Self-rated Health Measures Research Articles

Energy poverty: an overlooked determinant of health and climate resilience in Canada

ObjectiveDespite Canada being an important energy producer, not all Canadians can access or afford adequate levels of energy services at home to meet their needs, maintain healthy indoor temperatures, and live a decent life—a situation known as energy poverty. Depending on the measure, 6–19% of Canadian households face energy poverty. Health risks associated with energy poverty are documented in countries with milder climates. This study explores, for the first time in the Canadian context, the association between energy poverty and health.MethodsCross-sectional data are from the 2018 Canadian Housing Survey. Analyses are conducted on a sample weighted to represent 14 million Canadian households. The associations between expenditure-based and self-reported measures of energy poverty and self-rated general and mental health were assessed using logistic regression models, adjusted for potential confounding variables.ResultsThe odds of rating one’s general (OR: 1.48; 95%CI: 1.29, 1.70) and mental (OR: 1.21; 1.04, 1.41) health as poor are significantly higher for Canadian adults in households with a high share of energy expenditure to income. The likelihood of poor general and mental health was significantly higher for those dissatisfied with the energy efficiency of their dwelling, and with their ability to maintain a comfortable temperature both in the winter and in the summer.ConclusionExposure to energy poverty is associated with significantly increased likelihood of poor general and mental health. Given the high proportion of Canadian households facing energy poverty, with demonstrated implications for population health, tackling energy poverty is essential for an equitable energy transition and for climate resilience.

A single-item measure of self-rated mental health and psychological distress. In what situations can a single-item measure be useful?

To examine the association between self-rated mental health (SRMH) and psychological distress (PD) at multiple periods and subsequently assess the potential of SRMH as a screening tool. Staff working at a designated COVID-19 hospital in Sydney, Australia during March to May 2020 completed the SRMH and Kessler Psychological Distress Scale (K10) within a larger survey examining the pandemic's impact on health and well-being. SRMH was assessed before the pandemic (baseline), during its first peak in 2020 (time 2) and several months later (time 3). K10 was assessed for time 2 and time 3. All assessments took place at time 3. At time 2, 80% of respondents with high PD and 25% with low PD reported poor SRMH (χ2 = 21.3, p < .0001). At time 3, 90% with low PD reported good SRMH. Risk of high PD was greater for respondents with persistently poor SRMH (time 2: OR = 18.2, 95% CI = 7.7-42.8; time 3: OR = 14.4, 95% CI = 6.9-29.9) and, to a lesser extent, for those whose SRMH declined (time 2: OR = 11.6, 95% CI = 6.6-20.4; time 3: OR = 13.8, 95% CI = 2.9-66.9), compared to those with persistently good SRMH. During a crisis SRMH can identify the majority of those most likely to benefit from additional assessment and support. Persistently poor SRMH indicates highest risk, detectable from routine screening.

Psychometric Properties of the Brazilian Version of GOHAI among Community-Dwelling Elderly People.

This study assessed the psychometric properties of the Brazilian version of the Geriatric Oral Health Assessment Index (GOHAI). A representative sample of 613 community-dwelling elderly people aged from 65 to 74 years was selected. Sociodemographic data, GOHAI and self-perceived oral health measures were collected. Dental clinical measures were obtained through oral examinations. The dimensional structure and adequacy of components were assessed using Confirmatory Factor Analysis (CFA), inter-item correlations and item-scale correlations. Reliability was evaluated by internal consistency and Intraclass Correlation Coefficients. Correlations between GOHAI scores and self-reported oral health measures were conducted to assess convergent validity. The relationship between dental clinical measures and GOHAI was tested through Poisson Regression to examine discriminant validity. The link between GOHAI items and dimensions was supported by CFA. Item 12 showed a poor factor loading. The inter-item correlations varied from 0.047 to 0.442, and item-scale correlations ranged from 0.305 to 0.612. Cronbach's alpha was 0.704. The test-retest correlation for GOHAI was 0.882. GOHAI scores were correlated by self-rated oral health measures. Poor dental clinical measures were associated with GOHAI. The Brazilian version of GOHAI showed adequate psychometric properties. However, the weak dimensional structure of GOHAI suggests the need to perform cross-cultural adaptation of GOHAI for Brazilian elderly people.

Social position and economic system justification in Canada: Implications for advancing health equity and social justice from an exploratory study of factors shaping economic system justification.

Many socio-economic reforms that could reduce health disparities are not implemented because people justify existing systems and fear changes thereto. This study aimed to identify socio-demographic factors associated with system justifying beliefs to better understand how they are maintained in Canada. In doing so, we hypothesized that (1) systems justification is a default cognitive position, buttressed by the palliative benefits of system-justification, (2) lack of success in a given system generally motivates people to doubt the legitimacy of that system, and (3) system-justifying beliefs are rejected only when the costs of doing so are low enough and/or the benefits are high enough to outweigh the innate needs-fulfillment benefits of system-justification. Testing these hypotheses, we recruited participants living in Canada, aged 16+, to complete an online survey after being recruited via paid social media advertisements. Multivariable regression models identified factors associated with Economic System Justification Scale (ESJS) scores. Explanatory variables included demographic measures of social position, self-rated health, and patterns of social inclusion. Among 2,619 participants, system-justifying beliefs were wide-spread, with the average level of support across ESJS scale items exceeding 50%. Lower ESJS scores were associated with worse health, more loneliness, and lower socioeconomic status. Despite the pattern that marginalization erodes system-justification, several historically marginalized characteristics (e.g., non-white ethnicity and non-binary gender) were associated with relatively high system-justification, compared to matching privileged characteristics (e.g., white ethnicity; masculine gender). Supporting our hypotheses, we identify a general trend that social marginalization is associated with less system-justification. Those benefitting from the status quo (e.g., healthier, wealthier, less lonely) were more likely to hold system-justifying beliefs. However, some groups who are disadvantaged within the existing system reported higher system-justification-suggesting that system oppression may be a key moderator of the effect of social position on system justification.

Neighborhood greenness, but not walkability, is associated with self-rated measures of health in older adults: An analysis of the Canadian Longitudinal Study on Aging

The purpose of this analysis was to determine whether older Canadians residing in neighborhoods characterized by denser greenness or higher walkability have better self-reported health outcomes at 3-year follow-up. Data on self-reported chronic diseases (composite score of 10 conditions) and self-rated measures of health (general health, mental health, and healthy aging) from the Canadian Longitudinal Study on Aging (CLSA) were used as outcomes. The CLSA database was linked with the Canadian Active Living Environments (Can-ALE), a measure of walkability, and Normalized Difference Vegetation Index (NDVI), a measure of greenness. The analytic sample consisted of adults aged 65 and older (n = 15339, age 72.9 ± 5.6, 50 % female). Crude and adjusted associations were assessed using Poisson regression and proportional odds regression modelling. The 4th quartile of greenness was associated with the chronic disease index and all three measures of self-rated health (general health, mental health, and healthy aging); living in a neighborhood with the highest greenness was associated with better health three years later when compared to those in the lowest quartile of greenness. After adjustment for covariates of age, sex, income, education, and physical activity levels, only the association for the 3rd quartile of greenness was significantly associated with general health (OR: 0.90, 95 %CI: 0.81–0.99) and mental health (OR: 0.88, 95 %CI: 0.79-0.97). Can-ALE was not associated with any of the outcomes assessed. Future research assessing perceived environmental walkability and geriatric relevant health outcomes rather than chronic disease may provide greater insight into our understanding of age-friendly environments.

Reliability and predictive validity of two scales of self-rated health in China: results from China Health and Retirement Longitudinal Study (CHARLS)

BackgroundDespite the widespread use of the single item self-rated health (SRH) question, its reliability has never been evaluated in Chinese population.MethodsWe used data from the China Health and Retirement Longitudinal Study, waves 1–4 (2011–2019). In wave 1, the same SRH question was asked twice, separated by other questions, on a subset of 4533 subjects, allowing us to examine the test–retest reliability of SRH. In addition, two versions of SRH questions (the WHO and US versions) were asked (n = 11,429). Kappa (κ), weighted kappa ({kappa}_{w}), and polychoric correlation coefficient (ρ) were used for reliability assessment. Cox proportional-hazards models were estimated to assess the predictive validity of SRH measurement for mortality over 7 years of follow up. To do so, relative index of inequality (RII) and slope index of inequality (SII) were estimated for each SRH scale.ResultsThere was moderate to substantial test–retest reliability (κ = 0.54, {kappa}_{w}=0.63) of SRH; 31% of respondents who used the same scale twice changed their ratings after answering other questions. There was strong positive association between the two SRH measured by the two scales (ρ > 0.8). Compared with excellent/very good SRH, adjusted hazard ratios (HR) of death are 2.30 (95% CI, 1.70–3.13) for the US version and 1.86 (95% CI, 1.33–2.60) for the WHO version. Using slope indices of inequality, the WHO version estimated slightly larger mortality differences (RII = 3.50, SII = 15.53) than the US version (RII = 3.25, SII = 14.80).ConclusionsIn Chinese middle-aged and older population, the reliability of SRH is generally good, although the two commonly used versions of SRH scales could not be compared directly. Both indices predict mortality, with similar predictive validity.

Differential Associations Between the Area Deprivation Index and Measures of Physical Health for Older Black Adults.

This study explored the association between place-based characteristics (e.g., neighborhood socioeconomic deprivation) and physical health within older Black adults, a critical gap in the literature as identified by the National Institute on Minority Health and Health Disparities. The sample was from Wave 1 data of Baltimore Study of Black Aging: Patterns of Cognitive Aging (N = 450; Mage = 68.34). Variables included the area deprivation index (ADI), objective (e.g., average blood pressure) and subjective (e.g., self-rated health) measures of physical health. Multiple linear regression models were conducted controlling for key sociodemographic characteristics. Participants reporting better self-rated health and less likely to need help with activities of daily living were significantly more likely to be living in more disadvantaged neighborhoods based on national and state ADI, respectively, even after adjusting for covariates. A significant age and ADI interaction revealed better self-rated health was associated with a more disadvantaged neighborhood particularly for individuals ≤66 years. There was no significant association between ADI and objective physical health measures. The findings suggest that national- and state-level place-based characteristics should be considered along with individual-level factors, which can enrich the scientific understanding of how neighborhood characteristics relate to varying health indicators among older Black adults.

Development of a 5-year risk prediction model for type 2 diabetes in individuals with incident HbA1c-defined pre-diabetes in Denmark

IntroductionPre-diabetes increases the risk of type 2 diabetes, but data are sparse on predictors in a population-based clinical setting. We aimed to develop and validate prediction models for 5-year risks...

Financial Hardship, Religious Experience, and Health

Background Previous research has shown that religion mitigates the deleterious association between financial hardship and health. Although religion is a multidimensional construct, this strand of research has primarily focused on religious behavior or belief. Purpose The current study aims to extend previous findings by examining a neglected aspect of religious involvement—religious experience—and how it buffers the association between financial hardship and self-rated health. Methods The current study analyzes two waves of data from the Portraits of American Life Study (2006–2012) (N = 1020), a nationally representative sampling of American adults. It uses lagged dependent variable regression models. Results The analyses reveal that financial hardship measured at W2 is negatively associated with self-rated health at W2, net of W1 self-rated health and control measures. Religious experience of receiving direct help from angels in time of a need does not moderate this association. By contrast, the negative association between financial hardship and self-rated health is weakened among individuals who strongly agree that they experienced a supernatural miracle. Conclusions and Implications The findings in the study dovetail with the stress process model, indicating that religious experience serves as a personal resource that helps individuals deal with financial hardship. By highlighting the stress-buffering effects of religious experience, the current study rounds out our understanding of the complex linkages among stress, religion, and health.

Associations of Psychological Capital, Coping Style and Emotional Intelligence with Self-Rated Health Status of College Students in China During COVID-19 Pandemic.

BackgroundCOVID-19 lockdown can lead to mental health problem, and the problem is heterogeneous across individuals. In this study, we aimed to explore the association between the self-reported health status, emotional coping style, emotional intelligence and positive psychological state of college students during the COVID-19 pandemic in China.MethodsThe questionnaires of Self-rated Health Measurement Scale (SRHMS), Emotional Intelligence Scale (EIS), Psychological Capital Questionnaire (PCQ), Simplified Coping Style Questionnaire (SCSQ) were used for online survey. The study included 367 undergraduates.ResultsUndergraduate sex, sibling and birth of place were associated with either psychological capital scores or emotional intelligence. Online time per day had significantly negative associations with self-rated health and psychological capital scores. Multivariate analysis showed that the interaction between emotional intelligence, psychological capital and coping styles was statistically significant (β = −0.112, p = 0.045) in health status with psychological capital ranking the top (β = 0.428). Mediation analysis showed that psychological capital and coping style modified the effect of emotional intelligence on health status.ConclusionPsychological capital and coping style modified the effect of emotional intelligence on health status in college students during the COVID-19 pandemic. In this pandemic emergency, a comprehensive intervention, such as positive coping styles with optimistic emotional perception and understanding as well as social support, is an important measure against the pandemic-induced mental health problem in college students in China.

The Status of Occupational Stress and Its Influence on the Health of Medical Staff in Lanzhou, China.

This study aimed to understand the status quo of occupational stress and its impact on the health of medical staff and provide a theoretical basis for relieving occupational stress and improving the health status of medical staff. The occupational stress and health status of medical staff in 14 hospitals in Lanzhou were studied using a general questionnaire, Effort–Reward Imbalance questionnaire, and Self-Rated Health Measurement Scale. A total of 2169 participants were included in the analysis, and 59.4% of the medical staff experienced occupational stress. The results of the occupational stress survey showed that the prevalence of occupational stress among medical staff aged 40–50, with a master’s degree or above, senior professional title, working for 10–20 years, and working more than 48 h per week was higher than in the other groups. The health survey results showed that, compared with other groups, the scores of physical, mental, and social health were lower in medical staff with working years of 10–20 years and working hours of more than 48 h per week. The results show that working years and working hours per week affect not only the level of occupational stress but also physiological, psychological, and social health.

Sub-national patterns and correlates of depression among adults aged 45 years and older: findings from wave 1 of the Longitudinal Ageing Study in India

Depression is a major public health challenge linked with several poor health outcomes and disabilities among adults aged 45 years and older in India. We aimed to describe the prevalence of depression and its association with a variety of sociodemographic correlates and co-existing health conditions for this age group in India and its states. In this prospective cohort study, data from wave 1 (baseline) of the Longitudinal Ageing Study in India were used to estimate the national and subnational state level age-standardised prevalence of depression-major depressive episodes-using the internationally validated Composite International Diagnostic Interview-Short Form (CIDI-SF) scale. Hierarchical mixed effect multivariate logistic regression models were used to study the sociodemographic correlates and co-existing health conditions of major depressive episodes among the nationally representative sample of 72 250 adults aged 45 years and older from 35 states or union territories (except the state of Sikkim). Associations between depression and self-rated health, co-morbid conditions, functional health, and life satisfaction measures were also examined. A total of 40 335 (58·3%) females and 29 407 (41·7%) males aged 45 to 116 years (median age 58 years) participated. The overall age-standardised prevalence of depression based on CIDI-SF scale was 5·7% (95% CI 5·5-5·8) compared with 0·5% (0·5-0·6) self-reported prevalence of depression among adults aged 45 years and older in India. Wide sub-national variations were seen in depression prevalence, ranging from 0·8% (95% CI 0·3-1·3) in Mizoram state to 12·9% (11·6-14·2) in Madhya Pradesh. Prevalence was higher in females (6·3% [95% CI 6·1-6·6] vs 4·3% [4·1-4·6]) for India, and this higher prevalence was more pronounced in some of the northern states. The risk of depression was higher in those residing in rural areas, widowed, with no or low education, and in the poorest quintile. Depression showed a strong positive association with poor self-rated health (OR 2·39 [95% CI 2·21-2·59]; p<0·0001), with one or more limitations in the activities of daily living (ADL; OR 1·60 [1·46-1·75]; p<0·0001), instrumental ADL limitations (OR 1·51 [1·40-1·64]; p<0·0001), and low cognitive judgment of life satisfaction (OR 1·94 [95% CI 1·78-2·10]; p<0·0001). Despite the substantial burden, depression remains undiagnosed and strongly linked with poor health and wellbeing outcomes in adults aged 45 years and older in India. The ageing population of India and the subnational variations amplify the implications of this new evidence to address the substantial gaps in prevention and treatment of depression. LASI was funded by the Ministry of Health and Family Welfare, Government of India, the National Institute of Ageing, USA and the United Nations Population Fund, India.

Short Daily-Life Walking Bouts and Poor Self-Reported Health Predict the Onset of Depression in Community-Dwelling Older People: A 2-Year Longitudinal Cohort Study.

This study aimed to assess whether the amount and quality of daily-life walking obtained using wearable technology can predict depression onset over a 2-year period, independently of self-reported health status. Longitudinal cohort study. Three-hundred twenty-two community-dwelling older people recruited in Sydney, Australia. Participants were assessed at baseline on (1) depressive symptoms using the Patient Health Questionnaire-9; (2) average weekly physical activity levels over the past month using the Incidental and Planned Activity Questionnaire, (3) clinical mobility tests (ie, short physical performance battery, timed up-and-go test, 6-m walk test); and (4) amount and quality of daily-life walking assessed with a trunk accelerometer (MoveMonitor, McRoberts) for 1week. Participants were followed up for onset of depressive symptoms for 2years at 6-monthly intervals. Daily-life walking (ie, gait intensity in the mediolateral axis, daily step counts, duration of longest walk) and self-rated health predicted the new onset of depressive symptoms at 2years in univariable logistic regression models. In multivariable models containing a self-rated health measure, clinical mobility tests were not predictive of the onset of depressive symptoms. In contrast, a measure of daily-life walking (duration of longest walking bout) was identified as a significant predictor of depressive symptom onset [standardized odds ratio (SOR) 2.44, 95% CI 1.62-3.76] independent of self-rated health (SOR 1.51, 95% CI 1.16-1.96), with these 2 measures achieving a satisfactory prediction accuracy (area under the curve= 0.67, sensitivity: 0.78, specificity: 0.52). A risk algorithm based on daily-life walking bouts and self-reported health demonstrated good accuracy for the prediction of depression onset in older people over 2years. Wearable sensor data compared favorably with clinical mobility screens and may add important independent information for screening for depression among older people.

Interpersonal relationship and self-acceptance on emotional intelligence and mental health of college students

The study aimed to explore the role of interpersonal relationship and self-acceptance as potential moderator of the relationship between emotional intelligence and mental health of college students in China. The online survey platform “Questionnaire Star” was conducted among 367 undergraduates. The questionnaires of self-rated health measurement scale, emotional intelligence scale, interpersonal relationship assessment scale, and self-acceptance questionnaire was used for questionnaire survey and analysis. The self-rated health status was positively correlated with emotional intelligence and self-acceptance (r=0.541, 0.598, p&amp;lt;0.01), and negatively correlated with interpersonal relationships (r=-0.609, p&amp;lt;0.01). Further analysis using multivariate regression found that the interaction between emotional intelligence, interpersonal relationship and self-acceptance is statistically significant (β=-0.02, p&amp;lt;0.05), with the independent effect on health status is 0.7% (ΔR2=0.006), and the negative effect of interpersonal relationship was the biggest (β=-2.691). Conclusion This study highlighted the psychological protection ability of self-rated health, which is influenced by interpersonal relationship, self-acceptance and emotional intelligence. Interpersonal relationship is the main factor that affects the emotional intelligence on self-rated health. Under the same conditions of emotional intelligence and self-acceptance, college students with good interpersonal relationship have better self-measured health status.

The relationships between IBS and perceptions of physical and mental health—a Norwegian twin study

Background and aimsPoor quality of life is a main complaint among individuals with irritable bowel syndrome (IBS). Self-rated health (SRH) is a powerful predictor of clinical outcomes, and also reflects psychological and social aspects of life and an overall sense of well-being. This population-based twin study evaluates how IBS affects ratings of physical and mental health, and influences perceptions of hindrance of daily activity by physical or mental health. Further, we examine how IBS is related to these SRH measures.MethodsThe sample included 5288 Norwegian twins aged 40–80, of whom 575 (10.9%) suffer from IBS. Hierarchical regressions were used to estimate the impact of IBS on perceptions of health, before and after accounting for other chronic physical and mental health conditions. Two dimensions of SRH, physical and mental, and two aspects of functional limitations, the extent to which physical or mental health interferes with daily activities, were included as outcomes in separate models. Co-twin control analyses were used to explore whether the relationships between IBS and the four measures of SRH are causal, or due to shared genetic or shared environment effects.ResultsIBS was an independent predictor of poor self-rated physical health (OR = 1.82 [1.41; 2.33]), the size of this effect was comparable to that predicted by chronic somatic conditions. However, in contrast to somatic diseases, IBS was associated with the perception that poorer ratings of mental health (OR = 1.45 [1.02; 2.06]), but not physical health (OR = 1.23 [0.96; 1.58]), interfered with daily activity. The co‐twin control analyses suggest that causal mechanisms best explain the relationships between IBS with self-rated physical health and with hindrance of daily activities. In contrast, the relationship between IBS and self-rated mental health was consistent with shared genetic effects.ConclusionIBS is predictive of poor self-rated physical health. The relationship between IBS and self-rated mental health is best explained by shared genetic effects which might partially explain why mental health interferes with daily activity to a larger degree among those with IBS.

Assessment of self-rated health: The relative importance of physiological, mental, and socioeconomic factors.

The general self-rated health (SRH) question is the most common health measure employed in large population surveys. This study contributes to research on the concurrent validity of SRH using representative data with biomarkers from the Czech Republic, a population not previously used to assess the SRH measure. This work determines the relative contribution of biomedical and social characteristics to an individual's SRH assessment. Studies have already explored the associations between SRH and markers of physical health. However, according to a PubMed systematic literature search, the issue of the relative importance of physiological and psychosocial factors that affect individuals' assessments of their SRH has generally been neglected. Using data from a specialized epidemiological survey of the Czech population (N = 1021), this study adopted ordinary least squares regression to analyze the extent to which variance in SRH is explained by biomedical measures, mental health, health behavior, and socioeconomic characteristics. This analysis showed that SRH variance can be largely attributed to biomedical and psychological measures. Socioeconomic characteristics (i.e. marital status, education, economic activity, and household income) contributed to around 5% of the total variance. After controlling for age, sex, location, and socioeconomic status, biomarkers (i.e. C-reactive protein, blood glucose, triglyceride, low-density lipoprotein, and high-density lipoprotein), number of medical conditions, and current medications explained 11% of the total SRH variance. Mental health indicators contributed to an additional 9% of the variance. Body mass index and health behaviors (i.e. smoking and alcohol consumption) explained less than 2% of the variance. The results suggested that SRH was a valid measure of physiological and mental health in the Czech sample, and the observed differences were likely to have reflected inequalities in bodily and mental functions between social groups.

Cannabis use, attitudes, regulation and health: Survey data from an urban population of users and non-users.

Background: Although illegal in most countries, cannabis remains the most common illicit drug in Switzerland and worldwide. While there is growing evidence on adverse effects of cannabis use, most users do not report any problems or negative consequences. In the face of a sustained high prevalence of cannabis use and the recent legalization waves in different parts of the world, it is important to know how cannabis is perceived in the general population and how current users regulate their own use. The present study aims to investigate users’ and non-users’ attitudes towards cannabis regulations and towards current users. Additionally, self-rated health measures as well as protective behavioral strategies and other cannabis related variables were assessed.Design and methods: We collected data from 380 current users and 659 non-users who were recruited by invitation letter or online media platforms. The data was analyzed using basic descriptive statistical procedures.Results: Results revealed that both groups favor moderate cannabis regulation measures over prohibition and no regulation at all. On average, they report the same subjective health. Protective strategies are often used and are associated with better health and lower severity of dependence in cannabis users.Conclusions: Taken together, results indicate that safe use of cannabis is possible for most users, while there is a group of users at risk of 15-20%, which may benefit from control by regulatory measures. Significance for public health In the face of recent legalization waves in different parts of the world and the current public discourse on a possible legalization in Switzerland, it is important to know how cannabis is perceived in the general population and how current users regulate their own use. The manuscript contributes to the literature by showing that in Switzerland, users and non-users prefer a moderate regulation of cannabis over prohibition. Further, support is shown for recent findings that highlight the protective effect of behavioral strategies (measured by the Protective Behavioral Strategies for Marijuana, Pedersen et al.1) on adverse effects of marijuana, such as perceived dependence.

General and comparative self-rated health in chronic stroke: an important outcome measure for health professionals

BackgroundAfter a stroke, several aspects of health and function may influence how individuals perceive their own health. However, self-rated health (SRH), as well as its relationship with functioning, has been little explored in individuals with stroke. The aims of this study were to determine how individuals with chronic post-stroke disabilities evaluate their health, considering general, time- and age-comparative SRH questions and to investigate whether SRH measures would be influenced by the following health and functioning domains: mental/physical functions and personal factors.MethodsSixty-nine individuals with chronic post-stroke disabilities answered the three types of SRH questions and were assessed regarding depressive symptoms (emotional function domain), physical activity levels (physical function domain), and engagement in physical activity practice (personal factor domain). Subjects were divided into the following groups: good/poor for the general SRH question; better, similar, and "worse" for both time- and age-comparative questions. Between-group differences in the three domains for each SRH question were investigated (α = 5%).ResultsGeneral SRH was rated as good by 73% of the participants. Time- and age-comparative SRH was rated as better by 36% and 47% and as similar by 31% and 28% of the subjects, respectively. Significant between-group differences in emotional function were found for both the general and age-comparative questions. For the time-comparative question, significant differences were only observed for physical function.ConclusionSRH evaluation differed in individuals with chronic post-stroke disabilities according to the types of questions and health/functioning domains.

Income trajectories and self-rated health status in the UK

In line with the wide recognition of the connection between socioeconomic status and health outcomes, attention in the recent literature is extending the static perspective to the dynamic implications of income on health. This study contributes to the growing literature on the income-health nexus by evaluating income dynamics on various self-rated health measures in the UK. We explore the impact of different indicators of income experiences on self-rated health and wellbeing outcomes using data from the 11 Waves of Understanding Society UK Household Longitudinal Study between 2009 and 2019. First, we estimate a fixed-effects ordered logit model for various health and wellbeing measures, allowing us to control for unobserved time-invariant heterogeneity. Second, we evaluate the effects of income trajectories by linking longitudinal household income to cross-sectional health outcomes. Our results confirm the general evidence of positive impacts of increasing family income on health. Besides, we find that stability in income position is strongly associated with improved health and wellbeing. On the other hand, income volatility increases the odds of reporting poor health outcomes, particularly for those in low-income households. Also, more years spent in a lower-income quartile reduces the odds of reporting improved self-rated health. Finally, the significant difference in the estimated effects of income before and after 2016 highlights the significant shifts in the effects of income trajectories on self-reported health and wellbeing following the National Living Wage policy implementation.

Use of Single-Item Self-Rated Health Measure to Identify Frailty and Geriatric Assessment-Identified Impairments Among Older Adults with Cancer.

BackgroundPoor self-rated health (SRH) is a known predictor of frailty and mortality in the general population; however, its role among older adults with cancer is unknown. We evaluated the role of SRH as a potential screening tool to identify frailty and geriatric assessment (GA)-identified impairments.Materials and MethodsAdults ≥60 years diagnosed with cancer in the UAB Cancer & Aging Resilience Evaluation (CARE) registry underwent a GA at the time of initial consultation. We measured SRH using a single-item from the Patient-Reported Outcomes Measurement Information System global health scale and dichotomized responses as poor (poor, fair) and good (good, very good, and excellent). We evaluated the diagnostic performance of SRH in measuring frailty, and GA impairment (≥2 deficits among a set of seven GA domains). We examined the impact of SRH with survival using a Cox model adjusting for confounders, exploring the mediating role of frailty.ResultsSix hundred and three older adults with cancer were included, with a median age of 69 years. Overall, 45% (n = 274) reported poor SRH. Poor SRH demonstrated high sensitivity and specificity for identifying frailty (85% and 78%, respectively) and GA impairment (75% and 78%, respectively). In a Cox regression model, poor SRH was associated with inferior survival (HR = 2.26; 95% CI 1.60-3.18) after adjusting for confounders; frailty mediated 69% of this observed relationship.ConclusionSelf-rated health may be used as a screening tool to identify older adults with cancer with frailty and GA impairments. Poor SRH is associated with inferior survival, which is mediated by frailty.