Molarius Anu, Berglund Kenneth, Eriksson Charli, Lambe Mats, Nordström Eva, Eriksson Hans G, Feldman Inna
Västmanland County Council, Department of Community Medicine Västerås, Sweden.
Eur J Public Health. 2007 Apr;17(2):125-33. doi: 10.1093/eurpub/ckl070. Epub 2006 Jun 3.
Socioeconomic conditions and lifestyle factors have been found to be related to self-rated health, which is an established predictor of morbidity and mortality. Few studies, however, have investigated the independent effect of material and psychosocial conditions as well as lifestyle factors on self-rated health.
The association between socioeconomic conditions, lifestyle factors, and self-rated health was investigated using a postal survey questionnaire sent to a random population sample of men and women aged 18-79 years during March-May 2000. The overall response rate was 65%. The area investigated covers 58 municipalities in the central part of Sweden. Multivariate odds ratios for poor self-rated health were calculated for a range of variables. A total of 36 048 subjects with full data were included in the analysis. Similar analyses of the influence of working conditions were conducted among those employed aged 18-64 years (17 820 subjects).
The overall prevalence of poor self-rated health was 7% among men and 9% among women. Poor self-rated health was most common among persons who had been belittled, who had experienced economic hardship, who lacked social support, or who had retired early. A low educational level was independently associated with poor self-rated health among men, but not among women. Physically inactive as well as underweight and obese subjects were more likely to have poor self-rated health than other subjects. Working conditions associated with poor self-rated health were dissatisfaction with work, low job control and worry about losing one's job.
While a cross-sectional study does not allow definite conclusions as to which factors are determinants and which are consequences of poor self-rated, the present findings support the notion that both psychosocial and material conditions as well as lifestyle factors are independently related with poor self-rated health.
社会经济状况和生活方式因素已被发现与自评健康相关，而自评健康是发病率和死亡率的既定预测指标。然而，很少有研究调查物质和心理社会状况以及生活方式因素对自评健康的独立影响。
2000年3月至5月期间，通过向18至79岁的男性和女性随机抽样人群发送邮政调查问卷，调查社会经济状况、生活方式因素与自评健康之间的关联。总体回复率为65%。调查区域覆盖瑞典中部的58个市。计算了一系列变量的自评健康状况较差的多变量比值比。共有36048名有完整数据的受试者纳入分析。对18至64岁的在职人员（17820名受试者）进行了类似的工作条件影响分析。
男性自评健康状况较差的总体患病率为7%，女性为9%。自评健康状况较差在那些曾被贬低、经历过经济困难、缺乏社会支持或提前退休的人群中最为常见。低教育水平在男性中与自评健康状况较差独立相关，但在女性中并非如此。身体不活动以及体重过轻和肥胖的受试者比其他受试者更有可能自评健康状况较差。与自评健康状况较差相关的工作条件包括对工作不满意、工作控制感低以及担心失去工作。
虽然横断面研究无法就哪些因素是自评健康状况较差的决定因素以及哪些是其后果得出明确结论，但目前的研究结果支持这样一种观点，即心理社会和物质条件以及生活方式因素都与自评健康状况较差独立相关。
