Determinants of and socio-economic disparities in self-rated health in China

Jiaoli Cai,Peter C Coyte,Hongzhong Zhao

doi:10.1186/s12939-016-0496-4

Jiaoli Cai, Peter C Coyte + Show 1 more

Open Access

https://doi.org/10.1186/s12939-016-0496-4

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Abstract

BackgroundSelf-rated health (SRH) is not only used to measure health status and health inequalities, but also as a strong predictor of morbidity and mortality. The purpose of this study was to: 1) evaluate the factors that account for variations in self-rated health among Chinese citizens; and to 2) explore the process through which socio-economic status may impact self-rated health.MethodsData were derived from the Chinese General Social Survey (CGSS) (2013). Determinants of self-rated health were analyzed along four main dimensions: demographic characteristics, socio-economic status, lifestyle, and psychosocial factors. Multivariate odds ratios for good self-rated health were calculated for different variables in order to analyze the determinants. Binary logistic regression analysis was performed to assess the extent to which lifestyle and psychosocial factors explained the association between socio-economic status and self-rated health.ResultsAbout 65% of the survey respondents reported good self-rated health. Women, the elderly, married or single respondents and residents of Western China were less likely to report good self-rated health. Respondents who were engaged in work, had higher household income, reported high social class and higher socio-economic status compared with peers were more likely to report good self-rated health. Normal weight and physically active respondents along with those reporting a happy life, no depression, and good relationships with families and friends were related to good self-rated health. We also found the effect of socio-economic status on self-rated health was partly explained by lifestyle and psychosocial factors.ConclusionThe present findings support the notion that both socio-economic status and lifestyle as well as psychosocial factors were related with good self-rated health. The interventions targeting these factors could improve the health status of the population. The depression was the most influential predictor of self-rated health, especially for the women and the elderly. Although lifestyle and psychosocial factors explained partly the the association between socio-economic status and health, the reason why socio-economic difference exists in health must be further explored. What’s more, it needs to be further studied why the same determinant has different influence strengths on the health of different groups of people.

Highlights

Since the beginning of the 21st century, with the development of science and technology, people’s living standards have improved significantly
Because most socio-economic status variables remained significant after taking lifestyle and psychosocial factors into account, the findings suggest that the lifestyle and psychosocial factors considered in the current study are not likely to be the dominant mechanism by which socio-economic status impacts Self-rated health (SRH)
This study complements the international literature by reporting results from China, an upper-middle-income country, that highlights the factors associated with variations in SRH and explores the processes through which socio-economic status impacts SRH

Summary

Introduction

Since the beginning of the 21st century, with the development of science and technology, people’s living standards have improved significantly. Rural residents have low socio-economic status compared to urban residents, they were more likely to report good health. The study by Zhou [22] showed poor socio-economic status are negative impacts factors for the elderly living independently in rural China. They thought special attention is needed to those with lower socio-economic status and less children’s support. Sun et al [16] used the EQ-5D instrument to measure the population health status in China, and found that health status declines with advancing age It seems that vulnerable groups such as women, the elderly are less likely to report good health. Further research is needed to verify this, and to find out the reasons

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