The Difference of Mortality According to Self-Assessed Health Status

Low Self-Rated Health as A Risk Factor for Depression in South Korea: A Survey of Young Males and Females

This is a cross-sectional study aimed to examine whether low self-rated health (SRH) is a risk factor for depression among young males and females. Data from the SRH, quality of life (QoL) and depression questionnaires as well as general information, were collected from 512 males and females aged 20-29 years in South Korea. Chi-square test was used to analyze the distribution of depression between the high and low SRH groups. Logistic regression was used to analyze the relationship between SRH and depression after adjusting for covariates. There were 32.6% males and 30.1% females who were at risk for depression. A significant difference in the distribution of depression between the low and high SRH groups in both males and females was found. The low SRH group had a higher prevalence of depression than the high SRH group in both males and females in the crude analysis. However, when the BMI, economic status, and mental component score were adjusted, the OR of the low SRH group was still significant in males. Low SRH may be a risk factor for depression especially in males. Further studies to improve SRH by developing preventive measures against depression status while considering gender characteristics are needed.

Self-rated health as a predictor of mortality according to cognitive impairment: findings from the Korean Longitudinal Study of Aging (2006-2016)

OBJECTIVES

Self-rated health is an instrumental variable to assess the overall health status of a population. However, it remains questionable whether it is still useful for cognitively impaired individuals. Therefore, this study aims to analyze whether self-rated health by the cognitively impaired predicts mortality reliably.

METHODS

This study used 7,881 community-dwelling individuals, aged 45 and above, from the Korean Longitudinal Study of Aging (2006-2016). It used the Cox proportional hazard models for analysis. Cognitive status was classified based on the Korean Mini Mental State Examination score and a stratified analysis was used to determine whether the predictability of self-rated health varies according to cognitive status.

RESULTS

For cognitively intact individuals, the adjusted hazard ratios (aHR) of mortality were 2.00 (95% confidence interval [CI], 1.18 to 3.41, model 4) for those with ‘bad’ self-rated health and 2.40 (95% CI, 1.35 to 4.25, model 4) for those with ‘very bad’ self-rated heath, respectively, compared with those with ‘very good’ health. The results remain statistically significant even after adjusting for socio-demographic factors, health status, and health-related behaviors. For cognitively impaired individuals, the aHR of mortality was statistically significant for those with ‘very bad’ self-rated health, compared with those with ‘very good’ health, when socio-demographic factors were accounted for (aHR, 3.03; 95% CI, 1.11 to 8.28, model 2).

CONCLUSIONS

Self-rated health by cognitively impaired individuals remains useful in predicting mortality. It appears to be a valid and reliable health indicator for the rising population with cognitive impairment, especially caused by aging population.

Poor People and Poor Health: Examining the Mediating Effect of Unmet Healthcare Needs in Korea

Objectives

The purpose of this study was to estimate the mediating effect of subjective unmet healthcare needs on poor health. The mediating effect of unmet needs on health outcomes was estimated.

Methods

Cross-sectional research method was used to analyze Korea Health Panel data from 2011 to 2015, investigating the mediating effect for each annual dataset and lagged dependent variables.

Results

The magnitude of the effect of low income on poor health and the mediating effect of unmet needs were estimated using age, sex, education level, employment status, healthcare insurance status, disability, and chronic disease as control variables and self-rated health as the dependent variable. The mediating effect of unmet needs due to financial reasons was between 14.7% to 32.9% of the total marginal effect, and 7.2% to 18.7% in lagged model.

Conclusions

The fixed-effect logit model demonstrated that the existence of unmet needs raised the likelihood of poor self-rated health. However, only a small proportion of the effects of low income on health was mediated by unmet needs, and the results varied annually. Further studies are necessary to search for ways to explain the varying results in the Korea Health Panel data, as well as to consider a time series analysis of the mediating effect. The results of this study present the clear implication that even though it is crucial to address the unmet needs, but it is not enough to tackle the income related health inequalities.