Adverse health effects of low levels of perceived control in Swedish and Russian community samples

Abstract

BackgroundThis cross-sectional study of two middle-aged community samples from Sweden and Russia examined the distribution of perceived control scores in the two populations, investigated differences in individual control items between the populations, and assessed the association between perceived control and self-rated health.MethodsThe samples consisted of men and women aged 45–69 years, randomly selected from national and local population registers in southeast Sweden (n = 1007) and in Novosibirsk, Russia (n = 9231). Data were collected by structured questionnaires and clinical measures at a visit to a clinic. The questionnaire covered socioeconomic and lifestyle factors, societal circumstances, and psychosocial measures. Self-rated health was assessed by standard single question with five possible answers, with a cut-off point at the top two alternatives.Results32.2 % of Swedish men and women reported good health, compared to 10.3 % of Russian men and women. Levels of perceived control were also significantly lower in Russia than in Sweden and varied by socio-demographic parameters in both populations. Sub-item analysis of the control questionnaire revealed substantial differences between the populations both in the perception of control over life and over health. Logistic regression analysis revealed that the odds ratios (OR) of poor self-rated health were significantly increased in men and women with low perceived control in both countries (OR between 2.61 and 4.26).ConclusionAlthough the cross-sectional design does not allow causal inference, these results support the view that perceived control influences health, and that it may mediate the link between socioeconomic hardship and health.

Gender Patterns of Socioeconomic Differences in Premature Mortality: Follow-up of the Hungarian Epidemiological Panel

“…In our study, self-efficacy differed between surviving and deceased persons of both genders. These results are in agreement with the studies, which showed that low levels of perceived control have adverse effects on health [62,63].…”

Perceived control as a predictor of cardiovascular disease mortality in Poland. The HAPIEE study

“…Numerous authors highlight the need for research to investigate causal relationships between psychosocial factors and CVD mortality in this region [20][21][22][23].…”

Perceived neighbourhood cohesion and health among mid-aged Australian women

“…[160,307] Adding complexity to the apparent association between optimism and health, Ruthig and colleagues found that optimism, social support, self-rated health, and depression were inter-related, and that their associations with health behaviours vary with the health outcome being studied. [308] Social support, life satisfaction, life control and optimism have been reported to be associated with health behaviours, physical health, mental health, and mortality, [13,19,44,160,283,284,303,309,310]. There is also limited evidence that some of these variables are associated with perceived neighbourhood cohesion.…”

“…[284,306,310,404,418] Where perceived life control has been included in perceived neighbourhood cohesion and mental health research, life control has been shown to mediate the association. [146,316,317] In cross-sectional analyses of data collected in Chicago neighbourhoods, Mair and colleagues found that adjusting for social support did not affect the association between neighbourhood variables and depression measured by the CESD.…”

“…[152,160,162,163,283] People"s psychosocial characteristics have also been found to ameliorate the deleterious effects of low socioeconomic position on health. [147,153,[284][285][286] There is debate regarding whether psychological characteristics act on health directly or via an indirect mechanism. Although used as one part of a composite score, optimism has been identified as a variable that indirectly affects health outcomes.…”