A simple measure with complex determinants: investigation of the correlates of self-rated health in older men and women from three continents

Abstract

BackgroundSelf-rated health is commonly employed in research studies that seek to assess the health status of older individuals. Perceptions of health are, however, influenced by individual and societal level factors that may differ within and between countries. This study investigates levels of self-rated health (SRH) and correlates of SRH among older adults in Australia, United States of America (USA), Japan and South Korea.MethodsCross-sectional data were drawn from large surveys of older respondents (≥ 65 years) in Australia (n = 7,355), USA (n = 10,358), Japan (n = 3,541) and South Korea (n = 3,971), collected between 2000 and 2006. Harmonized variables were developed to represent socioeconomic, lifestyle and health indicators. We then assessed whether these variables, and their potentially different impact in different countries, could account for cross-national differences in levels of SRH.ResultsSRH differed significantly between countries, with older Koreans reporting much poorer health than those in the other three nations. This was not the result of biases in response patterns (for example central versus extreme tendency). Health-related correlates of SRH were similar across countries; those with more medical conditions, functional limitations or poor mental health gave poorer ratings. After accounting for the differential impact of determinants in different national contexts, Australians reported better SRH than other nations.ConclusionsWe conclude that when examining correlates of SRH, the similarities are greater than the differences between countries. There are however differences in levels of SRH which are not fully accounted for by the health correlates. Broad generalizations about styles of responding are not helpful for understanding these differences, which appear to be country, and possibly cohort specific. When using SRH to characterize the health status of older people, it is important to consider earlier life experiences of cohorts as well as national and individual factors in later life. Further research is required to understand the complex societal influences on perceptions of health.

Inequalities in self-rated health in Japan 1986–2007 according to household income and a novel occupational classification: national sampling survey series

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“…Self-rated health is increasingly used as an indicator in epidemiological studies 1 , chiefly due to a negative perception of health that itself consistently predicts functional decline in the elderly 2,3 and adults 4,5,6 . Self-rated health has proven to be a better predictor of adult mortality than objective measurements of health status 7,8 .…”

Autoavaliação do estado de saúde e fatores associados em idosos cadastrados na Estratégia Saúde da Família de Campina Grande, Paraíba

“…[2][3][4][5][6][7][8] In these assessments, the elderly individual is asked a simple question: "How do you feel about your health?" This method is clearly easy to apply, viable and inexpensive.…”