Inequalities in self-rated health among 45+ year-olds in Almaty, Kazakhstan: a cross-sectional study

Abstract

BackgroundSelf-rated health (SRH) has been widely studied to assess health inequalities in both developed and developing countries. However, no studies have been performed in Central Asia. The aim of the study was to assess gender-, ethnic-, and social inequalities in SRH in Almaty, Kazakhstan.MethodsAltogether, 1500 randomly selected adults aged 45 years or older were invited to participate in a cross-sectional study and 1199 agreed (response rate 80%). SRH was classified as poor, satisfactory, good and excellent. Multinomial logistic regression was applied to study associations between SRH and socio-demographic characteristics. Crude and adjusted odds ratios (OR) for poor vs. good and for satisfactory vs. good health were calculated with 95% confidence intervals (CI).ResultsAltogether, poor, satisfactory, good and excellent health was reported by 11.8%, 53.7%, 31.0% and 3.2% of the responders, respectively. Clear gradients in SRH were observed by age, education and self-reported material deprivation in both crude and adjusted analyses. Women were more likely to report poor (OR = 1.9, 95% CI: 1.2-3.1) or satisfactory (OR = 1.6, 95% CI: 1.2-2.1) than good health. Ethnic Russians and unmarried participants had greater odds for poor vs. good health (OR = 2.3, 95% CI: 1.5-3.7 and OR = 4.0, 95% CI: 2.7-6.1, respectively) and for satisfactory vs. good health (OR = 1.4, 95% CI: 1.1-1.9 and OR = 1.9, 95% CI: 1.4-2.5, respectively) in crude analysis, but the estimates were reduced to non-significant levels after adjustment. Unemployed and pensioners were less likely to report good health than white-collar workers while no difference in SRH was observed between white- and blue-collar workers.ConclusionConsiderable levels of inequalities in SRH by age, gender, education and particularly self-reported material deprivation, but not by ethnicity or marital status were found in Almaty, Kazakhstan. Further research is warranted to identify the factors behind the observed associations in Kazakhstan.

Diabetes prevalence, awareness and treatment and their correlates in older persons in urban and rural population in the Astana region, Kazakhstan

“…There is evidence that the social gradient in obesity changes with affluence and development; at earlier stages of transition, obesity shows a positive association with socioeconomic status but at later stages the gradient becomes inverse. [31] The higher prevalence of diabetes in ethnic Russians is analogous to previously reported lower self-rated health in the Russian vs. Kazakh ethnicity [32,33], however, in contrast to self-rated health, the difference for diabetes prevalence was only marginally statistically significant. While the increased risk in Russians may be related to life style of socioeconomic status, it was not attenuated in the fully adjusted model.…”

Long term unemployment, income, poverty, and social public expenditure, and their relationship with self-perceived health in Spain (2007–2011)

“…Socioeconomic conditions and the decrease in family income are linked to poor health indicators [ 25 , 26 ]. Aittomäki et al (2012, 2014) used longitudinal data to analyze how health inequalities are associated with the specifics of the labor market and family income [ 27 , 28 ].…”

Factors associated with self-rated health among migrant workers: results from a population-based cross-sectional study in Almaty, Kazakhstan

“…Research has shown that SRH is a strong predictor of health outcomes and mortality, independent of many biological and physical factors (Jylha 2009 ; Mavaddat et al 2011 ; Kaplan and Baron-Epel 2003 ; Supiyev et al 2014 ). In population studies, SRH has been shown to be a feasible, inclusive, and informative measure of health (Jylha 2009 ; Abikulova et al 2013 ; Idler and Benyamini 1997 ). A review of 27 community studies showed SRH was a predictor of mortality in nearly all of the studies, even after controlling for other relevant health indicators and covariates known to predict mortality (Idler and Benyamini 1997 ; Surkan et al 2009 ).…”