scholarly journals Trends in socioeconomic inequalities in self-rated health in Germany: a time-trend analysis of repeated cross-sectional health surveys between 2003 and 2012

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030216
Author(s):  
Benjamin Wachtler ◽  
Jens Hoebel ◽  
Thomas Lampert
Keyword(s):  
Adult Population ◽  
Socioeconomic Inequalities ◽  
Cross Sectional ◽  
Absolute Income ◽  
Self Rated Health ◽  
Private Households ◽  
Income Inequalities ◽  
Absolute And Relative Inequalities ◽  
Linear Probability ◽  
German Adult

ObjectivesThis study assessed the extent of educational and income inequalities in self-rated health (SRH) in the German adult population between 2003 and 2012 and how these inequalities changed over time.DesignRepeated cross-sectional health interview surveys conducted in 2003, 2009, 2010 and 2012.Setting and participantsThe study population was the German adult population aged 25–69, living in private households in Germany. In total 54 197 randomly selected participants (2003: 6890; 2009: 16 418; 2010: 17 145; 2012: 13 744) were included.Main outcome measuresSRH was assessed with one single question. Five answer categories were dichotomised into good (‘very good’ and ‘good’) versus poor (‘moderate’, ‘poor’, ‘very poor’) SRH. To estimate the extent of the correlation between absolute and relative inequalities in SRH on the one hand, and income and education on the other; slope indices of inequality (SII) and relative indices of inequality (RII) were estimated using linear probability and log-binomial regression models.ResultsThere were considerable and persisting educational and income inequalities in SRH in every survey year. Absolute educational inequalities were largely stable (2003: SII=0.25, 95% CI 0.21 to 0.30; 2012: 0.29, 95% CI 0.25 to 0.33; p trend=0.359). Similarly, absolute income inequalities were stable (2003: SII=0.22, 95% CI 0.17 to 0.27; 2012: SII=0.26, 95% CI 0.22 to 0.30; p trend=0.168). RII by education (2003: 2.53, 95% CI 2.11 to 3.03; 2012: 2.72, 95% CI 2.36 to 3.13; p trend=0.531) and income (2003: 2.09. 95% CI 1.75 to 2.49; 2012: 2.53, 95% CI 2.19 to 2.92; p trend=0.051) were equally stable over the same period.ConclusionsWe found considerable and persisting absolute and relative socioeconomic inequalities in SRH in the German adult population between 2003 and 2012, with those in lower socioeconomic position reporting poorer SRH. These findings should be a concern for both public health professionals and political decision makers.

scholarly journals Excellent Self-Rated Health among Swedish Boys and Girls and Its Relationship with Working Conditions in School: A Cross-Sectional Study

2021 ◽  
Vol 18 (3) ◽  
pp. 1310
Author(s):  
Sara Brolin Låftman ◽  
Maria Granvik Saminathen ◽  
Bitte Modin ◽  
Petra Löfstedt
Keyword(s):  
Academic Success ◽  
Working Conditions ◽  
Cross Sectional Study ◽  
Probability Models ◽  
Positive Health ◽  
Cross Sectional ◽  
School Aged Children ◽  
Self Rated Health ◽  
Linear Probability ◽  
Classmate Support

The aim of this study was to investigate the extent to which school demands, teacher support, and classmate support were associated with excellent self-rated health among students, and to examine if any such statistical predictions differed by gender. Data were drawn from the Swedish Health Behaviour in School-aged Children (HBSC) study of 2017/18, performed among adolescents in grades five, seven, and nine (n = 3701). Linear probability models showed that school demands were negatively associated with excellent self-rated health, whereas teacher and classmate support showed positive associations. The link with school demands was stronger for girls than boys, driven by the finding that in grades five and nine, school demands were associated with excellent self-rated health only among girls. In conclusion, the study suggests that working conditions in school in terms of manageable school demands and strong teacher and classmate support may benefit adolescents’ positive health. The finding that the link between school demands and excellent self-rated health was more evident among girls than among boys may be interpreted in light of girls’ on average stronger focus on schoolwork and academic success. The study contributes with to knowledge about how working conditions in school may impede or promote students’ positive health.

scholarly journals Patterns of multiple lifestyle risk factors and their link to mental health in the German adult population: a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022184 ◽  
Author(s):  
Josefine Atzendorf ◽  
Christian Apfelbacher ◽  
Elena Gomes de Matos ◽  
Ludwig Kraus ◽  
Daniela Piontek
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Adult Population ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Lifestyle Risk Factors ◽  
Unhealthy Diet ◽  
Lifestyle Risk ◽  
German Adult

ObjectivesLifestyle risk factors, such as drinking or unhealthy diet, can expotentiate detrimental health effects. Therefore, it is important to investigate multiple lifestyle risk factors instead of single ones. The study aims at: (1) identifying patterns of lifestyle risk factors within the adult general population in Germany and (2) examining associations between the extracted patterns and external factors.DesignCross-sectional study.SettingGeneral German adult population (aged 18–64 years).ParticipantsParticipants of the 2015 Epidemiological Survey of Substance Abuse (n=9204).Primary outcome measuresLifestyle risk factors (daily smoking, at-risk alcohol consumption, unhealthy diet, low physical activity, weekly use of pharmaceuticals, as well as consumption of cannabis and other illicit drugs).ResultsA latent class analysis was applied to identify patterns of lifestyle risk factors, and a multinomial logistic regression was carried out to examine associations between the extracted classes and external factors. A total of four classes were extracted which can be described as healthy lifestyle (58.5%), drinking lifestyle (24.4%), smoking lifestyle (15.4%) and a cumulate risk factors lifestyle (1.7%). Individuals who were male, at younger age and single as well as individuals with various mental health problems were more likely to show multiple lifestyle risk factors.ConclusionsHealthcare professionals should be aware of correlations between different lifestyle risk factors as well as between lifestyle risk groups and mental health. Health promotion strategies should further focus especially on younger and single men.

scholarly journals Prevalence and Correlates of Individuals Screening Positive for Depression and Anxiety on the PHQ-4 in the German General Population: Findings from the Nationally Representative German Socio-Economic Panel (GSOEP)

2020 ◽  
Vol 17 (21) ◽  
pp. 7865
Author(s):  
André Hajek ◽  
Hans-Helmut König
Keyword(s):  
Chronic Diseases ◽  
Adult Population ◽  
Population Based ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Self Rated Health ◽  
Patient Health ◽  
General Adult Population ◽  
Nationally Representative ◽  
Probable Depression

Our aim was to estimate the prevalence and correlates of probable depression and anxiety in the general adult population in Germany. Repeated cross-sectional data (i.e., cross-sectional data observed at different time points: year 2012 and year 2014) were derived from the innovation sample of the German Socio-Economic Panel, a population-based study of German households. The validated Patient Health Questionnaire (PHQ-4) was used to measure probable depression and anxiety. In the analytical sample, n equaled 2952 individuals. According to the PHQ-4 cut-off values, 10.4% of the individuals had probable depression and 9.8% of the individuals had probable anxiety. Regressions revealed that the likelihood of depression was positively associated with lower age (OR: 0.98 (95% CI: 0.98–0.99)), being unmarried (and living together with spouse) (OR: 0.75 (0.58–0.98)), worse self-rated health (OR: 1.99 (1.73–2.27)), and more chronic diseases (OR: 1.18 (1.07–1.31)). Furthermore, the likelihood of anxiety was positively associated with being female (OR: 1.36 (95% CI: 1.04–1.76)), lower age (OR: 0.98 (95% CI: 0.97–0.99)), low education (medium education, OR: 0.69 (0.50–0.95)), worse self-rated health (OR: 2.00 (1.74–2.30)), and more chronic diseases (OR: 1.15 (1.03–1.27)). The magnitude of depression and anxiety was highlighted. Clinicians should be aware of the factors associated with probable depression and anxiety.

scholarly journals Factors Associated with Poor Self-rated Health in Machhapuchhre Rural Municipality of Kaski District, Nepal: A Cross-sectional Survey

2018 ◽  
Vol 11 (02) ◽  
pp. 34-40
Author(s):  
Bimala Sharma ◽  
S Wagle ◽  
N Shrestha ◽  
MP Bhatt ◽  
BR Tiwari
Keyword(s):  
Health Status ◽  
General Health ◽  
Adult Population ◽  
Household Survey ◽  
Outcome Variable ◽  
General Health Status ◽  
Cross Sectional ◽  
Rural Municipality ◽  
Factors Associated ◽  
Self Rated Health

Introduction: Self-rated health reflects respondents’ overall perceptions of their general health status. It is a simple and reliable measure of general health status of the population. Objective: The objective of the study was to assess prevalence and associated factors of poor self-rated health among adult population in Machhapuchhre Rural Municipality of Kaski District, Nepal. Methods: A cross-sectional household survey was conducted among adult population at Machhapuchhre Rural Municipality. A structured questionnaire was used for the face to face interview. Household survey was conducted in July 2018. Self-rated health was measured by using a single question such as ‘In general, how would you rate your health?’ Responses were arranged along a five-point Likert-type scale: ‘excellent’, ‘good’, ‘fair’, ‘poor’ and very poor. The outcome variable was dichotomized as ‘good’ (excellent, good or fair) or ‘poor’ (poor or very poor). Chi-square test and multiple logistic regression analysis were performed; and odds ratios with corresponding 95% confidence intervals for poor self-rated health were presented. Results: Of total respondents, 13.2% respondents reported that they perceived their health as poor. Of the total, 14.3% respondents stated themselves as overweight and 8.8% mentioned they were unhappy. The study found that illiterate respondents, respondents with smoking habit and the individuals with poor psychological conditions were more likely to perceive their health as poor. Illiteracy, current smoking, perceived overweight, unhappiness, suicidal ideation and having depressed feeling were significant factors associated with poor self-rated health in the study. Conclusion: Education, health behavior and psychosocial health variables has important influences on self-rated health.

scholarly journals Widespread and widely widening? Examining absolute socioeconomic health inequalities in northern Sweden across twelve health indicators

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Kinza Degerlund Maldi ◽  
Miguel San Sebastian ◽  
Per E. Gustafsson ◽  
Frida Jonsson
Keyword(s):  
Health Inequalities ◽  
Physical Inactivity ◽  
Dental Health ◽  
Health Indicators ◽  
Socioeconomic Inequalities ◽  
Educational Inequalities ◽  
Self Rated Health ◽  
Income Inequalities ◽  
Socioeconomic Health Inequalities

Abstract Background Socioeconomic inequalities in health is a widely studied topic. However, epidemiological research tends to focus on one or a few outcomes conditioned on one indicator, overlooking the fact that health inequalities can vary depending on the outcome studied and the indicator used. To bridge this gap, this study aims to provide a comprehensive picture of the patterns of socioeconomic health inequalities in Northern Sweden over time, across a range of health outcomes, using an ‘outcome-wide’ epidemiological approach. Method Cross-sectional data from three waves of the ‘Health on Equal Terms’ survey, distributed in 2006, 2010 and 2014 were used. Firstly, socioeconomic inequalities by income and education for twelve outcomes (self-rated health, self-rated dental health, overweight, hypertension, diabetes, long-term illness, stress, depression, psychological distress, smoking, risky alcohol consumption, and physical inactivity) were examined by calculating the Slope Index of Inequality. Secondly, time trends for each outcome and socioeconomic indicator were estimated. Results Income inequalities increased for psychological distress and physical inactivity in men as well as for self-rated health, overweight, hypertension, long-term illness, and smoking among women. Educational inequalities increased for hypertension, long-term illness, and stress (the latter favouring lower education) in women. The only instance of decreasing income inequalities was seen for long-term illness in men, while education inequalities decreased for long-term illness in men and poor self-rated health, poor self-rated dental health, and smoking in women. Conclusion Patterns of absolute socioeconomic inequalities in health vary by health and socioeconomic indicator, as well as between men and women. Overall, trends appear more stagnant in men while they fluctuate in women. Income inequalities seem to be generally greater than educational inequalities when looking across several different health indicators, a message that can only be derived from this type of outcome-wide study. These disparate findings suggest that generalised and universal statements about the development of health inequalities can be too simplistic and potentially misleading. Nonetheless, despite inequalities being complex, they do exist and tend to increase. Thus, an outcome-wide approach is a valuable method which should be utilised to generate evidence for prioritisations of policy decisions.

scholarly journals Income, Relative Deprivation and the Self-Rated Health of Older People in Urban and Rural China

2021 ◽  
Vol 9 ◽  
Author(s):  
Wenzhe Qin ◽  
Lingzhong Xu ◽  
Shoucai Wu ◽  
Hui Shao
Keyword(s):  
Older People ◽  
Relative Deprivation ◽  
Rural China ◽  
Family Health ◽  
Rural Elderly ◽  
Cross Sectional ◽  
Individual Level ◽  
Absolute Income ◽  
Self Rated Health ◽  
Older Populations

Background: Substantial evidence indicated that absolute income is directly associated with health. Few studies have, however, examined if relative income may be equally associated with health. This study aimed to investigate the association between absolute income/relative deprivation (RD) and self-rated health (SRH). We also investigated whether the urban-rural difference was existing in these associations.Methods: Using cross-sectional data of 7,070 participants in the Shandong Family Health Service Survey of older people, this study applied binary logistic model and semi-parametric model to estimate the effect of absolute income and relative deprivation on SRH of older people. The Kakwani Index was used as a measure of relative deprivation at the individual level.Results: Absolute income has a significant positive effect on the SRH among both urban and rural older people. When considered RD as a variable, both absolute income and RD have negative significant effects on SRH among all older people. In addition, the negative effect of RD on rural elderly is more pronounced than that of urban older populations. Semi-parametric regression results show that there was a complex non-linear relationship between income and SRH. Psychological distress substantially attenuated the association between relative deprivation and SRH.Conclusions: Relative deprivation is negatively associated with self-rated health in both urban and rural older people after controlling the absolute income. RD may partly explain the association between income inequality and worse health status. Compared with the urban elderly, the effect of income-based relative deprivation on SRH was more pronounced among the rural elderly, and more care should be given to the lower income and rural older populations.

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