• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of jepicomhInstructions for authorsCurrent TOCJournal of Epidemiology and Community Health
J Epidemiol Community Health. Jul 1999; 53(7): 412–416.
PMCID: PMC1756920

Determinants of self assessed health among Spanish older people living at home

Abstract

STUDY OBJECTIVE: To identify the main determinants of self assessed health among community dwelling elderly. PARTICIPANTS AND SETTING: A representative sample of 677 people aged 65 and over of the city of Madrid, Spain. DESIGN: Cross sectional study. Information was collected through personal interviews at the homes of the selected subjects. The five category dependent variable was grouped into two categories: good and poor self assessed health. Age, sex, social class, use of physician services, number of chronic conditions, and functional capacity, were included as main explanatory factors. Adjusted odds ratios were estimated through multiple logistic regression models. MAIN RESULTS: A total of 49.5% of subjects rated their health as good or very good. Those aged 85 and over rated their health higher than those aged 65-74 (adjusted odds ratio (OR): 0.37; 95% confidence intervals (CI): 0.18, 0.77). The adjusted OR for an increase of three chronic conditions was 3.48 (95% CI: 2.49, 4.85). Functional capacity also showed a strong independent effect (OR: 3.64; 95% CI: 1.89, 7.02). Social class was one of the main determinants for the youngest group, with those in the upper class reporting a better health perception (OR: 3.28 95% CI: 1.70, 6.35), but showed no effect in the oldest old (OR: 1.05; 95% CI: 0.57, 1.96). CONCLUSIONS: Age, chronic conditions, and functional status were the main determinants of perceived health among Spanish elderly. The effect of social class on perceived health markedly decreases with age. This study may contribute to a better utilisation and interpretation of self ratings in research and in general practice.

 

Full Text

The Full Text of this article is available as a PDF (89K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Ware JE., Jr The status of health assessment 1994. Annu Rev Public Health. 1995;16:327–354. [PubMed]
  • Mossey JM, Shapiro E. Self-rated health: a predictor of mortality among the elderly. Am J Public Health. 1982 Aug;72(8):800–808. [PMC free article] [PubMed]
  • Kaplan G, Barell V, Lusky A. Subjective state of health and survival in elderly adults. J Gerontol. 1988 Jul;43(4):S114–S120. [PubMed]
  • Pijls LT, Feskens EJ, Kromhout D. Self-rated health, mortality, and chronic diseases in elderly men. The Zutphen Study, 1985-1990. Am J Epidemiol. 1993 Nov 15;138(10):840–848. [PubMed]
  • Appels A, Bosma H, Grabauskas V, Gostautas A, Sturmans F. Self-rated health and mortality in a Lithuanian and a Dutch population. Soc Sci Med. 1996 Mar;42(5):681–689. [PubMed]
  • Mor V, Wilcox V, Rakowski W, Hiris J. Functional transitions among the elderly: patterns, predictors, and related hospital use. Am J Public Health. 1994 Aug;84(8):1274–1280. [PMC free article] [PubMed]
  • Rakowski W, Hickey T. Mortality and the attribution of health problems to aging among older adults. Am J Public Health. 1992 Aug;82(8):1139–1141. [PMC free article] [PubMed]
  • Scott WK, Macera CA, Cornman CB, Sharpe PA. Functional health status as a predictor of mortality in men and women over 65. J Clin Epidemiol. 1997 Mar;50(3):291–296. [PubMed]
  • Bograd H, Ritzwoller DP, Calonge N, Shields K, Hanrahan M. Extending health maintenance organization insurance to the uninsured. A controlled measure of health care utilization. JAMA. 1997 Apr 2;277(13):1067–1072. [PubMed]
  • Pahor M, Guralnik JM, Corti MC, Foley DJ, Carbonin P, Havlik RJ. Long-term survival and use of antihypertensive medications in older persons. J Am Geriatr Soc. 1995 Nov;43(11):1191–1197. [PubMed]
  • Seidlitz L, Duberstein PR, Cox C, Conwell Y. Attitudes of older people toward suicide and assisted suicide: an analysis of Gallup Poll findings. J Am Geriatr Soc. 1995 Sep;43(9):993–998. [PubMed]
  • Vatten LJ, Holmen J, Krüger O, Forsén L, Tverdal A. Low blood pressure and mortality in the elderly: a 6-year follow-up of 18,022 Norwegian men and women age 65 years and older. Epidemiology. 1995 Jan;6(1):70–73. [PubMed]
  • Domingo Salvany A, Marcos Alonso J. Propuesta de un indicador de la "clase social" basado en la ocupación. Gac Sanit. 1989 Jan-Feb;3(10):320–326. [PubMed]
  • Pérula de Torres LA, Martínez de la Iglesia J, Ruiz Moral R, Fonseca del Pozo J. Variables relacionadas con el estado de salud autopercibido: estudio poblacional. Aten Primaria. 1995 Oct 15;16(6):323–329. [PubMed]
  • Murray J, Dunn G, Tarnopolsky A. Self-assessment of health: an exploration of the effects of physical and psychological symptoms. Psychol Med. 1982 May;12(2):371–378. [PubMed]
  • Cairney J, Arnold R. Social class, health and aging: socioeconomic determinants of self-reported morbidity among the noninstitutionalized elderly in Canada. Can J Public Health. 1996 May-Jun;87(3):199–203. [PubMed]
  • Barberger-Gateau P, Chaslerie A, Dartigues JF, Commenges D, Gagnon M, Salamon R. Health measures correlates in a French elderly community population: the PAQUID study. J Gerontol. 1992 Mar;47(2):S88–S95. [PubMed]
  • Moum T. Self-assessed health among Norwegian adults. Soc Sci Med. 1992 Oct;35(7):935–947. [PubMed]
  • Liang J, Bennett J, Whitelaw N, Maeda D. The structure of self-reported physical health among the aged in the United States and Japan. Med Care. 1991 Dec;29(12):1161–1180. [PubMed]
  • Ferraro KF. Self-ratings of health among the old and the old-old. J Health Soc Behav. 1980 Dec;21(4):377–383. [PubMed]
  • Johnson RJ, Wolinsky FD. The structure of health status among older adults: disease, disability, functional limitation, and perceived health. J Health Soc Behav. 1993 Jun;34(2):105–121. [PubMed]
  • Idler EL. Age differences in self-assessments of health: age changes, cohort differences, or survivorship? J Gerontol. 1993 Nov;48(6):S289–S300. [PubMed]
  • Lichtenstein RL, Thomas JW. A comparison of self-reported measures of perceived health and functional health in an elderly population. J Community Health. 1987 Winter;12(4):213–230. [PubMed]
  • Goldstein MS, Siegel JM, Boyer R. Predicting changes in perceived health status. Am J Public Health. 1984 Jun;74(6):611–614. [PMC free article] [PubMed]
  • Arber S, Ginn J. Gender and inequalities in health in later life. Soc Sci Med. 1993 Jan;36(1):33–46. [PubMed]
  • Wolinsky FD, Johnson RJ. The use of health services by older adults. J Gerontol. 1991 Nov;46(6):S345–S357. [PubMed]
  • Mutchler JE, Burr JA. Racial differences in health and health care service utilization in later life: the effect of socioeconomic status. J Health Soc Behav. 1991 Dec;32(4):342–356. [PubMed]
  • Blaum CS, Liang J, Liu X. The relationship of chronic diseases and health status to the health services utilization of older Americans. J Am Geriatr Soc. 1994 Oct;42(10):1087–1093. [PubMed]
  • Ford AB, Folmar SJ, Salmon RB, Medalie JH, Roy AW, Galazka SS. Health and function in the old and very old. J Am Geriatr Soc. 1988 Mar;36(3):187–197. [PubMed]
  • Bush TL, Miller SR, Golden AL, Hale WE. Self-report and medical record report agreement of selected medical conditions in the elderly. Am J Public Health. 1989 Nov;79(11):1554–1556. [PMC free article] [PubMed]
  • Kriegsman DM, Penninx BW, van Eijk JT, Boeke AJ, Deeg DJ. Self-reports and general practitioner information on the presence of chronic diseases in community dwelling elderly. A study on the accuracy of patients' self-reports and on determinants of inaccuracy. J Clin Epidemiol. 1996 Dec;49(12):1407–1417. [PubMed]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...