Socioeconomic status and the trajectory of self-rated health.

BACKGROUND

self-rated health (SRH) likely reflects both mental and physical health domains, and is assessed by asking individuals to describe their health status. Poor SRH is associated with disease incidence and subsequent mortality. Changes in SRH across time in persons with different incident diseases are uncharacterised.

METHODS

SRH was assessed in the Atherosclerosis Risk in Communities study via annual telephone interviews over a median of 17.6 years. Individual quadratic growth models were used for repeated measures of SRH in persons who remained disease-free during follow-up (n = 11,188), as well as among those who were diagnosed with myocardial infarction (MI; n = 1,071), stroke (n = 809), heart failure (HF; n = 1,592) or lung cancer (n = 433) and those who underwent a cardiac revascularisation procedure (n = 1,340) during follow-up.

RESULTS

among disease-free participants and across time, there was a trend for lowest mean SRH among persons living in low socioeconomic areas and highest mean SRH among persons living in high socioeconomic areas. Factors contributing to the decline in SRH over time included advanced age, lower educational attainment, smoking and obesity.

CONCLUSION

addressing factors related to poor SRH trajectories among patients pre- and post-incident disease may favourably affect health outcomes among patients regardless of type of disease.