Abstract
BackgroundThe high and fluctuating mortality and rising health inequalities in post-Soviet countries have attracted considerable attention. However, there are very few individual-level data on distribution of health outcomes in Central Asian countries of the former Soviet Union. We analysed socioeconomic predictors of two self-rated health outcomes in a national survey in Kazakhstan.MethodsWe used data from the 2012 Kazakhstan Household Health Survey on 12,560 respondents aged 15+. Self-rated health, self-reported worsening of health, and a range of socio-demographic variables were collected in an interview. The self-rated health outcomes were dichotomized and logistic regression was used to estimate their associations with education, income, ownership of a car, second house and computer, marital status, ethnicity and urban/rural residence.ResultsThe prevalence of poor/very poor self-rated health was 5.3%, and 11.0% of participants reported worse health compared to 1 year ago. After controlling for age, sex and region, all socio-demographic factors were related to self-rated health. After adjusting for all variables, education and car ownership showed the most consistent effects; the odds ratio of poor health and worsening of health were 0.43 (95% confidence interval 0.32-0.58) and 0.54 (0.44-0.68) for university vs. primary education, respectively, and 0.64 (0.51-0.82) and 0.68 (0.58-0.80) for car ownership, respectively. Unmarried persons, ethnic Russians and urban residents also had increased prevalence of poor health in multivariable models.ConclusionsDespite the limitations of using subjective health measures, these data suggest strong associations between two measures of self-rated health and a number of socioeconomic characteristics. Future studies and health policy initiatives in Kazakhstan and other Central Asian countries should take social determinants of health into account.
Highlights
The high and fluctuating mortality and rising health inequalities in post-Soviet countries have attracted considerable attention
Kazakhstan has one of the highest mortality rates in the WHO European region; in 2010, life expectancy at birth was 68.6 years, similar to 69.0 years in Russia but considerably lower than 81.2 years in the “old” European Union countries (WHO Health for all database)
Data source We used the data from Kazakhstan Household Health Survey (HHS) conducted in 2012
Summary
The high and fluctuating mortality and rising health inequalities in post-Soviet countries have attracted considerable attention. There are very few individual-level data on distribution of health outcomes in Central Asian countries of the former Soviet Union. The high mortality rates and dramatic changes in countries of the former Soviet Union since 1990 have attracted considerable attention [1,2,3,4,5]. Rising socioeconomic inequalities in Kazakhstan has one of the highest mortality rates in the WHO European region; in 2010, life expectancy at birth (men and women combined) was 68.6 years, similar to 69.0 years in Russia but considerably lower than 81.2 years in the “old” European Union countries (WHO Health for all database). We are aware of only one study in the literature exploring individuallevel influences on health in Kazakhstan [10] and were are not aware of any published study in other Central Asian countries
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