Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States of America.
Department of Public Policy and Management, University of Georgia, Athens, GA, United States of America.
PLoS One. 2023 Apr 5;18(4):e0283796. doi: 10.1371/journal.pone.0283796. eCollection 2023.
Self-rated health is an important health outcome and determinant of health. Improvements to our understanding on self-rated health could help design plans and strategies to improve self-rated health and achieve other preferred health outcomes. This study examined whether the link between functional limitations and self-rated health varies by neighborhood socioeconomic status.
This study used the Midlife in the United States study linked with the Social Deprivation Index developed by the Robert Graham Center. Our sample consist of noninstitutionalized middle to older adults in the United States (n = 6,085). Based on stepwise multiple regression models, we computed adjusted odds ratios to examine the relationships between neighborhood socioeconomic status, functional limitations, and self-rated health.
Respondents in the socioeconomically disadvantaged neighborhoods were older, had higher percentage of females, non-White respondents, lower educational attainment, lower perceived neighborhood quality, and worse health status with greater number of functional limitations than those in socioeconomically advantaged neighborhoods. Results showed a significant interaction was found where neighborhood-level discrepancies in self-rated health was biggest among individuals with highest number of functional limitations (B = -0.28, 95% CI[0.53, -0.04], p = 0.025). Specifically, individuals with the highest number of functional limitations from the disadvantaged neighborhoods had higher self-rated health compared to those from advantaged neighborhoods.
Our study findings highlight that neighborhood discrepancy in self-rated health is underestimated particularly among those with severe functional limitations. Moreover, when interpreting self-rated health status, values should not be taken face value, and should be considered together with the environmental conditions of where one resides.
自感健康是一个重要的健康结果和健康决定因素。对自感健康的理解的提高可以帮助设计计划和策略来改善自感健康状况并实现其他理想的健康结果。本研究考察了功能限制与自感健康之间的联系是否因邻里社会经济地位而异。
本研究使用了美国中年人与罗伯特·格雷厄姆中心开发的社会剥夺指数相联系的研究。我们的样本包括美国非机构化的中老年人（n=6085）。基于逐步多元回归模型，我们计算了调整后的优势比，以检验邻里社会经济地位、功能限制和自感健康之间的关系。
处于社会经济劣势社区的受访者年龄较大，女性比例较高，非白种人比例较高，受教育程度较低，感知邻里质量较低，健康状况较差，功能限制较多。结果显示，在功能限制最多的个体中，邻里间自感健康的差异存在显著的交互作用（B=-0.28，95%置信区间[0.53，-0.04]，p=0.025）。具体来说，来自劣势社区的功能限制最多的个体自感健康状况高于来自优势社区的个体。
我们的研究结果表明，自感健康状况的邻里差异被低估了，特别是在那些功能严重受限的个体中。此外，在解释自感健康状况时，不应只看数值，还应考虑到个人居住环境的条件。
