School of Political Science and Public Administration, Wuhan University, Wuhan, China.
Wuhan University Health Governance Research Centre, Wuhan University, Wuhan, China.
BMC Public Health. 2023 Jun 2;23(1):1056. doi: 10.1186/s12889-023-15970-8.
Self-rated health among old adults (SHOA) indicates individuals' subjective assessments and evaluations of their overall health based on objective physical circumstances. The purpose of this study was to analyze the current state and influencing factors of the subjective perception-based self-rated health (SH) by qualifying selected older adults with similar objective physical conditions, as well as to explore the equality and changing trends of SHOA based on influencing factors.
This study designed a cross-sectional study, conducted in three provinces in east, central and west China, and included 1,153 older adults (> = 60 years) with intact physical condition (IPC). The current state of SHOA and its influencing factors were analyzed using mean comparisons and Logistic regression (LR) models. The equality level and trend of SHOA's effect on health literacy, health habits, and access to health care were determined using the Lorenz curve, Gini coefficient, and Vector Autoregression (VAR) model.
The mean SHOA with IPC was 74.37 ± 13.22. Findings from LR modeling indicated that SHOA with IPC was mainly influenced by age and communication methods (P < 0.05). It was also observed that the total Gini coefficient of the allocation of SHOA with IPC based on communication methods was equal to 0.0188, and the VAR results showed that the total effect of change in SHOA on health literacy among older adults was negative and its duration of the effect exceeded 50.
The SHOA with IPC was shown to be better and was primarily influenced by age and communication methods. The observed effect of SHOA on health literacy was negative and lasting. To improve SHOA with IPC even further, policymakers could consider promoting the use of modern and convenient communication methods (such as smartphones) through training and purchasing subsidies, as well as focusing on increasing sustained attention and promoting health literacy and behavior among older adults with improved SH.
老年人自评健康（SHOA）表示个体基于客观身体状况对其整体健康的主观评估和评价。本研究旨在分析具有相似客观身体状况的选定老年人的主观感知自评健康（SH）的现状和影响因素，并探讨 SHOA 基于影响因素的平等和变化趋势。
本研究采用横断面研究设计，在中国东部、中部和西部三个省份进行，纳入 1153 名身体状况完好的老年人（≥60 岁）。采用均值比较和逻辑回归（LR）模型分析 SHOA 的现状及其影响因素。采用 Lorenz 曲线、基尼系数和向量自回归（VAR）模型确定 SHOA 对健康素养、健康习惯和获得医疗保健平等程度和变化趋势。
具有 IPC 的 SHOA 的平均水平为 74.37±13.22。LR 模型的结果表明，具有 IPC 的 SHOA 主要受年龄和沟通方式的影响（P<0.05）。还观察到，基于沟通方式分配具有 IPC 的 SHOA 的总基尼系数等于 0.0188，VAR 结果表明， SHOA 变化对老年人健康素养的总效应为负，其效应持续时间超过 50。
具有 IPC 的 SHOA 表现更好，主要受年龄和沟通方式的影响。观察到 SHOA 对健康素养的影响为负且持续。为了进一步提高具有 IPC 的 SHOA，政策制定者可以考虑通过培训和购买补贴来促进现代便捷沟通方式（如智能手机）的使用，并关注增加持续关注，促进健康素养和行为，提高具有改善 SH 的老年人的健康素养和行为。
