Academic journal article Central European Journal of Public Health

Is Age Associated with Self-Rated Health among Older People in Spain?

Academic journal article Central European Journal of Public Health

Is Age Associated with Self-Rated Health among Older People in Spain?

Article excerpt

SUMMARY

Objective: To examine the association of age and other factors with Self-rated Health (SRH) in the population aged 65 years or more in the context of action for health promotion in older adults.

Material and Methods: The data used come from the household and adults questionnaires of the National Health Survey of Spain for 2006. SRH was categorized as positive (very positive or positive) and negative (fair, poor or very poor). Odds ratios for positive SRH compared to negative SRH were calculated using logistic regression models for complex samples. The determinants of the Positive SRH were obtained for the elderly population.

Results: Among the population aged 65 years and older 39.7% report positive SRH. In this age group, those of 83 or more years have a better SRH. Other factors specific to this age group that improve the SRH are living alone, not having any functional dependence and high monthly family income.

Conclusions: The association between several factors (particularly age) and positive SHR in people aged 65 and older differs from the one found in the rest of the population. Understanding the factors positively associated with the positive SRH in this population is of great importance for the design of specific programmes aimed at improving the health of older people.

Key words: elderly population, self-rated health, healthy habits, logistic models, complex samples

INTRODUCTION

Self-rated Health (SRH) has been a widely used health indicator in health inequalities research in developed countries, particularly in the elderly population. Over the last twenty years in Spain and other similar countries research has consisted of describing the assessment of SHR, and its association with various health indicators (morbidity, disability, healthy habits, and use of health services) and sociodemographic characteristics (sex, age, social class, educational level, region of residence) (1-7). These studies found most of these factors being related with SHR; in particular, they conclude that health worsens with age and individuals from 65 or more years old do not differ in SRH from older cohorts. Such studies deployed prior to 2006 editions of the National Health Survey (NHS) of Spain. There is also evidence from data-sets different from NHS (8-10), where an association between age and the SHR is observed consistently with the abovementioned studies. Moreover, recent studies with NHS 2006 showed differences by age group for adults (1 1), particularly SRH worsens with age until the age of 49, while from 50 years old onwards people report better health than the younger.

To the best of our knowledge there are no studies neither testing whether this relationship is monotonie over age, nor assessing the influence of various factors, such as lifestyle, morbidity and disability on SRH in the population aged 65 years or more. Adopting this approach in the analysis of the SRH is necessary because of at least two reasons: firstly, the rise in chronic diseases and increased life expectancy in developed countries have created health inequalities between different age groups and particularly in elderly population; secondly, because SRH is a multidimensional indicator associated not only with health indicators such as mortality and morbidity but also with sociodemographic, disability, lifestyle and health services (12). It is possible to detect how these factors affect health in this age group. Therefore, we intend to analyze the relation between age and other factors with SRH in the population aged 65 years or more in order to understand the inequities in health for better guidance on specific public health programmes.

MATERIALS AND METHODS

Sampling

The NHS of Spain is a biennial survey conducted by the Ministry of Health and Consumer Affairs since 1987 and it has evolved methodologically and conceptually over the years. The NHS 2006 was adapted to the requirements of the European Health Survey project. …

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