Socioeconomic inequalities, health damaging behavior, and self-perceived health in Serbia: a cross-sectional study

Abstract

AimTo analyze the association of socioeconomic factors with self-perceived health in Serbia and examine whether this association can be partly explained by health behavior variables.MethodsWe used data from the 2007 Living Standards Measurement Study for Serbia. A representative sample of 13 831 persons aged ≥20 years was interviewed. The associations between demographic factors (age, sex, marital status, and type of settlement), socioeconomic factors (education, employment status, and household consumption tertiles), and health behavior variables (smoking, alcohol consumption) and self-perceived health were examined using logistic regression analyses.ResultsA stepwise gradient was found between education and self-perceived health for the total sample, men, and women. Compared to people with high education, people with low education had a 4.5 times higher chance of assessing their health as poor. Unemployed (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.29-2.10), inactive (OR, 2.82; 95% CI, 2.49-3.19), and the most deprived respondents (OR, 1.17; 95% CI, 1.02-1.34) were more likely to report poor self-perceived health than employed persons and the most affluent group. After adjustment for demographic and health behavior variables, the magnitudes of all associations decreased but remained clearly and significantly graded.ConclusionsThis study revealed inequalities in self-perceived health by socioeconomic position, in particular educational and employment status. The reduction of such inequalities through wisely tailored interventions that benefit people’s health should be a target of a national health policy in Serbia.

Association of Poor Self-Perceived Health with Demographic, Socioeconomic and Lifestyle Factors in the Croatian Adult Population

“…Results revealed that all four analysed socioeconomic factors were significantly associated with poor self-perceived health, not only in a univariate model, but also in a multivariable model controlled for demographic and lifestyle factors, suggesting that their association with poor self-perceived health is not mediated by demographic and lifestyle factors included in this analysis. This conclusion is confirmed by results of studies in other populations (Kraja, Kraja, Cakerri, & Burazeri, 2016;Janković, Janević, & Von dem Knesebeck, 2012). Similar findings were in line with some studies suggesting that self-perceived social status was related to self-rated health and irrespective of sex, self-perceived social status was related to self-rated health, depression, and long--standing illness or disability over and above education, occupational status, wealth, age, and marital status (Franzini & Fernandez-Esquer, 2006;Hu, Adler, Goldman, Weinstein, & Seeman, 2005;Ostrove, Feldman, & Adler, 1999;Singh-Manoux, Marmot, & Adler, 2005).…”

Inequalities in health in a municipality of Serbia

“…The results of this study correlate to results of various different studies which point to the fact that the level of education is in a proportional relationship with the selfassessment of health 13,14 and that it is possible that the inequality in healthcare is a consequence of the perceived fact that the people with higher education have more skills for solving everyday challenges which could have a negative influence on the health of an individual 15 .…”

Employment status and differences in physical activity behavior during times of economic hardship: results of a population-based study

“…[9] In addition, medical studies have found that stress increases both eating and smoking. [31][32][33][34] Moreover, job loss affects health behavior through an income effect.…”