Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA 02115, United States of America.
Bull World Health Organ. 2010 Feb;88(2):131-8. doi: 10.2471/BLT.09.067058. Epub 2009 Oct 1.
To assess the value of self-rated health assessments by examining the association between education and self-rated poor health.
We used the globally representative population-based sample from the 2002 World Health Survey, composed of 219,713 men and women aged 25 and over in 69 countries, to examine the association between education and self-rated poor health. In a binary regression model with a logit link function, we used self-rated poor health as the binary dependent variable, and age, sex and education as the independent variables.
Globally, there was an inverse association between years of schooling and self-rated poor health (odds ratio, OR: 0.929; 95% confidence interval, CI: 0.926-0.933). Compared with the individuals in the highest quintile of years of schooling, those in the lowest quintile were twice as likely to report poor health (OR: 2.292; 95% CI: 2.165-2.426). We found a dose-response relationship between quintiles of years of schooling and the ORs for reporting poor health. This association was consistent among men and women; low-, middle- and high-income countries; and regions.
Our findings suggest that self-reports of health may be useful for epidemiological investigations within countries, even in low-income settings.
通过考察教育与自评健康不良之间的关系，评估自评健康评估的价值。
我们使用来自全球 69 个国家的 25 岁及以上的 219713 名男性和女性的具有代表性的全球人群样本，来研究教育与自评健康不良之间的关系。在一个具有逻辑回归函数的二元回归模型中，我们使用自评健康不良作为二元因变量，年龄、性别和教育作为自变量。
全球范围内，受教育年限与自评健康不良之间呈负相关（比值比，OR：0.929；95%置信区间，CI：0.926-0.933）。与受教育年限最高五分位数的个体相比，受教育年限最低五分位数的个体自评健康不良的可能性是前者的两倍（OR：2.292；95%CI：2.165-2.426）。我们发现，受教育年限五分位数与报告健康不良的 OR 之间存在剂量-反应关系。这种关联在男性和女性、低收入、中等收入和高收入国家以及各区域中均一致。
我们的研究结果表明，健康自评可能对国家内部的流行病学调查有用，即使在低收入环境中也是如此。
