Self-reported health, functional status and chronic disease in community dwelling older adults: untangling the role of demographics.

Self-reported health, a widely used measure of general health status in population studies, can be affected by certain demographic variables such as gender, race/ethnicity and education. This cross-sectional assessment of the current health status of older adult residents was conducted in an inner-city Houston neighborhood in May, 2007. A survey instrument, with questions on chronic disease prevalence, health limitations/functional status, self-reported subjective health status in addition to demographic data on households was administered to a systematic random sample of residents. Older adults (>60 years of age) were interviewed (weighted N = 127) at their homes by trained interviewers. The results indicated that these residents, with low literacy levels, low household income and a high prevalence of frequently reported chronic diseases (hypertension, diabetes and arthritis) also reported non-participation in community activities, volunteerism and activities centered on organized religion, thus, potentially placing them at risk for social isolation. Women reported poorer self-reported health and appeared to fare worse in all health limitation indicators and reported greater structural barriers in involvement with their community. Blacks reported worse health outcomes on all indicators than other sub-groups, an indication that skills training in chronic disease self-management and in actively eliciting support from various sources may be beneficial for this group. Therefore, the use of self-reported health with a broad brush as an indicator of "true" population health status is not advisable. Sufficient consideration should be given to the racial/ethnic and gender differences and these should be accounted for.