Pain and self-rated health among middle-aged and older Canadians: an analysis of the Canadian community health survey―healthy aging

Abstract

BackgroundPain is an important health problem adversely affecting functionality and quality of life. Though self- rated health (SRH) is a major predictor of mortality, its relationship with pain is not well understood. We explore 1) how pain and age interact to influence SRH, and 2) provincial variations in SRH across Canada.MethodsWe analyzed cross-sectional data from Statistics Canada’s Canadian Community Health Survey-Healthy Aging (n = 30,685), which targeted those 45 years and older and was conducted from 2008 to 12-01 to 2009–11-30. The response rate was 74.4%.The topics covered included socio-demographics, well-being and chronic diseases. We performed both bivariate and multivariate analyses between each predictor and SRH; unadjusted and adjusted odds ratios and 95% confidence intervals are reported. Two-level logistic regression mixed model was used to account for provincial differences. An intraclass correlation coefficient was also computed.ResultsSlightly more than half of respondents (56.40%) were female. In bivariate analyses, those experiencing pain had an odds ratio of 0.20. Which means that the odds of reporting good self-rated health are 4 to 5 times lower for those with pain, compare to the odds of reporting good self-rated health among those without pain (p < 0.001). In multivariate analyses the highly educated, female gender, the never married or single and households with high yearly income were predictors of good health (p < 0.001). Those who reported depressive symptoms, the lonely, the obese, daily smokers and/or the stressed were less likely to rate their health as good (p < 0.001). The influence of pain on SRH was stronger among younger age groups (45–54 years) compared to older age groups (75-84 years, with an odds ratio of 3.53 [p < 0.001] versus 3.14 [p < 0.001]).ConclusionsPain, among other determinants, is associated with SRH. Individuals in rating their health may consider a variety of factors, some of which may not be apparent to health providers. We found that those who reported depressive symptoms, were daily smokers, the obese, the lonely, and/or having a stressful life were less likely to rate their health as good. No significant provincial variations in SRH in Canada was observed in this study.

Self-rated health and associated factors among the oldest-old: results from a cross-sectional study in Sweden

“…No independent associations between SRH and living conditions such as educational level, country of birth, living alone, cash margin and social support were found, even though low educational level and lack of social support were associated with poorer than good SRH in the bivariate analyses. This contradicts the findings from some previous studies where for example education [20,36], wealth and ethnicity [27] as well as social support [19] and loneliness [33] have been found to be associated with SRH in the elderly. However, some of these findings were obtained among younger elderly, whereas a smaller study on very old people, 80-89 years of age, in Sweden and Latvia did not find any association between SRH and educational level, income, marital status or social support [23] and one study in Spain found that the effect of social class among those aged 65 or older decreased with age [9].…”

“…We did not find any associations between other lifestyle factors than physical activity and SRH even though previous studies have found an association between e.g. smoking and SRH in the elderly [18,19,33]. The lack of association with smoking is possibly related to the small number of smokers (2%) in our study.…”

“…Former drinking is associated with poor SRH [36] and older people with health problems are more prone to abstain from alcohol than those without [38], which may have contributed to this explanation. In line with some other studies an increased risk of poorer than good SRH was also observed for obesity [32,33] but this association was no longer significant in the adjusted model.…”

“…Backpain has been shown to be a common negative correlate of SRH [32] and musculoskeletal pain to be a major contributor to the burden of poor SRH in the population [7]. The effect of pain on SRH seems, however, to be more marked among younger age groups than older age groups [33]. In this study, almost eight out of ten persons reported to have at least some problems with pain.…”

Self-rated health and socio-economic status among older adults in Northern Iceland

“…Self-rated health is considered a measure of general health status and is often used as a predictive measure of health outcomes [9,10]. Several socio-economic factors (SES) such as educational level [11], cohabitation, income level [4,11,12], and place of residency affect SRH in older people [13].…”