Abstract
To analyse the influence of micro- and macro-factors on self-rated health, and the role of generation on this relationship. Cross-sectional study using data from European Health Interview Surveys from 14 European countries. Individuals were divided into four generations ("silent generation", "baby boomers", and "generation X" and "Y"). We conducted multilevel analyses for each generation to study the influence of individual and national explanatory variables on self-rated health. Age showed an exponential effect in older generations. Education and employment presented the strongest association with low self-rated health, especially in "baby boomers" and women (low education: OR 3.5; 95% CI 3.2-3.9). Tobacco showed a negative effect in younger generations. Overweight and low physical activity were negatively associated with self-rated health regardless of generation. Countries from the Eastern welfare system showed the highest risk of low self-rated health and this association was higher in men for "silent generation" (OR 4.7; 95% CI 3.0-7.6). The influence of individual and national factors on self-rated health varies regarding generation. The target generation and the demographic structure of a country should be taken into account to develop more accurate health policies.
Highlights
Self-rated health is a multidimensional phenomenon that provides information about mental and physical wellness, which is associated with morbidity, mortality, and health care utilization (Wu et al 2013)
Education and employment presented the strongest association with low self-rated health, especially in ‘‘baby boomers’’ and women
Countries from the Eastern welfare system showed the highest risk of low self-rated health and this association was higher in men for ‘‘silent generation’’
Summary
Self-rated health is a multidimensional phenomenon that provides information about mental and physical wellness, which is associated with morbidity, mortality, and health care utilization (Wu et al 2013). Subjects like the personal concept of health, the reference group of the individual, their health expectations, and cultural conventions modulate people’s answer (Jylha 2009) In this regard, a person’s generation—defined as a group of people born within the same period of time and who share specific circumstances (Bristow 2016)—could play an important role on self-rated health assessment. Analysing generations in a chronological order, we observe that traditionalists value hard work, conformity, dedication, sacrifice, and patience; while baby boomers are optimistic and seek personal gratification and growth. They were the first generation to grow up in an affluent post-war society full of opportunities, which turned them into one of the most prosperous generations (Badley et al 2015). When changes in sociodemographic characteristics, lifestyles, and health status are considered, differences among cohorts decrease, but do not disappear (Chen et al 2007); it is plausible to affirm that inherent generational conditions affect self-rated health
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