School of Public Health, University of Saskatchewan, 104 Clinic Place, Room 3334, Saskatoon, SK S7N 5E3, Canada.
Int J Equity Health. 2017 Jun 6;16(1):94. doi: 10.1186/s12939-017-0595-x.
Perceived health status indicates people's overall perception of their health, including both physical and psychological dimensions. The aim of this study was to examine the determinants of self-perceived health for Canadians aged 40 and older using data from the Canadian Community Health Survey (2010).
Multiple logistic regression models were employed to identify factors associated with self-perceived health in two age groups: Adults aged 65+ and Adults aged 40-64.
We found that higher income was significantly associated with better health status while chronic conditions and stress were associated with worse health status. In the 40-64 and 65+ age groups, individuals in the highest income bracket were 4.65 and 1.94 times, respectively, more likely to report better health than individuals in the lowest income bracket. The difference in the level of income associated health inequities between the two age groups point to the need for understanding the reasons behind lower inequities among seniors and how much the social protections provided by the Canadian government to seniors contribute to lowering inequities.
Though Canada has a national public health insurance system providing coverage to all Canadians, health inequities associated with income persist providing further evidence of the importance of the social determinants of health. Examining the extent of these inequities and what factors influence them helps direct policy attention. In addition to documenting inequities, this paper discusses policy options for reducing the identified inequities.
感知健康状况表明人们对自身健康的总体感知，包括身体和心理两个方面。本研究旨在利用加拿大社区健康调查（2010 年）的数据，探讨 40 岁及以上加拿大人自我感知健康的决定因素。
采用多因素逻辑回归模型，对两个年龄组（65 岁及以上的成年人和 40-64 岁的成年人）的自我感知健康相关因素进行分析。
我们发现，较高的收入与更好的健康状况显著相关，而慢性疾病和压力则与更差的健康状况相关。在 40-64 岁和 65 岁及以上两个年龄组中，收入最高组报告健康状况较好的可能性分别是收入最低组的 4.65 倍和 1.94 倍。这两个年龄组之间与收入相关的健康不平等程度差异表明，需要了解老年人中不平等程度较低的原因，以及加拿大政府为老年人提供的社会保护在多大程度上有助于降低不平等程度。
尽管加拿大拥有覆盖所有加拿大公民的全民公共医疗保险制度，但与收入相关的健康不平等仍然存在，这进一步证明了健康社会决定因素的重要性。检查这些不平等的程度以及影响它们的因素有助于将政策重点引导到这些问题上。本文除了记录不平等现象外，还讨论了减少已确定不平等现象的政策选择。
