Self-reported Ill-health Research Articles

Do people with different sociodemographic backgrounds value their health differently? Evaluating the role of positional objectivity.

The fundamental disconnect between the actual and the perceived health of an individual raises considerable skepticism on the self-reported health data as it may be confounded by an individual's socio-economic status. In this light, the present study aims to assess if people with different sociodemographic backgrounds value their health differently. The health-state valuation using time-trade off was performed in a cross-sectional survey among a representative sample of 2,311 adults from India. Individuals were selected using a multistage stratified random sampling from five Indian states to elicit their present health-state, and to perform the health-state valuation exercise using computer assisted personal interviewing. A single block of standardized health-states was valued by multiple individuals, each belonging to different socio-demographic group. The difference in the valuation of health was assessed using bivariate analysis. The impact of different sociodemographic factors on the health-state valuation was evaluated using Tobit regression model. Differences in the valuation of health were observed among different groups of age, religion, family type, state of residence, substance abuse, presence of ailments at the time of valuation, and number of dependent members in the household. Even after controlling for the severity of the administered health states, factors having a significant association with the valuation of health are age, religion, state of residence, substance abuse, family type, number of dependent members in the household, and presence of chronic or both acute and chronic ailments. Younger individuals place a higher value to their health as compared to their older counterparts. As compared to a healthy individual, a person with ailments rates the same health-state as worse. Inequalities in self-reported ill-health cannot be attributed to positional objectivity; age, religion, state of residence, substance abuse, family type, dependents, and ailments impact individual health valuation.

Employment Quality and Mental and Self-Reported Health Inequities among Latinx Housecleaners: The Safe and Just Cleaners Study.

Precarious employment, such as housecleaning, is one important structural contributor to health inequities. We used an employment quality (EQ) framework to characterize the impact of employment conditions on mental and self-reported ill-health among Latinx housecleaners in the New York City metropolitan area. Using a community-based participatory research approach, we collected cross-sectional survey data from 402 housecleaners between August 2019 and February 2020 to characterize housecleaners' EQ and its association with depression, perceived stress, and self-reported health. We also measured work-related irritant eye, skin, and respiratory symptoms, which have been shown in previous research to be associated with housecleaners' exposure to chemical components of cleaning products. Our housecleaner cohort was largely female and immigrant and most had worked at least five years. Survey items capturing the EQ dimensions of unbalanced interpersonal relations, low material resources, and violations of workers' rights were associated with increased odds of depression, perceived stress, and self-reported ill-health. Work-related irritant eye, skin, and respiratory symptoms were also independently associated with mental and self-reported ill-health and some of the effects of EQ on health were potentially partially mediated through their association with work-related irritant symptoms. Findings can inform directions for community-based educational and policy initiatives to improve housecleaners' employment quality.

Prevalence and Factors Associated with Self-Reported Ill-Health among the Elderly in Osun State, Southwestern Nigeria: A Cross Sectional Study.

Information on the determinants of ill-health among elderly, if available, would certainly provide a useful guide to policy makers in their plan for appropriate interventions for this subgroup of the population. This study therefore assessed ill-health status and its associated factors among the elderly in Osun State Nigeria. The study design was a descriptive cross-section involving 491 elderly drawn from a simple random sample of five local government areas LGAs in Osun State Nigeria, in 2017. Self-reported illness (es) two weeks before the survey was taken as measure of ill-health among the elderly. Bivariate and multivariate statistical methods were used for data analysis, p< 0.05 was reckoned statistically significant. Overall, 228 (46.4%) reported one health issue or the other two weeks before the survey. Regular source of income [OR=0.63, 95% CI=0.43, 0.95], ever smoked [OR=2.35, 95% CI=1.31, 4.21] and having any source of worry [OR=2.52, 95% CI=1.68, 3.79] were significantly associated with self-reported ill-health among elderly. Whereas, having regular source of income, engaging in physical exercise, and being satisfied with residential status were all found to be protective against illnesses by crude statistical analysis, only having a source of regular income had independent protective association against illness. Prevalence of ill-health among elderly was considerably high. Factors significantly associated with ill-health include not having a regular source of income, ever smoked, and having any source of worry. Financial empowerment schemes and health education for elderly on harmful effect of smoking and excessive worrying on their health are hereby recommended.

Impact of Health Status and Related Factors on Labor Market Positions of Urban Mature Chinese

Based on the data collected from the National Bureau of Statistics of China, this study examines the associations of health and socio-economic-demographic-related factors with labor force participation in urban mature Chinese aged 40–59 years. We found that that people with self-perceived ill-health were 34 % more likely to retired early than those who self-rated as healthy. The self-assessed ill-health were found to be 105 % more likely to be unemployed than the healthy. Self-reported ill-health was 28 % more likely to be homemakers than healthy people, although the odds ratios between the two groups were not significantly different statistically. Remarkably different from what has been observed in the developed countries, obesity did not have a notable impact on retirement of Chinese urban residents from labor force. Other factors that significantly contribute to the increased probability of being out of labor force were gender (female had high odds ratio for being out of labor force), education level (the lower the education level, the higher the odds ratios), as well as age (older people were more likely to be out of labor force).

O5-5.6 Evaluation of the compression expansion and dynamic equilibrium theories using western Australian linked hospital morbidity and mortality data

IntroductionThree hypotheses have been advanced to predict changes in population health in countries experiencing low birth and death rates, and increasing expectation of life. Determining which of these best accounts...

Norm compliance and self-reported health among Swedish adolescents

This study examines the relationship between norm compliance and self-reported health in adolescents, and how this differs between genders. Our specific aim was to investigate if extremely high norm compliance revealed any particular health patterns. This empirical study used a web-based survey from 2005, which was distributed to all students (n = 5,066) in years 7-9 of compulsory school within six municipalities in northern Sweden. The respondents answered questions about their general health as well as specific health problems such as headaches, stomach ache, sleeping difficulties and stress. Compliance was measured according to different norm-related behaviour, such as truancy, crime and use of tobacco, alcohol and narcotics. The majority of respondents reported good health and norm-compliant behaviour. Girls reported more health problems than boys, a difference that increased with age. Those who were more norm compliant reported better health, fewer somatic complaints and less stress, which goes against our initial hypothesis that extremely high norm compliance and self-reported ill-health are related. There seemed to be a stronger relationship between self-reported health and norm compliance for girls than boys, in absolute terms. The results clearly show a relationship between norm compliance and health, and suggest inequalities between genders.

Socioeconomic-related health inequality in South Africa: evidence from General Household Surveys.

BackgroundInequalities in health have received considerable attention from health scientists and economists. In South Africa, inequalities exist in socio-economic status (SES) and in access to basic social services and are exacerbated by inequalities in health. While health systems, together with the wider social determinants of health, are relevant in seeking to improve health status and health inequalities, those that need good quality health care too seldom get it. Studies on the burden of ill-health in South Africa have shown consistently that, relative to the wealthy, the poor suffer more from more disease and violence. However, these studies are based on selected disease conditions and only consider a single point in time. Trend analyses have yet to be produced. This paper specifically investigates socio-economic related health inequality in South Africa and seeks to understand how the burden of self-reported illness and disability is distributed and whether this has changed since the early 2000s.MethodsSeveral rounds (2002, 2004, 2006, and 2008) of the South African General Household Surveys (GHS) data were used, with standardized and normalized self-reported illness and disability concentration indices to assess the distribution of illness and disability across socio-economic groups. Composite indices of socio-economic status were created using a set of common assets and household characteristics.ResultsThis study demonstrates the existence of socio-economic gradients in self-reported ill-health in South Africa. The burden of the major categories of ill-health and disability is greater among lower than higher socio-economic groups. Even non-communicable diseases, which are frequently seen as diseases of affluence, are increasingly being reported by lower socio-economic groups. For instance, the concentration index of flu (and diabetes) declined from about 0.17 (0.10) in 2002 to 0.05 (0.01) in 2008. These results have also been confirmed internationally.ConclusionThe current burden and distribution of ill-health indicates how critical it is for the South African health system to strive for access to and use of health services that is in line with need for such care. Concerted government efforts, within both the health sector and other social and economic sectors are therefore needed to address the significant health inequalities in South Africa.

Dissonances in self-reported health and mortality across denominational groups in Northern Ireland

Measures of self-reported health status are increasingly used in research and health policy. However, the inherent subjectivity of the responses gives rise to lingering concerns about their utility, especially across national and cultural boundaries. In this study we use religious denomination as a proxy for Scottish ancestry within Northern Ireland and demonstrate significant differences in levels of self-reported ill-health that are not fully reflected in mortality risks. These findings mirror the differences between Scotland and Northern Ireland previously shown in ecological studies and provide more definitive evidence that even within the United Kingdom factors other than morbidity levels influence the perception and reporting of health status. Possible explanations for the dissonance between morbidity and mortality levels are discussed and the reasons for a preference for socio-economic rather than cultural factors are described.

Self‐reported Health among Employees in Relation to Sex Segregation at Work Sites

Despite the high level of sex segregation of the labour market in Sweden and other countries, there is little knowledge on the association between sex segregation and ill-health. The aim of this study was to study associations between self-reported ill-health among women and men and the level of numerical sex segregation at their work sites and psychosocial work conditions. A cross-sectional questionnaire study was conducted among 10,000 employed persons in the County of Ostergötland, Sweden. The questionnaire covered the level of numerical sex segregation at the work site, work organisation and conditions, ill-health, and demography. The proportions of individuals at sex-integrated and sex-segregated work sites reporting frequent ill-health symptoms were calculated and compared using Chi-square test statistics. Prevalence's of physical and psychosocial work aspects were calculated. Logistic regression models were used to assess the associations between sex segregation and other aspects of the work situation and health. Among the men, 69% worked at male-dominated work sites, 16% at female-dominated, and 15% at sex-integrated work sites. Among the women, the equivalent rates were 8%, 75%, and 17%, respectively. Sex segregation was associated with all self-reported ill-health symptoms among the men, also when controlling for possible confounders. Other variables that were associated with self-reported ill-health symptoms were demands at work, negative expectations, and sickness presence. The present study generates sufficient findings to suggest that the link between sex segregation at work sites and ill-health is an important area that merits further attention.

The Swedish labour market in the 1990s: The very last of the healthy jobs?

The economic recession in Sweden in the 1990s influenced several aspects of the labour market, including the psychosocial work environment. This study examined psychosocial working conditions in relation to self-reported ill-health in the 1990s by means of the job strain model. The study was based on two representative cross-sectional samples of Swedish employed men and women in 1991 (n=3,292) and 2000 (n=3,010), together with a panel of employees who were included for both years (n=1,953). The main outcome measures were psychological distress and self-rated poor health. The primary method used was logistic regression. The results suggested that although adverse psychosocial conditions increased during the 1990s, the association with health weakened. However, further analyses showed that poor health increased in most groups with various types of psychosocial conditions, and that reduced relative differences in poor health were discernible. Finally, a longitudinal analysis showed that long-term exposure to and experience of deteriorating psychosocial conditions was most detrimental for health at the end of the 1990s, once health status at baseline had been adjusted for. The increased prevalence of health problems among most groups with various psychosocial conditions during the 1990s, together with reduced relative differences in poor health, might make it more difficult for employers and policy-makers to direct health policies towards specific groups of employees, as the "healthy'' job seems to have disappeared. Another important inference of the results is that psychosocial working conditions seem to be causally related to health.

Paraoxonase polymorphisms and self-reported chronic ill-health in farmers dipping sheep

Serum paraoxonase (PON1) provides protection against organophosphate induced toxicity. Recently we reported that the frequency of paraoxonase polymorphisms in sheep dippers with self-reported chronic ill-health differed from that in dippers with a similar dipping history but no ill-health. As these analyses may have included subjects with conditions unrelated to organophosphate exposure, the aim of this study was to examine whether the risk associated with PON1 polymorphisms varied using a more homogenous case and referent population. Each subject completed a detailed symptom questionnaire and their general practitioner was asked whether there was any history of neurological disease that could be confused with the effects of organophosphate poisoning. Subjects were then excluded both on clinical grounds and where identified as atypical on discriminant analysis. Risk associated with the PON1 192 and 55 genotypes altered little with these changes in the population. These findings are consistent with the hypothesis that organophosphates contribute to the self-reported ill-health of sheep dippers.

Associations of income with self-reported ill-health and health resources in a rural community sample of Austria.

Three levels of health indicators (1) self-reported ill-health, (2) internal health resources, and (3) external health resources were analysed in relation to a four-category house-hold income distribution in order to describe possible social gradients. The particular aim of this study was to obtain information on the association of income data with self-reported ill-health. This cross-sectional study was based on a health survey. The sample represents around 10% of the rural population of some communities in Styria, randomly selected from the population registry. Interview data was collected from 3781 participants aged 15 years and older, 1559 males and 2222 females. The results show that individuals from lower house-hold income classes are disadvantaged with regard to indicators of ill-health, internal and external health resources. Overall, the link between low income and poor health is highly consistent within our data. Considering our results we conclude that internal and external health resources are as unequally distributed over income levels as health outcome indicators.

The impact of anomia as a factor in a demand resource model of health

The particular aim of the present study was to explore the interrelations between the construct of anomia, conceptualized as internal health demand or resource, and self-reported ill-health in the framework of a demand resource model. The four main constructs of this model were considered as recursive causal levels: (1) socio-economic data, (2) external resources/demands, (3) internal resources/demands, and (4) ill-health. Study statistics comprised graphical models to reveal the relations between variables using the statistical program DIGRAM designed for discrete graphical models. This method of data analysis permits a focus on the link between anomia and the other three levels. The function of anomia as an intermediate data level which might prove to be an intervening variable can be evaluated. A total of 440 subjects of a random community sample were included in the final analysis. In the framework of a demand resource model, it was possible to confirm that the construct of anomia plays a key role in health outcome. Graphical models showed that a low degree of anomia is related to high psychological quality of life and few psychosomatic symptoms on the one hand, and to good social integration and emotional support, a low amount of daily hassles and high educational level on the other hand. As an overall conclusion, it can be stated that the evaluation by the graphical modeling procedure permits a good fit of theory with methods.