Can a Single General Self-Rated Health Question Mirror Social Determinant of Health?
Abstract
Background: Self-rated health (SRH) indicator is widely used and recommended in health research as a standard indicator for measuring health in different populations. This paper reports SRH of employees at Tehran University of Medical Sciences (TUMS), Tehran, Iran; and its related factors.
Methods: We used the TUMS Employee's Cohort Study (TEC) data, collected from September 2017 to August 2019. SRH of 2158 employees were assessed using a single question. Univariate and multivariate logistic regression were performed to determine factors associated with sub-optimal SRH.
Results: Overall, 14.9% (n = 321) of respondents rated their health as sub-optimal. Differences were observed with subgroups. Women, lower socioeconomic status (SES), experiences of more economic fluctuation conditions and lower reading scores could predict sub-optimal SRH variations in crude and adjusted regression analyses. The age, social capital, work experience and employment status could predict sub-optimal SRH variations only in crude regression analyses (P<0.05).
Conclusion: Differences in SRH report reflected differences in socioeconomic conditions. The biggest gap was observed between people of different SES (five times). Considering that SRH reflected socioeconomic characteristics of individuals, it may be considered as a quick, non-expensive, and simple way of identifying groups in need of addressing their social determinants of health.
1. Lorem G, Cook S, Leon DA, et al (2020). Self-reported health as a predictor of mortality: A cohort study of its relation to other health measurements and observation time. Sci Rep, 10 (1): 4886.
2. Cislaghi B, Cislaghi C (2019). Self-rated health as a valid indicator for health-equity analyses: evidence from the Italian health interview survey. BMC Public Health, 19 (1): 533.
3. Nedjat S (2015). Is self-rated health a good indicator for assessment of population health? A review article. Iran J Epidemiol, 10 (4): 89-96.
4. Jylhä M (2009). What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med, 69 (3): 307-16.
5. Chen H, Cohen P, Kasen S (2007). Cohort differences in self-rated health: evidence from a three-decade, community-based, longitudinal study of women. Am J Epidemiol, 166 (4): 439-46.
6. De Bruin A (1996). Health Interview Surveys: Towards International Harmonization of Methods and Instruments. WHO Regional Publications, European Series, No. 58: ERIC; 1996.
7. DeSalvo KB, Bloser N, Reynolds K, et al (2006). Mortality prediction with a single general self-rated health question. J Gen Intern Med, 21 (3): 267-75.
8. Breidablik H-J, Meland E, Lydersen S (2008). Self-rated health in adolescence: a multifactorial composite. Scand J Public Health, 36 (1): 12-20.
9. Layes A, Asada Y, Kephart G (2012). Whiners and deniers–What does self-rated health measure? Soc Sci Med, 75 (1): 1-9.
10. Salem MT, Abdulrahim S, Zurayk H (2010). Using open-ended data to enrich survey results on the meanings of self-rated health: a study among women in underprivileged communities in Beirut, Lebanon. Women Health, 49 (8): 625-41.
11. Park G, Chung W (2021). Self-rated health as a predictor of mortality according to cognitive impairment. Epidemiol Health, 43: e2021021.
12. Wuorela M, Lavonius S, Salminen M, et al (2020). Self-rated health and objective health status as predictors of all-cause mortality among older people: a prospective study with a 5-, 10-, and 27-year follow-up. BMC Geriatr, 20: 120.
13. Sheridan PE, Mair CA, Quiñones AR (2019). Associations between prevalent multimorbidity combinations and prospective disability and self-rated health among older adults in Europe. BMC Geriatr, 19 (1): 198.
14. Brenowitz WD, Hubbard RA, Crane PK, et al (2014). Longitudinal associations between self-rated health and performance-based physical function in a population-based cohort of older adults. PLoS One, 9 (11): e111761.
15. Ogunmoroti O, Utuama OA, Salami JA, et al (2018). Association between self-rated health and ideal cardiovascular health: The Baptist Health South Florida Employee Study. J Public Health (Oxf), 40 (4): e456-e463.
16. Chamberlain AM, Manemann SM, Dunlay SM, et al (2014). Self‐Rated Health Predicts Healthcare Utilization in Heart Failure. J Am Heart Assoc, 3 (3): e000931.
17. Gupta D, Patel K, Lis CG (2015). Self-rated health supersedes patient satisfaction with service quality as a predictor of survival in prostate cancer. Health Qual Life Outcomes, 13:137.
18. Young H, Grundy E, O'Reilly D, et al (2010). Self-rated health and mortality in the UK: results from the first comparative analysis of the England and Wales, Scotland, and Northern Ireland Longitudinal Studies. Popul Trends, 139 (1): 11-36.
19. Nedjat S, Mehrdad R, Yunesian M, et al (2020). Prospective cohort study on the social determinants of health: Teh-ran University of Medical Sciences employeescohort (TEC) study proto-col. BMC Public Health, 20 (1): 1703.
20. Solar O, Irwin A. A conceptual framework for action on the social determinants of health. WHO Document Production Services; 2010.
21. Yari A, Nadrian H, Rashidian H, et al (2014). Psychometric properties of the Persian version of Social Capital Questionnaire in Iran, Med J Islam Repub Iran, 28: 17.
22. Baigi V, Nedjat S, Fotouhi A, et al (2016). Subjective social status in association with various health and socioeconomic indicators in Tehran. J Public Health, 24 (6): 497-503.
23. Baron-Epel O, Kaplan G (2009). Can subjective and objective socioeconomic status explain minority health disparities in Israel? Soc Sci Med, 69 (10): 1460-7.
24. Sartipi M, Nedjat S, Mansournia MA, et al (2016). Assets as a socioeconomic status index: categorical principal components analysis vs. latent class analysis. Arch Iran Med, 19 (11): 791-79.
25. Vyas S, Kumaranayake L (2006). Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan, 21 (6): 459-68.
26. Bursac Z, Gauss CH, Williams DK, et al (2008). Purposeful selection of variables in logistic regression. Source Code Biol Med, 3: 17.
27. Field A. Discovering statistics using IBM SPSS statistics: sage; 2013.
28. Robine J-M, Jagger C, Group E-R (2003). Creating a coherent set of indicators to monitor health across Europe: the Euro-REVES 2 project. Eur J Public Health, 13(3 Suppl):6-14.
29. Singh-Manoux A, Dugravot A, Shipley MJ, et al (2007). The association between self-rated health and mortality in different socioeconomic groups in the GAZEL cohort study. Int J Epidemiol, 36 (6): 1222-8.
30. Desesquelles AF, Egidi V, Salvatore MA (2009). Why do Italian people rate their health worse than French people do? An exploration of cross-country differentials of self-rated health. Soc Sci Med, 68 (6): 1124-8.
31. Riediger ND, Bombak AE, Mudryj AN (2019). Health-related behaviours and their relationship with self-rated health among Canadian adults. BMC Public Health, 19 (1): 960.
32. Olamijuwon EO, Odimegwu CO, DeWet N (2018). Social cohesion and self-rated health among adults in South Africa: The moderating role of race. Health Place, 51: 89-96.
33. Moradi-Lakeh M, El Bcheraoui C, Tuffaha M, et al (2015). Self-rated health among Saudi adults: findings from a national survey, 2013. J Community Health, 40 (5): 920-6.
34. Nedjat S, Hosseinpoor AR, Forouzanfar MH, et al (2012). Decomposing socioeconomic inequality in self-rated health in Tehran. J Epidemiol Community Health, 66 (6): 495-500.
35. Maharlouei N, Akbari M, Shirazy MK, et al (2016). Factors associated with self-rated health status in Southwestern Iran: a population-based study. Public Health, 140: 179-85.
36. Rezaei S, Karyani AK, Khosravipour M, et al (2018). Self-Rated Health among General Population in the West of Iran: A Cross-Sectional Analysis of Socioeconomic Determinants. Epidemiol Biostat Public Health, 15 (2): e12886.
37. Ghalichi L, Nedjat S, Majdzadeh R, et al (2015). Determinants of self-rated health in Tehran, from individual characteristics towards community-level attributes. Arch Iran Med, 18 (5): 266-71.
38. Agyemang C, Denktaş S, Bruijnzeels M, et al (2006). Validity of the single-item question on self-rated health status in first generation Turkish and Moroccans versus native Dutch in the Netherlands. Public Health, 120 (6): 543-50.
39. Salehi F, Nedjat S, Cheraghi Z, et al (2017). Self-Rated Health Definition in the point of view of Iranian people. Payesh, 16 (3): 281-92.
40. Cai J, Coyte PC, Zhao H (2017). Determinants of and socio-economic disparities in self-rated health in China. Int J Equity Health, 16(1):7.
41. Montazeri A, Goshtasebi A, Vahdaninia M (2008). Educational inequalities in self-reported health in a general Iranian population. BMC Res Notes, 1:50.
42. Dong WL, Li YC, Wang ZQ, etal (2016). Self-rated health and health-related quality of life among Chinese residents, China, 2010. Health Qual Life Outcomes, 14:5.
43. Crimmins EM, Kim JK, Solé-Auró A (2011). Gender differences in health: results from SHARE, ELSA and HRS. Eur J Public Health, 21 (1): 81-91.
44. Mayor E (2015). Gender roles and traits in stress and health. Front Psychol, 6:779.
45. Kim Y, Park I, Kang S, et al (2018). Age and gender differences in health risk perception. Cent Eur J Public Health, 26 (1): 54-59.
46. Hassanzadeh J, Rezaeian S (2018). Self-Rated Health and Its Determinants in Female Population in Iran: A Community-Based Study. Health Scope, 7 (1): e68258.
47. Kim S-S, Choi J, Park K, et al (2014). Association between district-level perceived safety and self-rated health: a multilevel study in Seoul, South Korea. BMJ Open, 4 (7): e004695.
48. Asfar T, Ahmad B, Rastam S, et al (2007). Self-rated health and its determinants among adults in Syria: a model from the Middle East. BMC Public Health, 7: 177.
49. Jürges H, Avendano M, Mackenbach JP (2008). Are different measures of self-rated health comparable? An assessment in five European countries. Eur J Epidemiol, 23 (12): 773-81.
50. Vuorisalmi M, Lintonen T, Jylhä M (2006). Comparative vs global self-rated health: associations with age and functional ability. Aging Clin Exp Res, 18 (3): 211-7.
51. Kwon K, Park JB, Lee K-J, et al (2016). Association between employment status and self-rated health: Korean working conditions survey. Ann Occup Environ Med, 28 (1): 43.
52. Waenerlund A-K, Virtanen P, Hammarström A (2011). Is temporary employment related to health status? Analysis of the Northern Swedish Cohort. Scand J Public Health, 39 (5): 533-9.
53. Chemali Z, Ezzeddine F, Gelaye B, et al (2019). Burnout among healthcare providers in the complex environment of the Middle East: a systematic review. BMC Public Health, 19 (1): 1337.
54. Jalili M, Roodsari GS, Nia AB (2013). Burnout and associated factors among Iranian emergency medicine practitioners. Iran J Public Health, 42 (9): 1034-42.
55. Suzuki E, Takao S, Subramanian S, et al (2010). Does low workplace social capital have detrimental effect on workers' health? Soc Sci Med, 70 (9): 1367-72.
56. Pattyn E, Bracke P, et al (2012). The association between network social capital and self-rated health: pouring old wine in new bottles? Health Place, 18 (2): 358-65.
57. Baheiraei A, Bakouei F, Mohammadi E, et al (2016). Association between social capital and health in women of reproductive age: a population-based study. Glob Health Promot, 23(4):6-15.
58. Seyyedan F, Abdolsamadi M (2011). The relation of social capital with mental health in women and men. Social Welfare Quarterly, 11 (42): 229-54.
59. Bavishi A, Slade MD, Levy BR (2016). A chapter a day: Association of book reading with longevity. Soc Sci Med, 164: 44-48.
60. Kourkouta L, Iliadis C, Frantzana A,et al (2018). Reading and Health Benefts. J Healthc Commun, 3 (4): 39.
2. Cislaghi B, Cislaghi C (2019). Self-rated health as a valid indicator for health-equity analyses: evidence from the Italian health interview survey. BMC Public Health, 19 (1): 533.
3. Nedjat S (2015). Is self-rated health a good indicator for assessment of population health? A review article. Iran J Epidemiol, 10 (4): 89-96.
4. Jylhä M (2009). What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med, 69 (3): 307-16.
5. Chen H, Cohen P, Kasen S (2007). Cohort differences in self-rated health: evidence from a three-decade, community-based, longitudinal study of women. Am J Epidemiol, 166 (4): 439-46.
6. De Bruin A (1996). Health Interview Surveys: Towards International Harmonization of Methods and Instruments. WHO Regional Publications, European Series, No. 58: ERIC; 1996.
7. DeSalvo KB, Bloser N, Reynolds K, et al (2006). Mortality prediction with a single general self-rated health question. J Gen Intern Med, 21 (3): 267-75.
8. Breidablik H-J, Meland E, Lydersen S (2008). Self-rated health in adolescence: a multifactorial composite. Scand J Public Health, 36 (1): 12-20.
9. Layes A, Asada Y, Kephart G (2012). Whiners and deniers–What does self-rated health measure? Soc Sci Med, 75 (1): 1-9.
10. Salem MT, Abdulrahim S, Zurayk H (2010). Using open-ended data to enrich survey results on the meanings of self-rated health: a study among women in underprivileged communities in Beirut, Lebanon. Women Health, 49 (8): 625-41.
11. Park G, Chung W (2021). Self-rated health as a predictor of mortality according to cognitive impairment. Epidemiol Health, 43: e2021021.
12. Wuorela M, Lavonius S, Salminen M, et al (2020). Self-rated health and objective health status as predictors of all-cause mortality among older people: a prospective study with a 5-, 10-, and 27-year follow-up. BMC Geriatr, 20: 120.
13. Sheridan PE, Mair CA, Quiñones AR (2019). Associations between prevalent multimorbidity combinations and prospective disability and self-rated health among older adults in Europe. BMC Geriatr, 19 (1): 198.
14. Brenowitz WD, Hubbard RA, Crane PK, et al (2014). Longitudinal associations between self-rated health and performance-based physical function in a population-based cohort of older adults. PLoS One, 9 (11): e111761.
15. Ogunmoroti O, Utuama OA, Salami JA, et al (2018). Association between self-rated health and ideal cardiovascular health: The Baptist Health South Florida Employee Study. J Public Health (Oxf), 40 (4): e456-e463.
16. Chamberlain AM, Manemann SM, Dunlay SM, et al (2014). Self‐Rated Health Predicts Healthcare Utilization in Heart Failure. J Am Heart Assoc, 3 (3): e000931.
17. Gupta D, Patel K, Lis CG (2015). Self-rated health supersedes patient satisfaction with service quality as a predictor of survival in prostate cancer. Health Qual Life Outcomes, 13:137.
18. Young H, Grundy E, O'Reilly D, et al (2010). Self-rated health and mortality in the UK: results from the first comparative analysis of the England and Wales, Scotland, and Northern Ireland Longitudinal Studies. Popul Trends, 139 (1): 11-36.
19. Nedjat S, Mehrdad R, Yunesian M, et al (2020). Prospective cohort study on the social determinants of health: Teh-ran University of Medical Sciences employeescohort (TEC) study proto-col. BMC Public Health, 20 (1): 1703.
20. Solar O, Irwin A. A conceptual framework for action on the social determinants of health. WHO Document Production Services; 2010.
21. Yari A, Nadrian H, Rashidian H, et al (2014). Psychometric properties of the Persian version of Social Capital Questionnaire in Iran, Med J Islam Repub Iran, 28: 17.
22. Baigi V, Nedjat S, Fotouhi A, et al (2016). Subjective social status in association with various health and socioeconomic indicators in Tehran. J Public Health, 24 (6): 497-503.
23. Baron-Epel O, Kaplan G (2009). Can subjective and objective socioeconomic status explain minority health disparities in Israel? Soc Sci Med, 69 (10): 1460-7.
24. Sartipi M, Nedjat S, Mansournia MA, et al (2016). Assets as a socioeconomic status index: categorical principal components analysis vs. latent class analysis. Arch Iran Med, 19 (11): 791-79.
25. Vyas S, Kumaranayake L (2006). Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan, 21 (6): 459-68.
26. Bursac Z, Gauss CH, Williams DK, et al (2008). Purposeful selection of variables in logistic regression. Source Code Biol Med, 3: 17.
27. Field A. Discovering statistics using IBM SPSS statistics: sage; 2013.
28. Robine J-M, Jagger C, Group E-R (2003). Creating a coherent set of indicators to monitor health across Europe: the Euro-REVES 2 project. Eur J Public Health, 13(3 Suppl):6-14.
29. Singh-Manoux A, Dugravot A, Shipley MJ, et al (2007). The association between self-rated health and mortality in different socioeconomic groups in the GAZEL cohort study. Int J Epidemiol, 36 (6): 1222-8.
30. Desesquelles AF, Egidi V, Salvatore MA (2009). Why do Italian people rate their health worse than French people do? An exploration of cross-country differentials of self-rated health. Soc Sci Med, 68 (6): 1124-8.
31. Riediger ND, Bombak AE, Mudryj AN (2019). Health-related behaviours and their relationship with self-rated health among Canadian adults. BMC Public Health, 19 (1): 960.
32. Olamijuwon EO, Odimegwu CO, DeWet N (2018). Social cohesion and self-rated health among adults in South Africa: The moderating role of race. Health Place, 51: 89-96.
33. Moradi-Lakeh M, El Bcheraoui C, Tuffaha M, et al (2015). Self-rated health among Saudi adults: findings from a national survey, 2013. J Community Health, 40 (5): 920-6.
34. Nedjat S, Hosseinpoor AR, Forouzanfar MH, et al (2012). Decomposing socioeconomic inequality in self-rated health in Tehran. J Epidemiol Community Health, 66 (6): 495-500.
35. Maharlouei N, Akbari M, Shirazy MK, et al (2016). Factors associated with self-rated health status in Southwestern Iran: a population-based study. Public Health, 140: 179-85.
36. Rezaei S, Karyani AK, Khosravipour M, et al (2018). Self-Rated Health among General Population in the West of Iran: A Cross-Sectional Analysis of Socioeconomic Determinants. Epidemiol Biostat Public Health, 15 (2): e12886.
37. Ghalichi L, Nedjat S, Majdzadeh R, et al (2015). Determinants of self-rated health in Tehran, from individual characteristics towards community-level attributes. Arch Iran Med, 18 (5): 266-71.
38. Agyemang C, Denktaş S, Bruijnzeels M, et al (2006). Validity of the single-item question on self-rated health status in first generation Turkish and Moroccans versus native Dutch in the Netherlands. Public Health, 120 (6): 543-50.
39. Salehi F, Nedjat S, Cheraghi Z, et al (2017). Self-Rated Health Definition in the point of view of Iranian people. Payesh, 16 (3): 281-92.
40. Cai J, Coyte PC, Zhao H (2017). Determinants of and socio-economic disparities in self-rated health in China. Int J Equity Health, 16(1):7.
41. Montazeri A, Goshtasebi A, Vahdaninia M (2008). Educational inequalities in self-reported health in a general Iranian population. BMC Res Notes, 1:50.
42. Dong WL, Li YC, Wang ZQ, etal (2016). Self-rated health and health-related quality of life among Chinese residents, China, 2010. Health Qual Life Outcomes, 14:5.
43. Crimmins EM, Kim JK, Solé-Auró A (2011). Gender differences in health: results from SHARE, ELSA and HRS. Eur J Public Health, 21 (1): 81-91.
44. Mayor E (2015). Gender roles and traits in stress and health. Front Psychol, 6:779.
45. Kim Y, Park I, Kang S, et al (2018). Age and gender differences in health risk perception. Cent Eur J Public Health, 26 (1): 54-59.
46. Hassanzadeh J, Rezaeian S (2018). Self-Rated Health and Its Determinants in Female Population in Iran: A Community-Based Study. Health Scope, 7 (1): e68258.
47. Kim S-S, Choi J, Park K, et al (2014). Association between district-level perceived safety and self-rated health: a multilevel study in Seoul, South Korea. BMJ Open, 4 (7): e004695.
48. Asfar T, Ahmad B, Rastam S, et al (2007). Self-rated health and its determinants among adults in Syria: a model from the Middle East. BMC Public Health, 7: 177.
49. Jürges H, Avendano M, Mackenbach JP (2008). Are different measures of self-rated health comparable? An assessment in five European countries. Eur J Epidemiol, 23 (12): 773-81.
50. Vuorisalmi M, Lintonen T, Jylhä M (2006). Comparative vs global self-rated health: associations with age and functional ability. Aging Clin Exp Res, 18 (3): 211-7.
51. Kwon K, Park JB, Lee K-J, et al (2016). Association between employment status and self-rated health: Korean working conditions survey. Ann Occup Environ Med, 28 (1): 43.
52. Waenerlund A-K, Virtanen P, Hammarström A (2011). Is temporary employment related to health status? Analysis of the Northern Swedish Cohort. Scand J Public Health, 39 (5): 533-9.
53. Chemali Z, Ezzeddine F, Gelaye B, et al (2019). Burnout among healthcare providers in the complex environment of the Middle East: a systematic review. BMC Public Health, 19 (1): 1337.
54. Jalili M, Roodsari GS, Nia AB (2013). Burnout and associated factors among Iranian emergency medicine practitioners. Iran J Public Health, 42 (9): 1034-42.
55. Suzuki E, Takao S, Subramanian S, et al (2010). Does low workplace social capital have detrimental effect on workers' health? Soc Sci Med, 70 (9): 1367-72.
56. Pattyn E, Bracke P, et al (2012). The association between network social capital and self-rated health: pouring old wine in new bottles? Health Place, 18 (2): 358-65.
57. Baheiraei A, Bakouei F, Mohammadi E, et al (2016). Association between social capital and health in women of reproductive age: a population-based study. Glob Health Promot, 23(4):6-15.
58. Seyyedan F, Abdolsamadi M (2011). The relation of social capital with mental health in women and men. Social Welfare Quarterly, 11 (42): 229-54.
59. Bavishi A, Slade MD, Levy BR (2016). A chapter a day: Association of book reading with longevity. Soc Sci Med, 164: 44-48.
60. Kourkouta L, Iliadis C, Frantzana A,et al (2018). Reading and Health Benefts. J Healthc Commun, 3 (4): 39.
| Files | ||
| Issue | Vol 51 No 10 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v51i10.10994 | |
| Keywords | ||
| Self-rated health Socioeconomic status Workplace Employees Social determinants of health Iran | ||
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How to Cite
1.
Rezaei Z, Keshavarz Mohammadi N, Pouragha H, Shakibazadeh E. Can a Single General Self-Rated Health Question Mirror Social Determinant of Health?. Iran J Public Health. 2022;51(10):2350-2359.
