Abstract

BackgroundSelf-rated health (SRH) and socioeconomic position (SEP) as important determinants of health differences are associated with health and economic changes in society.The objectives of this paper were (1) to describe trends in SRH and (2) to analyze associations between SRH and SEP among adults in Estonia in 1996–2014.MethodsThe study was based on a 25–64-year-old subsample (n = 18757) of postal cross-sectional surveys conducted every second year in Estonia during 1990–2014. SRH was measured using five-point scale and was dichotomized to good and less-than-good. Standardized prevalence of SRH was calculated for each study year. Poisson regression with likelihood ratio test was performed for testing trends of SRH over study years. Age, nationality, marital status, education, work status and income were used to determine SEP. Logistic regression analysis was used to assess association between SRH and SEP.ResultsThe prevalence of dichotomized good self-rated health increased significantly over the whole study period with slight decrease in 2008–2010. Until 2002, good SRH was slightly more prevalent among men, but after that, among women. Good SRH was significantly associated with younger age, higher education and income and also with employment status among both, men and women. Good SRH was more prevalent among Estonian women and less prevalent among single men.ConclusionsThere was a definite increase of good SRH over two decades in Estonia following economic downturn between 2008 and 2010. Good SRH was associated with higher SEP over the study period. Further research is required to study the possible reasons behind increase of good SRH, and it’s association with SEP among adults in Estonia.

Highlights

  • Self-rated health (SRH) and socioeconomic position (SEP) as important determinants of health differences are associated with health and economic changes in society

  • Trends in self-rated health in 1996–2014 Based on five-point-scale the age-standardized prevalence of SRH changed significantly among men and women during the study period (p < 0.0001)

  • SRH was associated with higher SEP from 1996 to 2014 throughout the whole study period

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Summary

Introduction

Self-rated health (SRH) and socioeconomic position (SEP) as important determinants of health differences are associated with health and economic changes in society. The objectives of this paper were (1) to describe trends in SRH and (2) to analyze associations between SRH and SEP among adults in Estonia in 1996–2014. Among health measures besides of life expectancy, self rated health (SRH) can be used as an option which is recommended by WHO [6]. SRH is based on a single question asking people to rate their overall health status and has been shown to be reliable measure of individuals’ subjective health [6, 7]. Most of the studies cited here were based on single-year data, there is less amount of studies concerning time trends in SRH. Some earlier studies have reported the worsening of SRH over recent decades, for example in USA [14, 15] and improvement of SRH in Finland, Lithuania and Russia [2, 16]

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