Cardiovascular risk factor burden has a stronger association with self-rated poor health in adults in the US than in Sweden, especially for the lower educated

Abstract

There is an ongoing debate about the importance of biomedical and sociodemographic risk factors in the prediction of self-rated health. To compare the association of sociodemographic and cardiovascular risk factors and self-rated health in Sweden and the US. Data from two population-based cross-sectional health surveys, one in Sweden and one in the US. The surveys included questionnaire and measured data from 5,461 adults in Sweden and 7,643 in the US. Participants were between 35 and 65 years of age. The odds ratios for poor self-rated health for the included cardiovascular risk factors were greater in the US. Low education was significantly more prevalent among those with self-rated poor health in the US, but not in Sweden. Using Swedes with high education as reference group (OR = 1), adults in the US with low education and 2+ risk factors had a greater than threefold risk (OR = 6.3) of self-rated poor health compared with Swedish low-educated adults with the same risk factor burden (OR = 1.9). The better-educated US adults with 2+ risk factors were significantly more likely to report poor health (OR = 3.4) compared with their Swedish counterparts (OR = 2.4). The interaction between risk factors, education, and self-rated health suggests a frightening picture, especially for the US. Public health interventions for reducing cardiovascular risk factors need to include both population and individual measures. Taking people's overall evaluation of their health into account when assessing total health risk is important.