Differences In Self-rated Health Research Articles

Racial/ethnic differences in the relationship between wealth and health across young adulthood

BackgroundAlthough the relationship between socioeconomic position (SEP) and health has been well documented, very few prior investigations have examined the time-varying association between wealth and health across race/ethnicity. This study examined the racial/ethnic differences in the wealth–health associations during young adulthood. MethodData were drawn from the National Longitudinal Survey of Youth 1997 with three time points, when respondents were aged 20, 25, and 30. The primary dependent variable was dichotomized self-rated health (SRH). Two indices of wealth were calculated: respondents’ own reported net worth and reported parental net worth in 1997. Other SEP indicators included household income, education, employment status, and parental education. Three racial/ethnic groups were examined: nonHispanic White, non-Hispanic Black, and Hispanic. Two-level logistic regression was performed, stratified by race/ethnicity. ResultsIn the whole-sample analysis, racial/ethnic differences in SRH were not statistically significant, after controlling for wealth. For self-reported net worth during young adulthood, wealth has a incremental consistent effect on health among non-Hispanic White respondents and Hispanic respondents but not among Black respondents. Individual net worth and parental net worth were only significantly associated with health among the highest wealth quartiles among non-Hispanic Black respondents. Only individual net worth, not parental net worth, was significantly associated with SRH in the Hispanic sample. ConclusionThis study examined racial/ethnic differences in time-varying relationship between wealth and health during young adulthood. Findings indicate that there are notable racial/ethnic differences in the patterning of wealth–health association that appear to emerge in early adulthood. Implications for asset-based policy and programs are discussed.

Investigating food insecurity, health lifestyles, and self-rated health of older Canadians living alone

Background and objectivesThere is a large number of older Canadians living alone, calling for academic attention to the health outcomes of this demographic fact. Although many studies have investigated the association between living arrangements and health, little is known about potential underlying mechanisms regarding how living alone may predict older Canadians’ health. In this study, we address this research gap intending to contribute to offering policy suggestions for older Canadians who live alone.Research design and methodsWe applied Cockerham’s health lifestyle theory to explore to what degree living alone predicts worse health lifestyles and, further, to what degree these lifestyles can explain the association between living alone and older Canadians’ health. We used the 2017–2018 Canadian Community Social Survey (Annual Component) which has a response rate of 58.8%. We focused on respondents aged 60 and above, and the analytical sample size is 39,636.ResultsOlder Canadians living alone are more likely to have food insecurity problems and higher possibilities of smoking cigarettes compared to those living with spouses/partners with or without children. Compared to those living with spouses/partners only, the odds of solo-living older Canadians drinking regularly is significantly lower. There also exists a significant difference between older Canadians living alone and their counterparts living with spouses/partners that the former reported lower self-rated health compared to the latter. Moreover, food insecurity and the three health lifestyle variables are significantly associated with respondents’ self-rated health; food insecurity, cigarette smoking, and alcohol drinking can partially explain the difference in self-rated health due to living arrangements.Discussion and implicationsAccording to our findings, health officials are recommended to pay more attention to food insecurity and heavy smoking problems facing older Canadians who live by themselves. Local communities and other stakeholders are suggested to provide older adults living alone with more opportunities for social engagement and involvement since regular drinking may have played such a role in enhancing social life quality of the aged.

Rural urban differences in self-rated health among older adults: examining the role of marital status and living arrangements

BackgroundThe rural–urban gap in socioeconomic and morbidity status among older adults is prevalent in India. These disparities may impact the levels and factors of self-rated health (SRH). The objective of the study is to compare the levels and determinants of SRH between rural and urban areas by considering the moderating effects of marital status and living arrangements.Subjects and methodsThe present study used data from the Longitudinal Ageing Study in India (LASI) wave 1 (2017–18). A total sample of 30,633 older adults aged 60 years and above were selected for the study. Descriptive statistics, bivariate chi-square test, the interaction effect of living arrangements and marital status, and logistic estimation were applied to accomplish the study objectives.ResultsThe prevalence of poor SRH was found 7% higher in rural areas compared to urban counterparts. A substantial rural–urban disparity in the patterns of poor SRH was also observed. The interaction effect of marital status and living arrangement on self-rated health suggested that older adults who were currently unmarried and living alone were 38% more likely to report poor SRH than those who were currently married and co-residing in rural India. In addition to marital status and living situation, other factors that significantly influenced SRH include age, socio-cultural background (educational attainment and religion), economic background (employment status), health status (ADLs, IADLs, multi-morbidities), and geographic background (region).ConclusionThe present study's findings demonstrated that, notwithstanding local variations, marital status and living circumstances significantly influenced SRH in India. In the present study, unmarried older people living alone were more susceptible to poor SRH in rural areas. The present study supports the importance of reinforcing the concepts of care and support for older individuals. There is a need for special policy attention to older individuals, particularly those unmarried and living alone. Although older individuals had difficulty performing ADLs and IADLs and had multi-morbidities, they reported poorer health. Therefore, offering them social support and top-notch medical assistance is crucial.

Factors Associated with Poor Self-Rated Health among Older Women Living Alone.

Background: The study aimed to identify the differences in self-rated health (SRH) and the factors associated with poor SRH among older women who live alone, based on their sociodemographic and health characteristics. Methods: The sample consisted of 812 older women living alone and was obtained from the Seventh Korean National Health and Nutrition Examination Survey (Ⅶ-1, Ⅶ-2, Ⅶ-3). Complex sample analysis was performed using the independent t-test, the Chi-square test, and multiple logistic regression in SPSS/WIN 24.0 program. Results: The study found that SRH status in older women living alone differed according to age, education level, income, occupation, walking practices, sleeping hours, perceived stress, experiencing depression, diabetes, arthritis, and restrictions in daily functions. As the factors associated with poor SRH among older women living alone, a lower education level (OR = 1.89, CI = 1.19–3.02), higher perceived stress (OR = 4.92, CI = 1.84–13.16), experiencing arthritis (OR = 1.52, CI = 1.07–2.16), and higher restrictions in functioning (OR = 6.20, CI = 4.01–9.59) increased the likelihood of rating the poor SRH. Conclusion: SRH is an indicator of overall health status, and physical, psychological, and economic factors affect each other. Therefore, it is necessary to develop effective health education and intervention programs for vulnerable groups, including older women living alone with poor SRH.

The Influence of Subjective Social Status on Self-Rated Health: Evidence from China

Subjective Social Status (SSS) inevitably affects the self-rated health of individuals and /or societal groups. Based on the evidence from China, this paper aims to 1) assess the influence of Objective Social Status and Subjective Social Status on differences in self-rated health in China; 2) to examine the correlations between Subjective Social Status and perceived health. The data from the Chinese General Social Survey (CGSS) 2010 are selected to achieve the two aims with SSS measured by Subjective Family Economic Status (SFES, using the Likert scale) and Subjective Social Class (SSC, using the MacArthur scale), and Health Status measured by a continuous ill score calculated by the standard logarithmic normal distribution index conversion of self-rated health. Advanced statistical modeling using the nested multiple robust regression model and interaction analysis is used to deal with heteroscedasticity from the CGSS data. It is found that: 1) lower SSS is associated with poor health status and SSS is a more comprehensive predictor of health status; 2) aging has more apparent influences on the health of lower SSS groups; 3) lower SSS groups have received higher health returns from their educational attainment than higher SSS groups though they tend to be in poorer health status; 4) once have a chronic disease the health of lower SFES groups will suffer more deterioration than higher ones.

The Influence of Subjective Social Status on Self-Rated Health: Evidence from China

Subjective Social Status (SSS) inevitably affects the self-rated health of individuals and /or societal groups. Based on the evidence from China, this paper aims to 1) assess the influence of Objective Social Status and Subjective Social Status on differences in self-rated health in China; 2) to examine the correlations between Subjective Social Status and perceived health. The data from the Chinese General Social Survey (CGSS) 2010 are selected to achieve the two aims with SSS measured by Subjective Family Economic Status (SFES, using the Likert scale) and Subjective Social Class (SSC, using the MacArthur scale), and Health Status measured by a continuous ill score calculated by the standard logarithmic normal distribution index conversion of self-rated health. Advanced statistical modeling using the nested multiple robust regression model and interaction analysis is used to deal with heteroscedasticity from the CGSS data. It is found that: 1) lower SSS is associated with poor health status and SSS is a more comprehensive predictor of health status; 2) aging has more apparent influences on the health of lower SSS groups; 3) lower SSS groups have received higher health returns from their educational attainment than higher SSS groups though they tend to be in poorer health status; 4) once have a chronic disease the health of lower SFES groups will suffer more deterioration than higher ones.

A Collaborative Implementation Strategy to Increase Falls Prevention Training Using the Age-Friendly Health Systems Approach.

Falls in the home and in community environments are the leading cause of injuries and long-term disabilities for the aging population. The purpose of this study was to examine outcomes of a partnership among an academic institution, government agency, community organizations, and emergency management services to implement a falls prevention training program using an Age-Friendly Health Systems approach. In this prospective study, partners identified gaps in services and targeted and non-targeted delivery areas for implementation of an evidence-based falls prevention intervention addressing the 4Ms of Age-Friendly Health Systems—Mobility, Medications, Mentation, and What Matters. Descriptive statistics were calculated for program implementation and participant demographic variables, and paired t-test analysis compared scores for self-assessed general health and falls efficacy prior to and after program participation. Twenty-seven falls prevention classes were implemented, with over half (52%) in targeted areas. A total of 354 adults aged 50 and older participated, with N = 188 participants (53%) completing the program by attending at least five of eight sessions. Of completers, 35% resided in targeted areas. The results showed a statistically significant improvement in falls efficacy by program completers in targeted and non-targeted areas. However, there was no statistically significant difference in self-rated health. Overall, the findings of this study indicate that collaboration to deliver falls prevention training can be effective in reaching at-risk older adults. By mobilizing collaborative partnerships, limited resources can be allocated towards identifying at-risk older adults and improving community-based falls prevention education.

The effect of serving as a danwei leader before retirement on self-rated post-retirement health: empirical evidence from China

BackgroundWorker health is often influenced by their occupation type, and the accumulative effect of occupation has a significant impact on their health after retirement. Studies show that the type and level of occupation before retirement directly impact workers’ self-rated post-retirement health. However, there is little research on the self-rated post-retirement health of danwei leaders in China. This study seeks to examine the self-rated health level of Chinese danwei leaders after retirement. Furthermore, the differences between their self-rated health level and that of retirees from other occupations are explored by examining the accumulative effect of occupation and the mechanism underlying these differences.MethodsBased on 5,910 samples’ data from the 2018 China Longitudinal Aging Social Survey, ordinary least squares, logit, and propensity score matching models are used to investigate the self-rated health level of Chinese danwei leaders after retirement, their differences with other occupations, and the corresponding mechanism.ResultsThe results show that retired danwei leaders have higher self-rated health levels than retirees in other occupations. This was mainly found among female, non-eastern, married, not living with children, and highly educated respondents. The difference in self-rated health between retired danwei leaders and other retired groups was influenced by their post-retirement income and social status.ConclusionsIn China, retired danwei leaders rated their health higher than retirees from other occupations. Danwei leaders have high socioeconomic status due to their occupation. Compared with other groups, their advantages are significant and enjoyed for a long time. Additionally, most danwei leaders have high social influence even after retirement and their higher income and social status have a positive impact on their self-rated health compared with other employees. This study provides empirical evidence from China and extends current literature on the effects of occupational type and level on self-rated health after retirement.

Cultural Differences in Self‐Rated Health: The Role of Influence and Adjustment

AbstractPrevious studies have demonstrated cross‐cultural differences in the levels of self‐rated health (SRH), an individual's overall perception of their health, and that Korea and Japan tend to show relatively poor SRH despite higher life expectancy compared to countries like the United States. While it has been suggested that response styles and macro‐level cultural values contribute to such differences, there is limited research on what other factors might be. The present study focused on influence and adjustment strategies as a potential cultural factor that could partly explain the cultural differences in SRH. Results from structural equation modeling have shown that Americans reported greater influence and positive reappraisal, plus a lower adjustment of goals than Japanese individuals, which partially explained the higher SRH among Americans than in the Japanese. These patterns were found even when a more objective measure of health (i.e., chronic conditions) was controlled for. Together, the findings highlight the role of influence and adjustment in understanding cultural differences in SRH.

Racial/ethnic differences in social support and health among Asian American and non-Hispanic White midlife women: Results from the Study of Women’s Health Across the Nation (SWAN)

ABSTRACT Objective: Although prior research suggests Asian Americans experience physical health advantages relative to other racial/ethnic groups, increasing evidence points to health inequalities within Asian American subgroups. Disparities are especially pronounced among middle-aged Asian American women, who remain an understudied population, despite studies showing that midlife corresponds with distinct social stressors and changes in the availability of protective resources, such as social support. Thus, the purpose of the study was to examine racial/ethnic differences in social support and self-rated health (SRH) among middle-aged women. Design: With data from the Study of Women’s Health Across the Nation (SWAN; N = 1258), we used modified Poisson regression models to estimate incidence rate ratios (IRR), examining how social support shaped the risk of fair-to-poor SRH by race/ethnicity. We tested interactions between perceived stress, social support and race/ethnicity to determine whether the stress-buffering role of social support varies by group. Results: Results demonstrate racial/ethnic differences in SRH. Higher levels of social support were linked to higher fair-to-poor SRH among Chinese American women (IRR = 1.24; 95% CI [1.02, 1.52]); while greater social support conferred lower risk among White women. Interaction analyses revealed additional nuances in the stress-buffering effects of social support among Chinese American women, such that the health benefits of social support depended on levels of perceived stress (IRR = 0.75; 95% CI [0.57, 1.00]). Conclusions: These findings highlight important distinctions in the ways that psychosocial factors shape health across racial/ethnic groups. In particular, this study helps advance our understanding of important subgroup differences in the stress-buffering role of social support for Asian American midlife women. Interventions should focus on identifying sources of social strain among Asian American women that can increase the risk for poor health and identify alternative sources of support that mitigate stressors to improve health.

Health selection on self-rated health and the healthy migrant effect: Baseline and 1-year results from the health of Philippine Emigrants Study.

Studies of migration and health focus on a “healthy migrant effect” whereby migrants are healthier than individuals not migrating. Health selection remains the popular explanation of this phenomenon. However, studies are mixed on whether selection occurs and typically examine migrants post-departure. This study used a novel pre-migration dataset to identify which health and social domains differ between migrants and their non-migrant counterparts and their contribution to explaining variance in self-rated health by migrant status at pre-migration and 1-year later. Data were used from the baseline and 1-year follow-up of the Health of Philippine Emigrants Study (HoPES). We used multivariable ordinary least squares regression to examine differences in self-rated health between migrants to the U.S. and a comparable group of non-migrants at baseline (premigration) and one year later, accounting for seven domains: physical health, mental health, health behavior, demographics, socioeconomic factors and healthcare utilization, psychosocial factors, and social desirability. A migrant advantage was present for self-rated health at baseline and 1-year. Accounting for all domains, migrants reported better self-rated health compared to non-migrants both at baseline (β = 0.32; 95% CI = 0.22, 0.43) and at 1-year (β = 0.28; 95% CI = 0.10, 0.46). Migrant status, health behavior, and mental health accounted for most of the variance in self-rated health both at baseline and 1-year follow-up. This analysis provides evidence of migrant health selection and nuanced understanding to what is being captured by self-rated health in studies of migrant health that should be considered in future research.

Experiences With Physical Distancing: Coping Strategies and Positive Experiences

A representative U.S. sample of adults completed an online survey (N=360) about perceived changes in social health and wellbeing since the implementation of physical distancing restrictions in April. Analyses are conducted on a subsample of adults aged 60+ (n=93; m=65.7 years; SD=4.7). Baseline bivariate descriptive analyses showed no geographic-based differences in self-rated health, resilience, perceived financial wellbeing, or family/friend support measures. Content analysis of rural residents’ (n=20) responses about coping strategies and positive experiences across three time points (April/July/November) revealed aspects of resilience. Individuals coped via acceptance and planning; engaging in activities; and keeping with routines. Positive experiences were relatively stable over time, with individuals describing improved health habits and enhanced social connectedness with family/neighbors. Individuals identified societal betterment and saving money as unintended benefits of the efforts to mitigate the spread of COVID-19. When faced with adversity, identifying positive experiences may help individuals cope with challenges in the long-term

Exploring meal frequency and vegetable intake among immigrants 70\xa0years or older in Sweden

BackgroundEarlier research regarding immigrants has shown that lifestyle and environmental factors are of importance for the risk of developing certain diseases. Food habits are one of these factors. As there is little research concerning immigrants and food habits, the aim of the present paper was to explore food habits operationalised as meal frequency and vegetable intake among a group of older immigrants in Sweden. Specifically, the following questions were explored: changes in food habits when migrating, missing food from the native country, gender differences in food habits and association between food habits and self-rated health and well-being.MethodA total of 131 persons from the health-promoting study “Promoting Aging Migrants’ Capabilities” (PAMC) conducted in Gothenburg, Sweden, 2011–2014, were included in this exploratory secondary analysis of questionnaire data. Participants were 70 years or older, cognitively intact, and living in ordinary housing. They had all migrated to Sweden from Finland or the Western Balkan Region (Bosnia-Herzegovina, Croatia, Montenegro and Serbia). Descriptive statistics as well as binary logistic regression were used to answer the research questions.ResultsForty-eight percent of the participants in PAMC reported that they had changed their food habits when migrating, and 17% considered that they missed certain foods from their native country. Most of the participants migrated to Sweden more than 20 years ago. There was a significant difference in self-rated health in favour of the male participants (p = 0.02), but food habits, operationalised as meal frequency and vegetable intake, were not associated with self-rated health or life satisfaction.ConclusionMen rated their health as better than women did, but food habits operationalised as meal frequency or vegetable intake, were not associated with self-rated health or life satisfaction. Results from this secondary analysis were affected by methodological shortcomings. Further studies to understand the role of food habits in relation to health in a migration context are desired.Trial registration: NCT01841853, Registered April 29, 2013. Retrospectively registered.

Gender differences in the association between perceived income sufficiency and self-rated health among older adults: A population-based study in India

This study explores whether gender differences in self-rated health can be attributed to socioeconomic status and self-perceived income sufficiency in particular. We used data from the Building a Knowledge Base on Population Ageing in India (BKPAI-2011) and carried out the descriptive and bivariate analysis along with a chi-square test to explore the significance of possible associations between explanatory and outcome variables in the study. Also, sex-stratified multiple logistic regression models were employed to fulfill the study objectives. The results show that a higher percentage of older women (58.4%) reported their health as fair/poor than older men (52%). Older women reported poor self-rated health than older men with similar self-perceived income sufficiency (OR: 2.04; p < .001 vs. OR: 1.56; p < .010). All the health indicators such as suffering from higher number of chronic conditions (AOR: 3.70; p < .001 vs. AOR: 2.73; p < .001) and disability (AOR: 3.79; p < .001 vs. AOR: 3.33; p < .001) increased odds of rating of poor health among older women than men, except having two plus difficulty in activities of daily living (ADL), which was positively associated with reporting poor health among men than women (OR: 4.03; p < .001 vs. OR: 2.36; p < .001). The study highlights the gender differences in self-rating of health associated with subjective income status and other socioeconomic and health-related variables that are important while framing social policies for the Indian graying population.

Differences in Self-Rated Health and Physical Activity Due to Education Level among Koreans: Understanding Implications of Physical Education.

Background:We aimed to explore the effect of education levels on self-rated health and physical activity (PA) and to provide basic data for developing interventions based on physical education to improve the quality of life among Koreans.Methods:The 2019 Community Health Survey data were selected through primary and secondary phylogenetic extraction. The survey was conducted among Korean adults aged ≥19 years (n=229,099), in 2019, using an electronic questionnaire. The education levels were classified into eight groups: uneducated, Seodang/Hanhak (traditional Korean school), elementary school, middle school, high school, college (2 or 3 years), university (4 years), and post-graduate or higher. In this study, the effect of participants’ education levels on self-rated health levels and PA was investigated (the PA subdimensions were: the number of days of vigorous PA, moderate-intensity PA, walking, and flexibility exercises).Results:1) Regarding self-rated health, significant differences according to education level were recorded (P<0.001), with higher education levels leading to higher averages. 2) Regarding PA, significant differences according to education level were revealed, and the number of days of vigorous PA, walking, and flexibility exercise (P<0.001) increased with higher education levels. Moreover, the university (4 years) group reported the highest average. However, the middle school group reported the highest average for the number of days of moderate-intensity PA (P<0.001), and the average number of days decreased as the education level increased after middle school.Conclusion:Education plays an important role in maintaining health, and practicing appropriate PA contributes to one’s quality of life.

Public health in restructuring coastal communities: Generational trends in self-rated health following the decline in small-scale fishing. The HUNT study, Norway

Restructuring rural communities can be seen as natural population level experiments of great social epidemiological interest. Following the extensive decline in small-scale fishing in the later decades of the 20th century, many coastal communities have undergone considerable societal restructuring. In Norway, this has entailed a substantial reduction of the fishing workforce, concurrent with new employment opportunities in public sector and aquaculture. The former socialization into fishing from a young age is greatly reduced, with coastal youths now facing other life courses than preceding generations. As restructuring of societies is found to be intertwined with public health, coastal communities can provide valuable insights on public health during times of transitions. In this study, we use repeated cross-sectional population health data from rural Norwegian municipalities to assess the development of self-rated health over four decades in a coastal population who has undergone restructuring of local labour markets. We assess generational differences in health by comparing the prevalence of poor self-rated health at three ages reflecting three generations at each cross section: youths, adults and elderly. We compare results to adjacent geographical areas to assess geographical differences in self-rated health over time. We found a higher predicted prevalence of poor self-rated health in rural coastal adults and elderly compared to other geographical areas across all decades. However, trends revealed improving self-rated health in rural coastal adults and elderly, as well as narrowing health gaps between the rural coastal population and the remaining geographical areas in this Norwegian setting. Our results shed light on public health development in restructuring coastal communities.

Distinguishing independent and shared effects of material/structural conditions and psychosocial resources on educational inequalities in self-rated health: results from structural equation modelling

ObjectivesThe aim of this study was to distinguish independent and shared effects of material/structural factors and psychosocial resources in explaining educational inequalities in self-rated health (SRH) by using structural equation modelling. Study designCross-sectional survey. MethodsData were derived from a questionnaire sent to a random sample of the population in five counties in Sweden in 2008. The study population (aged 25–75 years) included 15,099 men and 17,883 women. Exploratory structural equation modelling was used to analyse the pathways from educational level to SRH. ResultsThe pathway including both material/structural factors (e.g. financial buffer and unemployment) and psychosocial resources (e.g. sense of coherence and social participation) explained about 40% of educational differences in SRH for both men and women. The pathways including only the independent effects of psychosocial resources (14% in men and 20% in women) or material/structural factors (9% and 18%, respectively) explained substantial but smaller proportions of the differences. ConclusionsThe major pathway explaining educational inequalities in SRH included both material/structural factors and psychosocial resources. Therefore, to reduce educational inequalities in SRH, interventions need to address both material/structural conditions and psychosocial resources across educational groups.

Positive and negative ageing perceptions account for health differences between older immigrant and native populations in the Netherlands

BackgroundThis study assessed the extent to which persistent differences in self-rated health (SRH) between older immigrants and natives are attributable to negative and positive ageing perceptions.MethodsThe study was conducted with three population groups in Rotterdam, the Netherlands: native Dutch people aged ≥70 years (n = 1150), Turkish immigrants aged ≥65 years (n = 680) and Moroccan immigrants aged ≥65 years (n = 292). To assess participants’ internal ageing representations, we used the short Aging Perceptions Questionnaire, which distinguishes negative (consequences, chronic and cyclical timeline awareness, and emotional representations) and positive (positive consequences, positive and negative control) dimensions and has been validated in native and immigrant populations. We analysed differences in ageing perceptions between immigrants and natives and the associations of ageing perceptions with SRH. We used Karlson–Holm–Breen decomposition to assess ageing perceptions’ mediation of the relationship between migration background and SRH.ResultsOlder immigrants had stronger negative and weaker positive ageing perceptions (excepting the positive consequences of ageing) than did Dutch natives. Ageing perceptions mediated the relationship between migration background and SRH. SRH differences between Turkish immigrants and native Dutch older persons were explained mainly by differences in negative consequences and cyclical timeline awareness. SRH differences between Moroccan immigrants and native Dutch older persons were attributable mainly to differences in negative consequences and positive control.ConclusionsDifferences in positive and negative ageing perceptions between older immigrants and natives in the Netherlands largely explained SRH differences between these population groups.

How do gender based disparities affect women’s self-rated health and anxiety in the European Union?

ABSTRACT This study analyses the differences in self-rated health (SRH) and self-rated anxiety (SRA) among the countries of the Euro-Area through the European Working Conditions Survey (2015). The article, thus, proposes a grouping of countries based on the Global Gender Gap Index, developed by the World Economic Forum, to justify differences in SRH and SRA. The descriptive analysis demonstrates remarkable differences among countries. The gender response pattern is also different. The estimates, made using the odds ratio method, reveal that women are more likely to report higher anxiety than poor health (56% vs 25%). The estimates show that in those countries where the situation of women compares unfavourably to that of men, the probability of women reporting poorer health status is higher. The situation with SRA, however, is different. In those countries with greater economic and political equality, the probability of women suffering anxiety increases. It is feasible that economic gender equality, which often results in greater incorporation of women in the labour market, could negatively affect SRA if women assume increased workloads and responsibility while maintaining the tasks associated with caring for home and family.

Assessing the Validity of Self-rated Health Across Ethnic Groups: Implications for Health Disparities Research.

This study examines the association between morbidity (i.e., chronic health conditions) and self-rated health (SRH) with the aim of testing the within-group and across-group validity of SRH across nine ethnic groups: non-Latinx White, Mexican, Puerto Rican, Cuban, African American, Afro-Caribbean, Chinese, Filipino, and Vietnamese Americans. In addition, we assess whether acculturation (i.e., nativity, years of US residency, language of interview) and health-related factors (e.g., mental disorder) account for ethnic distinctions in SRH. Data are from the National Survey of American Life (NSAL) and the National Latino and Asian American Study (NLAAS) (N = 8338). Weighted proportions and means for SRH and chronic conditions are reported. Ordered logistic regression analysis is used to determine ethnic group patterns in SRH. Despite evidence of within-group validity of SRH for each ethnic group, our results seriously challenge the across-group validity of SRH. For example, Chinese and Vietnamese respondents report lower SRH despite having fewer chronic conditions relative to non-Latinx Whites. Moreover, Mexican Americans report fewer chronic health problems but lower SRH compared to non-Latinx Whites. Acculturation factors (e.g., language of interview) partially explain the Mexican-White difference in SRH. Among Chinese Americans, completing an interview in English is associated with higher SRH relative to those who completed an interview in Chinese. These findings have implications for health disparities research that uses SRH as the dependent measure. Studies that compare the health profiles of diverse ethnic groups should use the SRH measure with caution, as SRH does not align with ethnic patterns of morbidity.