Magwene Elena M, Quiñones Ana R, Marshall Gillian L, Makaroun Lena K, Thielke Stephen
Mental Health Service, VA Puget Sound Health Care System, Seattle, WA.
Oregon Health and Science University, Portland, OR.
J Public Health Res. 2017 Sep 29;6(2):967. doi: 10.4081/jphr.2017.967. eCollection 2017 Sep 21.
Self-rated health (SRH) shows strong associations with measures of health and well-being. Increasingly, studies have used self-rated mental health (SRMH) as a predictor of various outcomes, independently or together with SRH. Research has not firmly established if and how these two constructs differ. We sought to characterize the relationship between SRH and SRMH, and to determine how this relationship differed across subgroups defined by sociodemographic and health-related characteristics.
We analyzed data from the 2012 CAHPS Medicare Advantage Survey. SRH and SRMH ratings were crosstabulated to determine the distribution of responses across response categories. The expected joint probability distribution was computed and compared to the observed distribution. A constructed variable indicated whether SRMH was better, the same, or worse than SRH. We analyzed the distribution of this variable across various subgroups defined by sociodemographic and health-related factors.
A total of 114,905 Medicare Advantage beneficiaries responded to both the SRH and SRMH questions. Both in general and within all subgroups, SRMH was usually rated as better than SRH, and rarely as worse.
Within a large group of Medicare recipients, the overwhelming trend was for recipients to rate their mental health as at least as good as their overall health, regardless of any sociodemographic and health-related factors. This finding of a shifted distribution encourages caution in the analytic use of selfrated mental health, particularly the use of both SRH and SRMH for adjustment. Additional research is needed to help clarify the complex relationship between these variables.
自评健康（SRH）与健康及幸福感指标显示出强烈关联。越来越多的研究已将自评心理健康（SRMH）单独或与SRH一起用作各种结果的预测指标。研究尚未明确这两个概念是否以及如何不同。我们试图描述SRH与SRMH之间的关系，并确定这种关系在由社会人口统计学和健康相关特征定义的亚组中如何不同。
我们分析了2012年CAHPS医疗保险优势调查的数据。对SRH和SRMH评分进行交叉制表，以确定各回答类别中的回答分布情况。计算预期的联合概率分布并与观察到的分布进行比较。构建一个变量来表明SRMH比SRH更好、相同还是更差。我们分析了该变量在由社会人口统计学和健康相关因素定义的各个亚组中的分布情况。
共有114,905名医疗保险优势受益人回答了SRH和SRMH问题。总体而言以及在所有亚组中，通常SRMH的评分都高于SRH，很少低于SRH。
在一大群医疗保险受益人中，压倒性的趋势是，无论任何社会人口统计学和健康相关因素如何，受益人对其心理健康的评分至少与总体健康一样好。这种分布变化的发现促使在分析使用自评心理健康时要谨慎，特别是在同时使用SRH和SRMH进行调整时。需要进一步的研究来帮助阐明这些变量之间的复杂关系。
