Factors affecting change over time in self-reported health

Active mobility and mental health: A scoping review towards a healthier world

Research has proven that engaging in active mobility (AM), namely walking and cycling for transportation, significantly enhances physical activity levels, leading to better physical health. It is still unclear whether AM could also offer any mental health benefits. This scoping review aims to provide a comprehensive understanding of the current knowledge on the relationship between AM and mental health, given its crucial role in public health. The authors searched online databases to isolate primary studies written in English involving an adult sample (16 or over). AM was the exposure factor. Many mental health elements were included as outcomes (depression, anxiety, self-esteem, self-efficacy, stress, psychological and subjective well-being, resilience, loneliness and social support, quality of life, mood, life satisfaction and sleep). The results were organised in a narrative summary per each outcome selected, graphical syntheses and an overview of gaps to be further examined. The authors identified a total of 55 papers as relevant. The results show inconsistency in study designs, definition and operationalisation of the variables, approach and methodologies used. A cross-sectional design was the dominant choice, primarily examining data from national public health surveys. Nonetheless, there has been improvement in outcomes of interests, initially mainly the quality of life and affect. Lately, authors have focused on a broader range of mental health-related factors (such as travel satisfaction). The experimental studies showed promising mental health improvements in those who used active modes more than those who used motorised vehicles. It creates a rationale for further research towards implementing a unified theoretical and methodological framework to study the link between AM and mental health. The ultimate goal is to generate solid conclusions that could support building societies and cities through public health promotion and sustainable strategies, like walking and cycling as a means of transport.

Sex/Gender Differences in the Association between Residential Green Space and Self-Rated Health-A Sex/Gender-Focused Systematic Review

Though sex/gender is an important social determinant of health, sex/gender inequalities have not been considered comprehensively in environmental health research thus far. The aim of this systematic review was to clarify whether sex/gender theoretical concepts were addressed in studies on the impact of residential green space on self-rated health and whether effect modification by sex/gender was observed. Three electronic databases were searched to identify epidemiological studies on perceived or objective residential green/blue space and self-rated health. Necessary for study inclusion was mentioning at least one keyword for sex/gender in title or abstract, adult study participants and data on self-rated health and on availability and/or use of green/blue spaces. Decisive for study inclusion was consideration of sex/gender differences in the impact of perceived or objective residential green/blue spaces on self-rated health in the analysis and presentation of results. Seven studies were included. They presented an overall positive impact of green space on self-rated health. No consistent sex/gender differences in the impact of green space on self-rated health were found in these studies. However, all studies used a binary operationalization male/female without further theoretical foundation. Research quality could be enhanced by integrating sex/gender-theoretical concepts into study design and interpretation of results.

Are Changes in Self-Rated Health Associated With Memory Decline in Older Adults?

Objective: The association between patterns of change in self-rated health (SRH) and memory trajectories in older adults was examined using a systematic approach. Method: Data from the Health and Retirement Study ( n = 6,016) and the English Longitudinal Study of Ageing ( n = 734) were analyzed. Individuals were grouped into five categories according to their pattern of change in SRH over 8 years: stable excellent/very good/good, stable fair/poor, improvement, decline, and fluctuating pattern without a trend. Memory was measured using immediate and delayed recall tests. Kruskal–Wallis, chi-squares tests, and linear mixed models were used to examine the association. Results: Different rates of decline in memory can be identified in the different patterns of change in SRH. Those who had a stable excellent/very good/good pattern had the slowest rate of decline. Discussion: Our findings suggest that SRH status and patterns of change could be used as a marker of cognitive decline in prevention screening programs.

Factors related to self-reported health status in low income midlife women

Transition throughout midlife can affect women's perception of their health status. Multiple factors are potentially related to self-reported health status (SRHS), but it was not clear what factors are related to SRHS for midlife women, especially those with low income. This study examined factors related to SRHS in low income midlife women over time. A multi-step linear regression of longitudinal Medicaid Managed Care (MMC) data (n = 310) from July 2000 through November 2006 was used. Participants completed SRHS at initial (baseline) enrollment into MMC (T1), with a second assessment completed 11 to 23 months later for those retaining MMC eligibility (T2). Results indicated that disability and number of medical conditions were the factors most related to SRHS. SRHS scores differed significantly between non-disabled and disabled women. For disabled women, SRHS improved significantly between T1 and T2 (p < .001), but not for non-disabled women. Those with lower SRHS scores used community agencies more often. Further studies of SRHS and health-related factors are needed as SRHS is frequently an indicator of population health. Greater evidenced-based knowledge of SRHS in midlife women will inform preventive interventions for this population.

Neighborhood racial composition and trajectories of child self-rated health: an application of longitudinal propensity scores

Children function within multiple socio-environmental contexts including family, school, and neighborhood. The role each of these contexts play in determining well-being is dynamic and changes throughout early-middle childhood. Recent literature on neighborhood context and health suggests that the life-course processes involved in building trajectories of health are not adequately captured in cross-sectional analysis, which has been the empirical focus of much of the research in this area. In this study we use a nationally representative longitudinal sample of approximately 21,400 United States school children derived from the Early Childhood Longitudinal Study--Kindergarten Cohort (ECLS-K) survey to examine the impact of longitudinal measures of neighborhood racial composition on child self-rated health between kindergarten and 8th grade. We employ two-level multilevel longitudinal logistic regression models with time-varying propensity scores to examine variation in the initial status and trajectories of child self-rated health between kindergarten and 8th grade. Since the ECLS-K tracked child mobility over time, we are able to model the impact of changes in neighborhood racial composition. We find significant differences in initial poor self-rated health by child race, household socioeconomic status and parental marital status but no evidence of a change in trajectory of health over time. Using time-varying propensity scores, we find no effect of neighborhood racial composition on initial health status or health status trajectories.

The role of age, gender, mood states and exercise frequency on exercise dependence

OBJECTIVES

The purpose of our study was to explore the prevalence, and the role of mood, exercise frequency, age, and gender differences of exercise dependence.

METHODS

Regular exercisers (N = 409) completed a socio-demographic questionnaire, the Exercise Dependence Scale, and the Profile of Mood States. For data analyses, the participants were stratified for sex and age (age ranges = young adults: 18-24 years, adults: 25-44 years, and middle-aged adults: 45-64 years).

RESULTS

We found that: (a) 4.4% of the participants were classified as at-risk for exercise dependence; (b) the men and the two younger groups (i.e., young adults and adults) had higher exercise dependence scores; and (c) age, gender, exercise frequency, and mood state were related to exercise dependence.

CONCLUSIONS

Our results support previous research on the prevalence of exercise dependence and reveal that adulthood may be the critical age for developing exercise dependence. These findings have practical implication for identifying individuals at-risk for exercise dependence symptoms, and may aid in targeting and guiding the implementation of prevention program for adults.

Small area contextual effects on self-reported health: evidence from Riverside, Calgary

Background

We study geographic variation within one community in the City of Calgary using a more fine-grained geographic unit than the Census tract, the Census Dissemination Area (DA). While most Riverside residents consider their neighbourhood to be a fairly cohesive community, we explore the effect of socio-economic variation between these small geographic areas on individuals' self-reported health, net of individual level determinants.

Methods

We merge data from the 2001 Census for Riverside, Calgary with a 2004 random telephone survey of Riverside residents. Our data are unique in that we have information on individuals from every DA wholly contained in the Riverside community. These data enable us to conduct multinomial logistic regression analyses of self-reported health using both individual-level and DA-level variables as predictors.

Results

We find significant variation in measures of DA socio-economic status within the Riverside community. We find that individual self-reported health is affected by variation in an index of DA-level socio-economic disadvantage, controlling for individual variation in gender, age, and socio-economic status. We investigate each aspect of the DA index of disadvantage separately, and find that average education and the percent of households that are headed by a lone parent are most important.

Conclusions

These findings demonstrate that, even within a cohesive community, contextual effects on health can be located at a smaller geographic level than the Census tract. Research on the effects of local area socio-economic disadvantage on health that combines administrative and survey data enables researchers to develop more comprehensive measures of social and material deprivation. Our findings suggest that both social and material deprivation affect health at the local level.

The relationship between coping, self-esteem and health on outdoor walking ability among older adults in Norway

Walking is an essential component of outdoor mobility, and recognised as one of the best forms of physical activity for older adults. The purpose of this study is to examine the relationships between socio-demographic factors, coping resources, self-esteem and health status with the outdoor walking ability of people aged 55–79 years living in the community. The hypothesis is that there is a positive association between outdoor walking ability and coping, self-esteem and health status. A nationally-representative sample of 3,069 women and men answered questions regarding socio-demographic attributes, coping resources, self-esteem, health status and outdoor walking ability. The mean age of the respondents was 65.6 years. Around one-half of the sample were women, and around one-half were aged 65 or more years. One-third (32.3%) of the sample were married or cohabiting. Regarding outdoor walking ability, only 0.7 per cent of the respondents were not able to walk at all, and 80.8 per cent could walk at least one kilometre without a pause. Binary logistic multivariate regression analyses showed that those who had good outdoor walking ability (one kilometre or more) were significantly younger than those who did not, and that they were predominantly men, partnered or married, not in paid work, experienced significantly little pain, had better self-reported health and higher perceived coping.

Five years of lifestyle intervention improved self-reported mental and physical health in a general population: the Inter99 study

INTRODUCTION

Self-reported health has been shown to predict mortality. We lack knowledge on whether a lifestyle intervention can improve self-reported mental and physical health in a general population.

METHODS

Inter99, Denmark (1999-2006) is a randomised population-based intervention study. We screened for ischemic heart disease and repeatedly offered advice and assistance to obtain a healthier lifestyle. Health related quality of life was measured by Short Form 12 (SF-12); completed by 9322 at baseline and 7719 at five-year follow-up. In linear mixed models we investigated the effect of the intervention on self-reported health over time.

RESULTS

At baseline men had higher physical health-component scores (PCS) than women. Living with a partner, being employed, and being healthy was associated with high PCS. The mental health-component scores (MCS) showed the same socio-demographic differences, except that MCS increased with age. Significantly fewer participants in the intervention groups had decreased their PCS and MCS compared with the control group. Adjusted multilevel analyses confirmed that the intervention significantly improved physical- (p=0.008) and mental health (p<0.001) over time compared with the control group.

CONCLUSION

Screening for ischemic heart disease and offering lifestyle intervention had a significantly beneficial effect on mental and physical self-reported health in the long term in a general population.

The relationship between lifestyle and self-reported health in a general population: the Inter99 study

OBJECTIVES

The aim of this paper is to describe the relationship between smoking status, dietary habits, physical activity and alcohol intake, and mental and physical self-reported health in a general population.

MEASURES

A large population-based study Inter99, Copenhagen, Denmark, 1999-2006. Self-reported health-related quality of life was measured by Short Form 12 (SF-12). Mental and physical health component scores were computed.

RESULTS

At baseline, SF-12 was completed by 6305 (92.3%) participants in the intervention groups, and 3017 (72.4%) persons in the control group. In cross-sectional analyses, persons with an unhealthy lifestyle reported significantly worse physical and mental health than persons with a healthier lifestyle. In longitudinal data, using adjusted multivariate analyses (N=3,084), we found an association between increased physical activity at five-year follow-up and improvement in physical health ( odds ratio=2.30 (95% confidence interval=1.7-3.2)) in the high-intensity intervention group. Improvement in mental health was associated with a much healthier diet at 5-year follow-up than at baseline ( odds ratio=1.68 (95% confidence interval=1.1-2.5)).

CONCLUSIONS

This study describes the negative relationship between unhealthy lifestyle and self-reported mental and physical health in a general population. Also, it shows the impact of improvements in lifestyle on self-reported health in a general population, which has not been investigated before.