Association between impairment and self-rated health: a brazilian population study considering type, origin, and degree of limitation

Abstract

Background Perceived health is a well-known, low-cost measure in public health, and has been used in several studies on individuals with impairment. Although many studies have related impairment to self-rated health (SRH), few have considered the origin and degree of limitation of the impairment. This study examined whether physical, hearing, or visual impairments—when analyzed according to origin (congenital or acquired) and degree of limitation (with or without)—are associated with the SRH status. Methods This cross-sectional study used data of 43,681 adult individuals from the Brazilian National Health Survey (NHS, 2013). The outcome SRH was dichotomized into poor (including the regular, poor, and very poor responses) or good (including the good and very good responses). Crude and adjusted (for socio-demographic characteristics and chronic diseases history) prevalence ratios (PR) estimates were evaluated using Poisson regression models with the robust variance estimator. Results Poor SRH prevalence was estimated at 31.8% (95%CI:31.0–33.0) among the non-impaired population, 65.6% (95%CI:60.6–70.0) among individuals with physical impairment, 50.3% (95%CI:45.0–56.0) for people with hearing impairment, and 55.3% (95%CI:51.8–59.0) for the visually impaired. Individuals with congenital physical impairment—with or without limitations—presented the strongest association with the poorest SRH status. Participants with non-limiting, congenital hearing impairment showed a protective factor to poor SRH (PR = 0.40 95%CI: 0.38–0.52). Individuals with acquired visual impairment with limitations demonstrated the strongest association with poor SRH (PR = 1.48 95%CI:1.47–1.49). Among the impaired population, middle-aged participants showed a stronger association with poor SRH than older adult participants. Conclusions Impairment is associated with poor SRH status, especially among people with physical impairment. The origin and degree of limitation of each type of impairment differently impacts SRH among the impaired population.

Impact of hearing loss on cognitive function in community-dwelling older adults: serial mediation of self-rated health and depressive anxiety symptoms

“…Although there is a high prevalence of poor SRH in older adults with hearing loss, the underlying mechanisms remain unclear. Most studies support that the nature of hearing loss (congenital or acquired) and the degree to which hearing loss causes limitations in daily activities affect SRH ( Anderle et al, 2023 ). Hearing loss in older adults not only affects their daily communication and interactions but also leads to other health problems such as impaired lower limb function, frailty syndrome, and IADL disability ( Yévenes-Briones et al, 2021 ).…”

“…This is because they develop alternative communication mechanisms apart from speaking and hearing. Moreover, after receiving hearing aids and/or rehabilitation, they develop coping strategies, such as sign language and oral-facial reading, to integrate into the community ( Anderle et al, 2023 ). All of this evidence suggests that individuals who are unable to cope with the changes brought about by hearing loss and lack appropriate coping strategies, such as seeking professional help or using hearing aids, are more likely to experience poor SRH.…”

“…Although research on how hearing loss affects SRH in older adults is limited, findings from empirical studies demonstrate that older adults with hearing loss are likely to rate their health as poorer. A recent study conducted in Brazil found that 50.3% of patients with hearing loss reported poor SRH ( Anderle et al, 2023 ). Participating in community events, such as club activities and outings with friends, is extremely important for the physical and social engagement of many older adults.…”