Self-Perceived Health and Its Associations with Social Factors and Perceived Environmental Quality in Southern Kazakhstan: a Cross-Sectional Study

Abstract

Introduction: Self-perceived health (SPH) has been shown to be a valid proxy indicator of health status in epidemiological studies. Substantial social variations in SPH have been previously reported from Kazakhstan. Southern Kazakhstan is among the poorest regions of the country with limited health information in international peer-reviewed literature. Aim: The aim of this study was to assess SPH in Southern Kazakhstan and its associations with selected social factors and perceived environmental quality. Methods: Altogether, 1 148 permanent residents of the Turkistan region aged 16-63 years participated in a cross-sectional study. Data on SPH, age, gender, ethnicity, marital status, education, perceived environmental quality, smoking and alcohol consumption were collected by a questionnaire. Associations between SPH and selected socio-demographic and geographical variables were assessed using multivariable logistic regression. Crude and adjusted odds ratios (OR) were calculated. Results: Poor, satisfactory, good and very good SPH was reported by 4.4 %, 27.1 %, 55.3 % and 13.2 % of the participants, respectively. Men (OR = 2.11; 95 % CI: 1.53-2.89), cohabiting responders (OR = 2.37; 95 % CI: 1.30-4.35), those who perceived environmental quality as unhealthy (OR = 2.12; 95 % CI: 1.31-3.43) or satisfactory (OR = 1.75; 95 % CI: 1.16-2.66), smokers (OR = 1.64; 95 % CI: 1.02-2.64), alcohol drinkers (OR = 1.44; 95 % CI: 1.00-2.06) and residents of Ordabasinski district (OR = 1.98; 95 % CI: 1.22-3.23) were more likely to report poorer health (poor+satisfactory combined) than their counterparts in the reference categories in the final multivariable model. Conclusions: The observed variations in SPH in Southern Kazakhstan contribute to the knowledge on inequalities in health in Kazakhstan and warrant monitoring of health inequalities on the national level. Further research in Southern Kazakhstan should address the factors behind the associations documented in this study.