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

Abstract

BackgroundSelf-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.MethodsData 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.ResultsAbout 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.ConclusionThe 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.

All-cause mortality rate in China: do residents in economically developed regions have better health?

“…As local demographic characteristics often affect population health, we included the population aged under 5 (%), the population aged over 65 (%), female-to-male ratio (%), population density (the number of residents divided by land area, /km 2 ), and minority (%) as independent variables [8,24,25]. In addition, populations with a high school education or above (%) and migrant (%) were introduced as covariates since they reflect socioeconomic status, which may lead to health disparities [8,26]. As a critical issue in this study, urban-suburban-rural settings were introduced to reflect the administrative level and location of the study unit according to the National Census Survey and the China City Statistic Yearbook [18,20].…”

“…A fair number of individual-level observations in China have noted geographic variations in residents' health with measures including comorbidity of chronic disease [6], quality of life [7], and self-rated health [8]. In contrast, regional-level studies in China tended to employ a provincial-level analysis.…”

Associação entre sintomas depressivos e aspectos nutricionais em idosos residentes do município de São Paulo: um estudo de base populacional

“…Dados da Pesquisa Social Geral da China (CGSS) evidenciam a depressão como preditor mais influente da saúde auto avaliada, especialmente entre mulheres e os idosos. Além disso, 65% dos entrevistados relatam que o status socioeconômico, estilo de vida e os fatores psicossociais, estão relacionados a uma melhor auto avaliação da saúde (Cai et al, 2017).…”

Exposição à violência e autoavaliação de saúde: análise de dados da Pesquisa Nacional de Saúde (PNS), 2013

“…Na última década, muitas áreas de investigação em ciências sociais e epidemiologia têm buscado refinar a pesquisa dos determinantes sociais e individuais da autoavaliação de saúde (Barros et al, 2009;Cai et al, 2017;Cau et al, 2016; Chireh e D'Arcy, 2018; Garcia et al, 2010;Lodin et al, 2017;Mascarenhas et al, 2017;Ou et al, 2018;Santos et al, 2007). Entre os determinantes individuais, é possível dizer, com base na literatura, que as pessoas, conforme envelhecem, tendem a classificar pior a sua saúde, ou seja, quanto mais se avança para faixas etárias maiores, mais o estado geral de saúde diminui e, consequentemente, a autoavaliação de saúde decai (Andrade e Mehta, 2018;Barros et al, 2009;Cai et al, 2017;Carvalho et al, 2015;Cau et al, 2016;Chireh e D'Arcy, 2018 Os achados em relação à autoavaliação em saúde e sexo indicam que mulheres tendem a avaliar sua saúde como ruimcomparativamente pior que a dos homens (Andrade e Mehta, 2018;Barros et al, 2009;Cai et al, 2017;Cau et al, 2016;Chireh e D'Arcy, 2018;Hosseinpoor et al, 2012;Sundaram, 2004 (Hosseinpoor et al, 2012).…”

“…Está bem estabelecida, também, a relação entre a autoavaliação do estado de saúde e os fatores de escolaridade e renda. Os estudos demonstram uma autoavaliação de saúde mais negativa nos indivíduos com menor escolaridade e menor renda (Andrade e Mehta, 2018;Barros et al, 2009;Cai et al, 2017;Carvalho et al, 2015;Chireh e D'Arcy, 2018 Ainda sobre aspectos individuais, os hábitos relacionados ao estilo de vida também têm sido relacionados à autoavaliação de saúde (Barros et al, 2009;Cai et al, 2017;Cau et al, 2016;Hansen et al, 2015;Ou et al, 2018;Pavão et al, 2013).…”