Institute of Neuroscience and Physiology, Neuropsychiatric Epidemiology, Sahlgrenska Academy, University of Gothenburg, Wallinsgatan 6, SE-431 41 Mölndal, Sweden.
Sahlgrenska Academy, Center for Ageing and Health-AGECAP, Gothenburg University, Wallinsgatan 6, SE-431 41 Mölndal, Sweden.
Age Ageing. 2017 Nov 1;46(6):932-939. doi: 10.1093/ageing/afx126.
empirical evidence from high-income countries suggests that self-rated health (SRH) is useful as a brief and simple outcome measure in public health research. However, in many low- and middle-income countries (LMIC) there is a lack of evaluation and the cross-cultural validity of SRH remains largely untested. This study aims to explore the prevalence of SRH and its association with mortality in older adults in LMIC in order to cross-culturally validate the construct of SRH.
population-based cohort studies including 16,940 persons aged ≥65 years in China, India, Cuba, Dominican Republic, Peru, Venezuela, Mexico and Puerto Rico in 2003. SRH was assessed by asking 'how do you rate your overall health in the past 30 days' with responses ranging from excellent to poor. Covariates included socio-demographic characteristics, use of health services and health factors. Mortality was ascertained through a screening of all respondents until 2007.
the prevalence of good SRH was higher in urban compared to rural sites, except in China. Men reported higher SRH than women, and depression had the largest negative impact on SRH in all sites. Without adjustment, those with poor SRH showed a 142% increase risk of dying within 4 years compared to those with moderate SRH. After adjusting for all covariates, those with poor SRH still showed a 43% increased risk.
our findings support the use of SRH as a simple measure in survey settings to identify vulnerable groups and evaluate health interventions in resource-scares settings.
来自高收入国家的经验证据表明，自感健康（SRH）作为公共卫生研究中的一种简单的简短结果衡量标准是有用的。然而，在许多低收入和中等收入国家（LMIC）中，缺乏对其的评估，SRH 的跨文化有效性在很大程度上尚未得到检验。本研究旨在探讨 LMIC 中老年人的 SRH 流行情况及其与死亡率的关系，以跨文化验证 SRH 的结构。
本研究纳入了 2003 年在中国、印度、古巴、多米尼加共和国、秘鲁、委内瑞拉、墨西哥和波多黎各的 16940 名年龄≥65 岁的人群进行基于人群的队列研究。SRH 通过询问“在过去 30 天内，您如何评价自己的整体健康状况”来评估，回答范围从极好到极差。协变量包括社会人口统计学特征、卫生服务使用情况和健康因素。通过对所有受访者进行筛查，直到 2007 年确定死亡率。
除中国外，城市地区的良好 SRH 流行率高于农村地区。男性报告的 SRH 比女性高，所有地点的抑郁对 SRH 的负面影响最大。未经调整，与中等 SRH 相比，SRH 较差的人在 4 年内死亡的风险增加了 142%。在调整了所有协变量后，SRH 较差的人仍然显示出 43%的死亡风险增加。
我们的研究结果支持在调查环境中使用 SRH 作为一种简单的测量方法来识别弱势群体，并在资源匮乏的环境中评估卫生干预措施。
