Duntava Aija, Borisova Liubov V, Mäkinen Ilkka Henrik
Department of Sociology, Uppsala University, Sweden.
SSM Popul Health. 2021 Sep 6;16:100911. doi: 10.1016/j.ssmph.2021.100911. eCollection 2021 Dec.
The main objective of this study is to explore the relationships between the three commonly used proxies of health, morbidity, functional limitation, and subjective health, using the most recent data from 18 European countries. The existing studies on the topic are outdated, limited to the United States and to elderly population. Data on 32,679 respondents of the European Social Survey (2014) were analyzed using structural equation modeling. The results suggest that (a) morbidity and functional limitation lead to poorer self-rated health, and (b) morbidity increases the probability of reporting functional limitation(s). Moreover, functional limitation mediates the relationship between morbidity and self-rated health. The model as a whole holds across both genders and all age groups. However, specific tests (SEM multi-group analyses, -tests) show differences in the health structure between all seven subsamples compared with each other. When both gender and age are taken into account the differences in the structure of health seem to diminish, apart from the elderly, suggesting that the health structure of the elderly differs from others. It is recommended for policy planners to acknowledge the group differences when shaping the policies and health services.
本研究的主要目的是利用来自18个欧洲国家的最新数据，探讨健康、发病率、功能受限和主观健康这三个常用健康指标之间的关系。关于该主题的现有研究已过时，且仅限于美国和老年人群体。使用结构方程模型对欧洲社会调查（2014年）的32,679名受访者的数据进行了分析。结果表明：（a）发病率和功能受限会导致自评健康状况变差；（b）发病率会增加报告功能受限的可能性。此外，功能受限在发病率和自评健康之间起中介作用。该模型总体上适用于所有性别和年龄组。然而，具体测试（结构方程模型多组分析、t检验）表明，与其他所有七个子样本相比，健康结构存在差异。当同时考虑性别和年龄时，除老年人外，健康结构的差异似乎会减小，这表明老年人的健康结构与其他人不同。建议政策制定者在制定政策和提供医疗服务时认识到群体差异。
