Socioeconomic differences in self-rated health among women: a comparison of St. Petersburg to Estonia and Finland

Population norms of health-related quality of life in Moscow, Russia: the EQ-5D-5L-based survey

Purpose

To develop population norms for the EQ-5D-5L questionnaire based on a representative sample of Moscow citizens.

Methods

We used quota sampling accounting for sex, age group and administrative district of residence. Respondents in randomly selected outdoor and indoor locations were surveyed with the official Russian paper-and-pencil version of the EQ-5D-5L questionnaire and a set of socio-demographic questions. We estimated four types of EQ-5D results: the distribution of limitations according to EQ-5D-5L dimensions, the perception of the health-related quality of life (HRQoL) with a visual analogue scale (EQ VAS), the unweighted score for a respondent’s health state (Level Sum Score, LSS) and the Russian health preferences-based weighted score (EQ index). In order to estimate the EQ-5D-5L index, we used a newly developed Russian EQ-5D-3L value set, together with EuroQol Group cross-over methodology.

Results

A total of 1020 respondents (18–93 years old) from the general Moscow adult population completed the EQ-5D-5L questionnaire. HRQoL domains with the largest number of identified health limitations were pain/discomfort (48.6%) and anxiety/depression (44.1%). Two hundred seventy-nine respondents (27.0%) did not report any health restrictions. The mean EQ VAS and EQ-5D-5L index were 74.1 (SD 17.3) and 0.907 (0.106) respectively. Multivariate analysis showed that female sex, advanced age and lack of access to the Internet had a negative influence on HRQoL, whereas residence in certain districts had a positive impact.

Conclusions

The study provides population norms of health-related quality of life in Moscow, measured according to the EQ-5D-5L questionnaire. These reference values can be used to optimise the effectiveness of resource allocation in healthcare.

Electronic supplementary material

The online version of this article (10.1007/s11136-020-02705-0) contains supplementary material, which is available to authorised users.

Associations of socioeconomic and religious factors with health: a population-based, comparison study between China and Korea using the 2010 East Asian social survey

Background

Cross-national comparisons of the associations of socioeconomic and religious factors with health can facilitate our understanding of differences in health determinants between countries and the development of policies to reduce health differentials appropriate to each country. However, very few such studies have been conducted in East Asia.

Methods

This study set out to compare the associations of socioeconomic and religious factors with health in China and Korea using the 2010 East Asian Social Survey, which was based on nationally representative samples. The study participants included 4980 individuals, 3629 in China and 1351 in Korea, aged ≥20 years. The dependent variable, individuals’ self-rated health, was categorized into poor, good, and excellent. Socioeconomic (education, employment, household income, and self-assessed social class) and religious factors (affiliation) were used as independent variables of interest. A multinomial logistic regression was performed with and without adjustments for factors such as demographics, health-related risks, the health system, and social capital.

Results

According to the results, China had a higher proportion of individuals who reported excellent health than did Korea (57.4% vs. 52.0%). After adjusting for all studied confounders, we found that the employment, household income, and social class gradient in health were significant in China, whereas the education and religion gradients in health were significant in Korea. For example, the odds ratio for poor health versus excellent health among those in the highest social class was 0.47 (95% CI, 0.27–0.84), compared to that of people in the lowest social class in China; and this odds ratio in people with college education or higher was 0.28 (95% CI, 0.14–0.59) compared to that of people with elementary school education or lower in Korea.

Conclusions

These findings demonstrate the important role of socioeconomic and religious factors in health in China and Korea as well as clear differences in this regard. Further cross-national studies are needed to provide a better understanding of the relationship between socioeconomic and religious factors and health and to draft appropriate health improvement policies in both countries.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-6380-y) contains supplementary material, which is available to authorized users.

Regional differences and determinants of self-rated health in a lower middle income rural Society of China

Objective

Self-rated health represents a reliable and important health measure related to general health and quality of life. This study aimed to identify the differences of health states of rural residents in a lower middle income setting in China and its associated factors.

Methods

A descriptive study of a stratified random sample of 3870 individuals was conducted in rural Anhui during 2015. We investigated the influence of five independent variables: individual demographic characteristics, family factors, social capital traits, physical health conditions and healthy lifestyle habits of participants who self-related their health as good. A chi-square test and ordinal logistic regression analyses were used to identify the relationship of these variables and self-rated health.

Results

The study found that respondents who negatively rated their health often were female, elderly, poor, lived alone, had low levels of education, inadequate social support, poor physical health, used healthcare services and lived in the lower economic regions. We found no significant correlations between self-rated health and employment, marital status, medical insurance, or exercise frequency. Surprisingly, smoking and drinking also seemed to be unrelated to poor self-reported health.

Conclusion

Health differences based on region were apparent in rural China. We highlighted the possible impacts of income, age, physical health, education, advanced age, and social support on health. The results from this study could inform the delivery of appropriate health and social healthcare interventions to promote rural residents’ health and quality of life.

Maternal Educational Attainment at Birth Promotes Future Self-Rated Health of White but Not Black Youth: A 15-Year Cohort of a National Sample

Background: Socioeconomic status (SES) is essential for maintaining health, and self-rated health (SRH) is not an exception to this rule. This study explored racial differences in the protective effects of maternal educational attainment at birth against poor SRH of the youth 15 years later. Methods: Using data from the Fragile Families and Child Wellbeing Study (FFCWS), this 15-year longitudinal study followed 1934 youths from birth to age 15. This sample was composed of White (n = 497, 25.7%), and Black (n = 1437, 74.3%) youths. The independent variable was maternal educational attainment at birth. SRH at age 15 was the dependent variable. Family structure was the covariate. Race was the focal moderator. We ran logistic regression models in the pooled sample, as well as stratified models based on race. Results: In the pooled sample, maternal educational attainment and family structure were not predictive of SRH for the youths at age 15. Race interacted with maternal educational attainment, indicating a stronger association between maternal educational attainment at birth on youth SRH for Whites compared to Blacks. In race stratified models, maternal educational attainment at birth was protective against poor SRH for White but not Black youths. Conclusion: White but not Black youths gain less SRH from their maternal educational attainment. Enhancing education attainment may not have identical effects across racial groups. The health status of Blacks may be less responsive to improvements in maternal educational attainment. Policies should go beyond investing in educational attainment by empowering Black families to better use the educational attainment that they gain. Policies and programs should reduce the costs of upward social mobility for minority families.

Socioeconomic Status, Health Behaviors, Obesity and Self-Rated Health among Older Arabs in Israel

Socioeconomic inequalities in health are well documented. Recently, researchers have shown interest in exploring the mechanisms by which measures of SES operate through it to impact SRH, such as material, psychosocial and behavioral factors. To examine the relationships between SES indicators and self-rated health (SRH); and to determine whether health behaviors and obesity mediate the association between SES indicators and SRH. A secondary analysis of data previously collected through the third survey of socioeconomic and health status of the Arab population in Israel, in which the SRH of 878 Arab-Israelis age 50 or older were analyzed using logistic regression. The results showed that higher education level and current employment in old age are associated with better SRH. However, neither subjective economic status nor family income was associated with SRH. Greater physical activity was found to be related to good\very good SRH, while obesity was associated with less than good SRH. Finally, health behaviors (physical activity) and obesity were revealed as mediators between SES indicators (education and employment status) and SRH. The results highlight the importance of high education level and employment status in old age to reduce health inequalities. The findings also show that the relationship between SES and SRH can operate through behavioral mechanisms (i.e., physical activity) and their consequences (i.e., obesity), that can, however, be changed in old age.

Determinants of and socio-economic disparities in self-rated health in China

Background

Self-rated health (SRH) is not only used to measure health status and health inequalities, but also as a strong predictor of morbidity and mortality. The purpose of this study was to: 1) evaluate the factors that account for variations in self-rated health among Chinese citizens; and to 2) explore the process through which socio-economic status may impact self-rated health.

Methods

Data were derived from the Chinese General Social Survey (CGSS) (2013). Determinants of self-rated health were analyzed along four main dimensions: demographic characteristics, socio-economic status, lifestyle, and psychosocial factors. Multivariate odds ratios for good self-rated health were calculated for different variables in order to analyze the determinants. Binary logistic regression analysis was performed to assess the extent to which lifestyle and psychosocial factors explained the association between socio-economic status and self-rated health.

Results

About 65% of the survey respondents reported good self-rated health. Women, the elderly, married or single respondents and residents of Western China were less likely to report good self-rated health. Respondents who were engaged in work, had higher household income, reported high social class and higher socio-economic status compared with peers were more likely to report good self-rated health. Normal weight and physically active respondents along with those reporting a happy life, no depression, and good relationships with families and friends were related to good self-rated health. We also found the effect of socio-economic status on self-rated health was partly explained by lifestyle and psychosocial factors.

Conclusion

The present findings support the notion that both socio-economic status and lifestyle as well as psychosocial factors were related with good self-rated health. The interventions targeting these factors could improve the health status of the population. The depression was the most influential predictor of self-rated health, especially for the women and the elderly. Although lifestyle and psychosocial factors explained partly the the association between socio-economic status and health, the reason why socio-economic difference exists in health must be further explored. What’s more, it needs to be further studied why the same determinant has different influence strengths on the health of different groups of people.

CONTRASTING CONCURRENT AND CHILDHOOD SOCIOECONOMIC PREDICTORS OF SELF-RATED HEALTH AMONG OLDER EUROPEAN MEN AND WOMEN

This study aimed to assess the relative importance of childhood and adulthood socioeconomic position (SEP) on the self-rated health (SRH) of men and women aged 50 or higher in Europe, controlling for a substantial number of mediators and health conditions. Data from Wave 2 (current data) and Wave 3 (retrospective material) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were combined (N=20,829) and logistic regression models applied; the analysis was carried out for males and females separately. The findings indicate that concurrent and past SEP, when considered separately, are both very significant predictors of SRH. When all factors were included in a comprehensive model most childhood and adult SEP variables retained their significance, implying that both types of socioeconomic circumstances have a strong and independent effect on SRH. However, the relative importance of several childhood indicators was reduced, signifying that their effect on SRH is mediated by adult SEP and, especially, educational attainment. Some childhood predictors, such as having experienced a period of hunger, remained very significant. Though these findings roughly hold for both sexes, the relative effects differentiate by sex. Current SEP is more important among women, with the exception of income and 'making ends meet in the household'. Childhood SEP indicators are more significant among men.

Self-perception and quality of life among overweight and obese rural housewives in Kelantan, Malaysia

Introduction

Obesity, in the past was perceived to be the problem of the rich, but recent studies have reported that the problem of obesity is a worldwide problem and rural population is no less affected. Self-perceived health and weight appropriateness is an important component of weight-loss and eating behaviors and may be mediated by local, social and cultural patterning. In addition to the quality of life assessment, it should therefore be an important focal point for the design and implementation of clinical and public health policies.

Methods

The present study was carried out to assess the self-perception of weight appropriateness as well as the quality of life of overweight and obese individual among the rural population particularly among housewives. A total of 421 respondents participated in the study which consisted of 36.6% in the overweight and 63.4% in the obese categories.

Results

the analysis of the survey revealed that self-perception regarding obesity among respondents show common similarities, particularly in self reporting on health, dietary habit and also the concept of beauty and a beautiful body. Character and behavior are highly regarded in evaluating a person’s self-worth in society. The results on the quality of life using the ORWELL 97 instrument show that the quality of life of respondents was moderate. Most of the respondents were aware of their body weight and indicated an intention to lose weight but also reported themselves as healthy or very healthy.

Conclusion

The results of the survey indicated that perception on obesity did not differed very much between respondents, in fact there existed a lot of similarities in their perception about health, quality of life, personal health and self-satisfaction with own body. However, their quality of life was within the normal or moderate level based on the ORWELL 97 assessment. Even though most of the respondents were aware of their body weight and indicated an intention to lose weight they also reported themselves as healthy or very healthy, suggesting that public health messages intended for rural housewives need to be more tailored to health-related consequences of fatness.

Social Determinants of Self-reported Health Among Population in Republic of Macedonia - Results from a Case-control Study

INTRODUCTION

Studying self-reported health is considered an indicator for morbidity and mortality that may be used in primary health care to detect poor health in certain population groups that predicts health care utilization.

GOAL

The goal of the survey is to assess the socioeconomic self-rated health gradient and to describe contribution of behavioral risk factors to this gradient among population in Republic of Macedonia.

MATERIAL AND METHODS

Data is collected through a "nested case-control study", conducted in the period March - December, 2013. "Cases" are households with TB patient(s) registered in the period July, 2012 - June, 2013 and "controls" are households randomly chosen in cases' immediate vicinity.

RESULTS

The total study population is 562 households with total of 2720 respondents. Self-rated health was reported as excellent or good by only half of the respondents, with slightly less positive answers among cases compared to controls and evident differences in responses for poor or extreme difficulties in everyday life. Positive association was found between poor rated health and long-standing diseases and education was associated with poor self-rated health. Adding questions on mobility, self-care, pain, cognition, interpersonal activities and affect has only reaffirmed the findings, with statistically significant differences among study groups along all six dimensions.

CONCLUSION

The ease of use of simple questions to ask for self-rated health makes it an extremely beneficial tool in health care planning.