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Killie IL, Braaten T, Lorem GF, Borch KB. Associations Between Self-Rated Health and Mortality in the Norwegian Women and Cancer (NOWAC) Study. Clin Epidemiol 2024; 16:109-120. [PMID: 38404707 PMCID: PMC10893877 DOI: 10.2147/clep.s433965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024] Open
Abstract
Purpose We investigated the association between self-rated health (SRH) and cancer incidence and SRH and all-cause mortality among Norwegian women. Population and Methods We used data from 110,104 women in the Norwegian Women and Cancer (NOWAC) cohort aged 41-70 years at baseline. We used flexible parametric survival analysis with restricted cubic splines to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between SRH and mortality in the entire cohort. We employed the same method in a multistate design to assess associations between baseline SRH and 1) cancer incidence, and 2) all-cause mortality in subgroups of women who did and did not receive a cancer diagnosis during follow-up. Results With very good SRH as reference category for all associations and median age at end of follow-up, lower SRH was associated with increased mortality (HRgood SRH 1.19, 95% CI 1.12-1.26) and HRpoor SRH 1.81, 95% CI 1.66-1.97). Lower SRH at baseline was associated with cancer incidence (HRgood SRH 1.14, 95% CI 1.08-1.20 and HRpoor SRH 1.44, 95% CI: 1.32-1.58). Poor baseline SRH was associated with increased mortality for women who received a cancer diagnosis (HRpoor SRH 1.20, 95% CI 1.04-1.39), and SRH showed a strong association with increased mortality for women who stayed cancer free (HRgood SRH 1.59, 95% CI 1.44-1.77 and HRpoor SRH 3.34, 95% CI 2.91-3.84). Conclusion Lower SRH at baseline predicted increased cancer risk and all-cause mortality in middle-aged to older women. Poor SRH at baseline predicted all-cause mortality in women who later received a cancer diagnosis. Both good and poor SRH at baseline predicted all-cause mortality in women who stayed cancer-free, and the association was stronger for these women compared to both the entire cohort and to women who were subsequently diagnosed with cancer.
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Affiliation(s)
- Ida Løken Killie
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Tonje Braaten
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Geir Fagerjord Lorem
- Department of Psychology, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Kristin Benjaminsen Borch
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
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Dong E, Xu T, Shi J, Ba D, Zhou H, Li Z, Huang C. Healthy immigration effect among internal migrants in megacities: a cross-sectional study in Shanghai, China. Front Public Health 2023; 11:1167697. [PMID: 37377549 PMCID: PMC10291071 DOI: 10.3389/fpubh.2023.1167697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Objectives To verify the healthy immigration effect on self-rated health (SRH) among Chinese internal migrants, identify the determinants of SRH, and provide recommendations for the Chinese government to formulate effective intervention strategies to improve population governance and health management in megacities. Methods A sample comprising 1,147 white-and blue-collar migrant workers was randomly selected through an online survey conducted in Shanghai from August to December 2021. Multivariate logistic regression models were used to verify the healthy immigration effect as well as determinants of the effect among internal migrants in Shanghai. Results Among 1,024 eligible internal migrants, 864 (84.4%) were aged between 18 and 59 years, 545 (53.2%) were men, and 818 (79.9%) were married. When confounders in the logistic regression models were adjusted, the odds ratio of SRH for internal migrants who had lived in Shanghai for 5-10 years was 2.418 (p < 0.001), whereas the odds ratio for those who had lived there for ≥10 years was not statistically significant. Additionally, marital status, a postgraduate or higher degree, income level, number of physical examinations in the past 12 months, and the number of critical diseases they were suffering from, were significant contributing factors for favorable SRH among the internal migrants. Furthermore, a cross-sectional analysis revealed that SRH demonstrated a healthy immigration effect among blue-collar internal migrants from the manufacturing industry but not among white-collar internal migrants. Conclusion A healthy immigration effect was observed among internal migrants in Shanghai. The migrant population that had lived in Shanghai for 5-10 years had more health advantages than the locals, whereas those who had lived there for ≥10 years did not. The Chinese government should understand this effect and enact measures accordingly, such as implementing physical examinations, improving acculturation, addressing individual characteristics, and improving socioeconomic conditions to improve the physical and mental health of internal migrants. Enacting such changes could facilitate the integration of migrants into the local culture of megacities.
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Affiliation(s)
- Enhong Dong
- School of Nursing and Health Management, Shanghai University of Medicine and Health Science, Shanghai, China
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Ting Xu
- School of Nursing and Health Management, Shanghai University of Medicine and Health Science, Shanghai, China
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Jiahua Shi
- Huangpu District Health Promotion Center, Shanghai, China
| | - Dongjiao Ba
- XinHong Community Health Service Center of Minhang District, Shanghai, China
| | - Haiwang Zhou
- Institute of Urban and Demographic Studies, Shanghai Academy of Social Sciences, Shanghai, China
| | - Zhijian Li
- Department of Human Resources Management, Shanghai Sixth People’s Hospital, Shanghai, China
| | - Cheng Huang
- Antai College of Economics and Management, Shanghai Jiao Tong University, Shanghai, China
- The Center for Health Economics and Management, Shanghai Jiao Tong University, Shanghai, China
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Rosskamp M, Verbeeck J, Gadeyne S, Verdoodt F, De Schutter H. Socio-Economic Position, Cancer Incidence and Stage at Diagnosis: A Nationwide Cohort Study in Belgium. Cancers (Basel) 2021; 13:cancers13050933. [PMID: 33668089 PMCID: PMC7956180 DOI: 10.3390/cancers13050933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Socio-economic position is associated with cancer incidence, but the direction and magnitude of this relationship differs across cancer types, geographical regions, and socio-economic parameters. In this nationwide cohort study, we evaluated the association between different individual-level socio-economic and -demographic factors, cancer incidence, and stage at diagnosis in Belgium. Methods: The 2001 census was linked to the nationwide Belgian Cancer Registry for cancer diagnoses between 2004 and 2013. Socio-economic parameters included education level, household composition, and housing conditions. Incidence rate ratios were assessed through Poisson regression models. Stage-specific analyses were conducted through logistic regression models. Results: Deprived groups showed higher risks for lung cancer and head and neck cancers, whereas an inverse relation was observed for malignant melanoma and female breast cancer. Typically, associations were more pronounced in men than in women. A lower socio-economic position was associated with reduced chances of being diagnosed with known or early stage at diagnosis; the strongest disparities were found for male lung cancer and female breast cancer. Conclusions: This study identified population groups at increased risk of cancer and unknown or advanced stage at diagnosis in Belgium. Further investigation is needed to build a comprehensive picture of socio-economic inequality in cancer incidence.
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Affiliation(s)
- Michael Rosskamp
- Belgian Cancer Registry, Rue Royale 215, B-1210 Brussels, Belgium; (J.V.); (F.V.); (H.D.S.)
- Correspondence: ; Tel.: +32-2-250-1010
| | - Julie Verbeeck
- Belgian Cancer Registry, Rue Royale 215, B-1210 Brussels, Belgium; (J.V.); (F.V.); (H.D.S.)
| | - Sylvie Gadeyne
- Sociology Department, Interface Demography, Vrije Universiteit Brussel, Pleinlaan 5, B-1050 Brussels, Belgium;
| | - Freija Verdoodt
- Belgian Cancer Registry, Rue Royale 215, B-1210 Brussels, Belgium; (J.V.); (F.V.); (H.D.S.)
| | - Harlinde De Schutter
- Belgian Cancer Registry, Rue Royale 215, B-1210 Brussels, Belgium; (J.V.); (F.V.); (H.D.S.)
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Fernandes SGG, Pirkle CM, Sentell T, Costa JV, Maciel ACC, da Câmara SMA. Association between self-rated health and physical performance in middle-aged and older women from Northeast Brazil. PeerJ 2020; 8:e8876. [PMID: 32309044 PMCID: PMC7153554 DOI: 10.7717/peerj.8876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 03/09/2020] [Indexed: 11/20/2022] Open
Abstract
Background Self-rated Health (SRH) is regarded as a simple and valid measure of a person’s health status, given its association to adverse health outcomes, including low physical performance in older populations. However, studies investigating these associations in low- and middle-income settings are scarce, especially for middle-aged populations. Understanding the validity of SRH in relation to objective health measures in low-income populations could assist in decision making about health policy and strategies, especially in under-resourced settings. Objective Assess the relationship between SRH and physical performance measures in middle-aged and older women in a low-income setting of Brazil. Methods This is a cross-sectional study of 571 middle-aged (40–59 years old) and older (60–80 years old) women living in Parnamirim and Santa Cruz in the Northeast region of Brazil. Participants reported their health status and were allocated to the “SRH good” or “SRH poor” groups. The physical performance evaluation included: handgrip strength, one-legged balance with eyes open and closed and chair stand test. The relationship between SRH and physical performance for middle-aged and older women was assessed by quantile regression (modeling medians) adjusted for potential confounders (age, socioeconomic variables, body mass index, menopause status, age at first birth, parity, chronic conditions and physical activity). Results Middle-aged women from the “SRH good” group presented better physical performance with 1.75 kgf stronger handgrip strength (95% CI [0.47–3.02]; p = 0.004), 1.31 s longer balance with eyes closed ([0.00–2.61]; p = 0.030), and they were 0.56 s faster in the chair stand test ([0.18–0.94]; p = 0.009) than those who reported “SRH poor”. No association was found for balance with eyes open. For older women, there was no evidence of associations between physical performance and SRH. Conclusion This study showed that SRH is significantly associated with objective measures of physical performance in a sample of low-income middle-aged women. SRH can be an important tool to indicate the need for further evaluation of physical performance among middle-aged women and can be particularly useful for low-income communities.
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Affiliation(s)
- Sabrina Gabrielle Gomes Fernandes
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | - Catherine M Pirkle
- Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Tetine Sentell
- Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI, USA
| | - José Vilton Costa
- Department of Demography and Actuarial Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Saionara Maria Aires da Câmara
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
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Aftyka A, Rosa W, Taczała J. Self-rated health in mothers of children hospitalised for severe illnesses and mothers of healthy children: cross-sectional study. Scand J Caring Sci 2019; 34:698-709. [PMID: 31657048 DOI: 10.1111/scs.12774] [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: 02/14/2019] [Revised: 09/12/2019] [Accepted: 09/15/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Self-rated health (SRH) is a recognised tool for predicting morbidity and mortality. AIM The aim of the study was to investigate and compare SRH in a group of mothers of hospitalised children and mothers of healthy children and to indicate the variables associated with poor SRH in both groups. METHODS We conducted questionnaire-based cross-sectional research in a group of 184 women. Half of the respondents (n = 92) were the mothers of children hospitalised for a severe illnesses (Group H). The control group (n = 92) comprised mothers of healthy children (Group C). Self-Rated Health (SRH), Numerical Rating Scale (NRS), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale-Revised (IES-R) and Interpersonal Support Evaluation List (ISEL-40 v. GP) were used. In order to facilitate critical appraisal and interpretation of results, STROBE recommendations were used. RESULTS The prevalence of poor SRH was greater in mothers of children hospitalised for a severe illness than in those of healthy children (35 and 19%, respectively). In both groups, the risk of poor SRH was statistically significantly higher in those mothers who for the past 7 days reported at least moderate pain and in mothers who manifested anxiety symptoms. In both groups, the prevalence of poor SRH was statistically significantly lower if the respondents' children were in good health. The risk of poor SRH was associated with poor financial status in group H and with depression and at least moderate pain for the past 7 days in group C. RELEVANCE TO CLINICAL PRACTICE In order to provide mothers of severely ill children with high-quality health care including preventive measures, it is recommended that their health is assessed by healthcare professionals.
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Affiliation(s)
- Anna Aftyka
- Department of Anaesthesiological and Intensive Care Nursing, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Wojciech Rosa
- Department of Applied Mathematics, Faculty of Technology Fundamentals, Lublin University of Technology, Lublin, Poland
| | - Jolanta Taczała
- Department of Rehabilitation and Physiotherapy, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
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Jackson SE, Williams K, Beeken RJ, Steptoe A. Changes in Health and Wellbeing in the Years Leading up to a Cancer Diagnosis: A Prospective Cohort Study. Cancer Prev Res (Phila) 2019; 12:79-88. [PMID: 30606717 PMCID: PMC6365212 DOI: 10.1158/1940-6207.capr-18-0277] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 10/10/2018] [Accepted: 12/10/2018] [Indexed: 12/30/2022]
Abstract
Emerging evidence suggests cancer survivors suffer impairments in health and wellbeing that predate their diagnosis. This study prospectively examined changes from 4 to 6 years prediagnosis to 0 to 2 years postdiagnosis. Data were from 477 cancer survivors and 5,451 cancer-free comparisons participating in the English Longitudinal Study of Ageing. We examined group-by-time interactions for self-rated health, quality of life (QoL), depression, life satisfaction and impairments in mobility, activities of daily living (ADL), and instrumental ADLs (IADL). All health and wellbeing markers worsened over time in both groups. A greater decline in cancer survivors' self-rated health was evident as early as 2 to 4 years prediagnosis (P < 0.001). Around diagnosis, there were greater declines in IADL impairment (P < 0.001), QoL (P < 0.001), and depression (P < 0.001) in cancer survivors than in controls. Mobility and ADL impairments were consistently more prevalent among cancer survivors (P < 0.001), and life satisfaction was consistently lower (P = 0.004), but the rate of change over time did not differ significantly between groups. These results suggest there may be early signs of deterioration in perceived health that precede development of symptoms leading to cancer diagnosis by many years. Some of the impaired wellbeing in cancer patients may be long-standing, while other changes are more acute and may require targeted support following diagnosis.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK.
| | - Kate Williams
- Department of Behavioural Science and Health, University College London, London, UK
- Acaster Lloyd Consulting Ltd, London, UK
| | - Rebecca J Beeken
- Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
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Folker AP, Hegelund ER, Mortensen EL, Wimmelmann CL, Flensborg-Madsen T. The association between life satisfaction, vitality, self-rated health, and risk of cancer. Qual Life Res 2018; 28:947-954. [PMID: 30536220 DOI: 10.1007/s11136-018-2083-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE Only few prospective studies have been conducted on the contribution of quality of life-related factors to the risk of cancer. The aim of this study was to investigate the prospective associations of three quality of life-related factors with the risk of cancer; life satisfaction, vitality, and self-rated health. METHODS In 2009-2011, 7189 participants in the Copenhagen Aging and Midlife Biobank were asked to rate their life satisfaction, their vitality, and their health. The study population was followed until the end of 2015 for registration of cancer in the Danish National Patient Register. RESULTS During the follow-up period, cancer was diagnosed in 312 individuals. Life satisfaction was not associated with the risk of cancer. Vitality was significantly associated with the risk of cancer, but the association became non-significant after adjustment for age, sex, socioeconomic position, and lifestyle factors. However, when additionally adjusting for life satisfaction, individuals who rated their vitality as low had a hazard ratio of 1.46 (95% confidence interval [CI] 1.04-2.07) for the development of cancer. Individuals who rated their health as poor had a hazard ratio of 1.70 (95% CI 1.27-2.26) for the development of cancer, compared with individuals with good, very good, or excellent self-rated health. The association remained significant after adjustment for basic confounders, life satisfaction, and vitality. CONCLUSION A better grasp of the significance of quality of life-related factors for the risk of cancer may be of great importance to population-based cancer prevention that aims to target early risk factors for development of cancer across widespread cancer sites.
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Affiliation(s)
- Anna Paldam Folker
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455, Copenhagen K, Denmark.
| | - Emilie Rune Hegelund
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen K, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen K, Denmark
| | - Cathrine Lawaetz Wimmelmann
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen K, Denmark
| | - Trine Flensborg-Madsen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Box 2099, 1014, Copenhagen K, Denmark
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