Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Eur J Public Health. 2012 Apr;22(2):284-9. doi: 10.1093/eurpub/ckr001. Epub 2011 Mar 7.
Living in a particular region might affect health. We aimed to assess variations between regions in individual health. The role of socio-economic factors in the associations was also investigated.
World Health Survey data were analysed on 220 487 individuals. Main outcomes included self-reported health, health complaints and disability. The main predictor variable was a modified regional classification of countries. Multilevel logistic regression was used to assess associations between individual health and regions, while accounting for individual and country-level socio-economic factors, notably occupation, education, national income and female literacy.
Individual health varied significantly between regions. For instance, compared with Western Europeans, Southern Asians and Western Africans reported poorer health, the odds ratios (ORs) being 2.05 [95% confidence interval (CI) 1.31-3.23] and 1.88 (95% CI 1.26-2.81), respectively. Accounting for socio-economic factors attenuated or, in a few cases, reversed the associations. For example, the OR for Southern Asia and Western Africa respectively became 0.94 (95% CI 0.37-2.37) and 0.77 (95% CI 0.26-2.25). Individuals from Central Europe and the Former Soviet Union were the most likely to report poor health, OR 1.92 (95% CI 1.07-3.44) and OR 4.17 (95% CI 1.91-9.10) respectively. Overall, men were less likely than women to report poor health.
Substantial regional variations in individual health exist, only partly explained by socio-economic factors. Additional policy and health research are needed to investigate Central Europe and Former Soviet Union rates that consistently lag behind Latin America, Asia and Africa.
生活在特定地区可能会影响健康。我们旨在评估个体健康方面的地区差异。还研究了社会经济因素在这些关联中的作用。
对 220487 名个体的世界卫生调查数据进行了分析。主要结局包括自我报告的健康状况、健康抱怨和残疾。主要预测变量是对国家的改良区域分类。使用多水平逻辑回归评估个体健康与地区之间的关联，同时考虑个体和国家层面的社会经济因素，特别是职业、教育、国民收入和女性识字率。
个体健康在地区之间存在显著差异。例如，与西欧人相比，南亚人和西非人报告的健康状况较差，优势比（OR）分别为 2.05（95%置信区间（CI）为 1.31-3.23）和 1.88（95%CI 为 1.26-2.81）。考虑到社会经济因素后，关联减弱或在某些情况下发生逆转。例如，南亚和西非的 OR 分别变为 0.94（95%CI 为 0.37-2.37）和 0.77（95%CI 为 0.26-2.25）。中欧和前苏联的个体最有可能报告健康状况不佳，OR 分别为 1.92（95%CI 为 1.07-3.44）和 4.17（95%CI 为 1.91-9.10）。总体而言，男性报告健康状况不佳的可能性低于女性。
个体健康存在显著的地区差异，仅部分由社会经济因素解释。需要进行更多的政策和健康研究，以调查中欧和前苏联地区的情况，这些地区的健康状况持续落后于拉丁美洲、亚洲和非洲。
