHODS Analyses were based on the cross-sectional data from the China Kadoorie Biobank Study and approximately 300,000 adults were analyzed. Logistics regression was used to analyze the association between self-rated health (good or poor) and anthropometric and body composition measures (height, weight, body mass index (BMI), waist circumference (WC), hip circumference (HC) and body fat percentage, waist-to-hip ratio and waist-to-height ratio). Stratified analyses were undertaken to understand the effect modification of socioeconomic status on the association. RESULT Odds ratio of self-rated better health had an inverted U-shape association with weight, BMI, WC and body fat, with weight levels increasing until around 73.8 and 65.7 kg for male and female, BMI around 26.8 kg/m2, WC around 85.8 and 87.6 cm, body fat around 24.3 and 36.3%, and then declining thereafter. Height and HC also indicated a slightly inverted U-shape association. The strongest association was observed after adjustment was weight, with one standard deviation greater weight associated with 10.2% and 10.6% increased odds in male and female. CONCLUSIONS Being underweight and overweight are both risk factors for poor self-rated health in males and females, and weight is the best indicator of self-rated health compared with other measures.
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Affiliation(s)
- Kun Tang
- Department of Global Health, Peking University, Beijing, China
| | - Yingxi Zhao
- Institute for Medical Humanities, Peking University, Beijing, China
| | - Chunyan Li
- School of Public Health, Peking University, Beijing, China
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Cullinan J, Cawley J. Parental misclassification of child overweight/obese status: The role of parental education and parental weight status. ECONOMICS AND HUMAN BIOLOGY 2017; 24:92-103. [PMID: 27915138 DOI: 10.1016/j.ehb.2016.11.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 09/20/2016] [Accepted: 11/07/2016] [Indexed: 06/06/2023]
Abstract
Childhood overweight and obesity is a major public health challenge for policymakers in many countries. As the most common supervisors of children's activities, parents have a potentially important role to play in obesity prevention. However, a precondition for parents to improve their children's diets, encourage them to be more physically active, or take them to see a doctor about their weight is for the parent to first recognize that their child is overweight or obese. This paper examines the extent of parental misclassification of child weight status, and its correlates, focusing on the role of parental education and the parent's own obesity status. We find evidence that, among non-obese parents, those who are better-educated report their child's weight status more accurately, but among obese parents, the better-educated are 45.18% more likely than parents with lower secondary education to give a false negative report of their child's overweight/obesity; this may reflect social desirability bias.
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Affiliation(s)
- John Cullinan
- JE Cairnes School of Business & Economics, National University of Ireland, Galway, Ireland.
| | - John Cawley
- Department of Policy Analysis and Management and Department of Economics, Cornell University, Ithaca, NY 14853, United States.
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