Medical Sociology, OE 5420, Hannover Medical School, Carl-Neuberg Str. 1, 30625, Hannover, Germany.
Int J Public Health. 2019 Jul;64(6):921-933. doi: 10.1007/s00038-019-01235-y. Epub 2019 Mar 27.
This study analyzes longitudinal trends in self-rated health (SRH) by taking age- and gender-specific differences into account.
Data of 29,251 women and 26,967 men were obtained from the German Socio-Economic Panel between 1995 and 2014. Generalized Estimation Equation analysis for logistic regression was used to estimate changes in odds of (very) good SRH over time. Development of (un)healthy life expectancy was calculated by applying the Sullivan method.
While in women, the odds of good SRH increased significantly over time for the ages 41-50 to 71-80 years, improvements among men were most apparent for the ages 61-70 and 71-80 years. By contrast, for both genders, no improvements in SRH were found in the youngest (31-40 years) and eldest age group (81-90 years) and in men aging 51-60 years. Over time, healthy life expectancy at age 31 increased by 3 years in women and 2 years in men, leading to a reduced but not eliminated gender gap in SRH.
Our findings support the hypothesis of relative compression of morbidity. However, trends in SRH differed according to age and gender, calling for health promotion efforts that meet diverse needs at different stages of life.
本研究通过考虑年龄和性别差异，分析自感健康（SRH）的纵向趋势。
本研究的数据来自德国社会经济面板调查 1995 年至 2014 年期间的 29251 名女性和 26967 名男性。采用广义估计方程分析逻辑回归，以估计随时间变化的（非常）良好 SRH 的可能性。采用沙利文法计算不健康预期寿命的发展。
在女性中，41-50 岁至 71-80 岁的年龄段，良好 SRH 的可能性显著增加，而男性的改善在 61-70 岁和 71-80 岁的年龄段最为明显。相比之下，对于两个性别而言，在最年轻（31-40 岁）和最年长（81-90 岁）的年龄组以及 51-60 岁的男性年龄组中，SRH 没有改善。随着时间的推移，31 岁时的健康预期寿命在女性中增加了 3 年，在男性中增加了 2 年，导致 SRH 中的性别差距虽然缩小但并未消除。
我们的研究结果支持相对发病率压缩假说。然而，SRH 的趋势因年龄和性别而异，需要在不同的生命阶段满足不同需求的健康促进努力。
