Abuladze Liili, Kunder Nele, Lang Katrin, Vaask Sirje
Estonian Institute for Population Studies, School of Governance, Law and Society, Tallinn University, Tallinn, Estonia.
Department of Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia.
BMJ Open. 2017 Jun 9;7(6):e013257. doi: 10.1136/bmjopen-2016-013257.
The population of Estonia has one of the lowest life expectancies and health statuses in Europe. This is reflected in a lower perception of health among older adults. This study focuses on the role of health behaviour (smoking, alcohol consumption, physical activity and nutrition) in self-rated health, accounting for sociodemographic characteristics, activity limitations and long-term illnesses as well as satisfaction with life of older Estonian men and women.
We use representative cross-sectional data from Wave 4 of the Estonian Survey of Health, Ageing and Retirement in Europe, conducted mainly in 2011.
Frequencies, χ tests and logistic regression models include respondents aged 50 years and older, with no upper age limit (n=6660).
Men have 20% higher odds (CI 1.02 to 1.43) of poor self-rated health. Being of foreign origin (OR 1.48; CI 1.24 to 1.77), having a basic (2.50; CI 2.06 to 3.00) or secondary (1.71; CI 1.43 to 2.04) education, being retired (2.00; CI 1.65 to 2.44) or staying at home (1.49; CI 1.16 to 1.93) and having activity limitations (3.25; CI 2.77 to 3.80) or long-term illnesses (4.78; CI 4.08 to 5.60) are related to poor self-rated health. Never being involved in vigorous (2.30; CI 1.90 to 2.79) or moderate physical activity (1.41; CI 1.02 to 1.94), and consuming legumes and eggs less frequently (1.25; CI 1.08 to 1.45) is associated with poorer self-rated health. Lower satisfaction with life accounts for some of the variation (2.28; CI 1.92 to 2.71).
There is a strong cumulative effect of one's previous life course on the self-rated health of older adults in Estonia, suggesting that public health policies have long-term consequences rather than immediate consequences. Health services supporting health behaviours and targeting vulnerable population groups with specific sociodemographic characteristics and health problems may influence self-rated health for some. Public health services emphasising social activities or psychological aspects may be most successful in improving self-rated health of older Estonians through satisfaction with life.
爱沙尼亚的人口预期寿命和健康状况在欧洲处于最低水平之一。这反映在老年人对健康的认知较低。本研究关注健康行为（吸烟、饮酒、体育活动和营养）在自我评估健康中的作用，同时考虑社会人口学特征、活动受限情况、长期疾病以及爱沙尼亚老年男性和女性的生活满意度。
我们使用了主要在2011年进行的欧洲爱沙尼亚健康、老龄化与退休调查第4波的代表性横断面数据。
频率分析、χ检验和逻辑回归模型纳入了50岁及以上的受访者，无年龄上限（n = 6660）。
男性自我评估健康状况较差的几率高出20%（置信区间为1.02至1.43）。具有外国血统（比值比1.48；置信区间1.24至1.77）、接受基础（2.50；置信区间2.06至3.00）或中等（1.71；置信区间1.43至2.04）教育、已退休（2.00；置信区间1.65至2.44）或待在家中（1.49；置信区间1.16至1.93）以及存在活动受限情况（3.25；置信区间2.77至3.80）或患有长期疾病（4.78；置信区间4.08至5.60）均与自我评估健康状况较差相关。从未参与剧烈（2.30；置信区间1.90至2.79）或适度体育活动（1.41；置信区间1.02至1.94），以及较少食用豆类和蛋类（1.25；置信区间1.08至1.45）与自我评估健康状况较差有关。生活满意度较低解释了部分差异（2.28；置信区间1.92至2.71）。
在爱沙尼亚，一个人过去的人生历程对老年人的自我评估健康有很强的累积影响，这表明公共卫生政策具有长期而非即时的后果。支持健康行为并针对具有特定社会人口学特征和健康问题的弱势群体的卫生服务可能会对一些人的自我评估健康产生影响。强调社会活动或心理方面的公共卫生服务可能通过提高生活满意度最有效地改善爱沙尼亚老年人的自我评估健康。
