Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Research article

Self-rated health as a valid indicator for health-equity analyses: evidence from the Italian health interview survey

Authors: Beniamino Cislaghi, Cesare Cislaghi

Published in: BMC Public Health | Issue 1/2019

Login to get access

Abstract

Background

Self-rated health is widely considered a good indicator of morbidity and mortality but its validity for health equity analysis and public health policies in Italy is often disregarded by policy-makers. This study had three objectives. O1: To explore response distribution across dimensions of age, chronic health conditions, functional limitations and SRH in Italy. O2: To explore associations between SRH and healthcare demand in Italy. O3: To explore the association between SRH and household income.

Methods

Cross-sectional data were obtained from the 2015 Health Interview Survey (HIS) conducted in Italy. Italian respondents (n = 20,814) were included in logistic regression analyses. O1: associations of chronic health conditions (CHC), functional limitations (FL), and age with self-rated health (SRH) were tested. O2: associations of CHC, FL, and SRH with hospitalisation (H), medical specialist consultations (MSC), and medicine use (MU) were tested. O3: associations of SRH and CHC with household income (PEI) were tested.

Results

O1: CHC, FL, and age had an independent summative effect on respondents’ SRH. O2: SRH predicted H and MSC more than CHC; age and MU were more strongly correlated than SRH and MU. O3: SRH and PEI were significantly correlated, while we found no correlation between CHC and PEI.

Conclusions

Drawing from our results and the relevant literature, we suggest that policy-makers in Italy could use SRH measures to: 1) predict healthcare demand for effective allocation of resources; 2) assess subjective effectiveness of treatments; and 3) understand geosocial pockets of health inequity that require special attention.
Literature
1.
Miilunpalo S, Vuori I, Oji P, Pasanen M, Urponen H. Self-rated health status as a health measure: the predictive value of self-reported health status on the use of physician services and on mortality in the working-age population. J Clin Epidemiol. 1997;50(5):517–28.CrossRef
2.
Krause NM, Jay GM. What do global self-rated health items measure? Med Care. 1994:930–42.
3.
Bjorner JB, Fayers P, Idler E. Self-rated health. Assessing quality of life; 2005. p. 309–23.
4.
GL M, EB D. Self-assessment of health: a longitudinal study of elderly subjects. J Health Soc Behav. 1973;14(1):87–93.CrossRef
5.
Burström B, Fredlund P. Self rated health: is it as good a predictor of subsequent mortality among adults in lower as well as in higher social classes? J Epidemiol Community Health. 2001;55:836–40.CrossRef
6.
Fayers PM, Sprangers MAG. Understanding self-rated health. Lancet. 2002;359(9302):187–8.CrossRef
7.
Bellon JA. Validity of self reported utilisation of primary health care services in an urban population in Spain. J Epid Comm Health. 2000;54:544–51.CrossRef
8.
Vie TL, Hufthammer KO, Holmen TL, Meland E, Breidablik HJ. Is self-rated health a stable and predictive factor for allostatic load in early adulthood? Findings from the Nord Trondelag health study (HUNT). Soc Sci Med. 2014;117:1–9.CrossRef
9.
Bombak AE. Self-rated health and public health: a critical perspective. Front Public Health. 2013;1:1–4.CrossRef
10.
11.
Barsky A, Cleary P, Klerman G. Determinants of perceived health status of medical outpatients. Soc Sci Med. 1992;42:141–5.
12.
Fylkesnes K, Førde O. Determinants and dimensions involved in self-evaluation of health. Soc Sci Med. 1992;35:271–9.CrossRef
13.
Roudijk B, Donders R, Stalmeier P. Cultural values: can they explain self-reported health? Qual Life Res. 2017;26(6):1531–9.CrossRef
14.
von dem Knesebeck O, Dragano N, Siegrist J. Social capital and self-rated health in 21 European countries. GMS Psycho-Social-Medicine. 2005;2:Doc02.
15.
Caroli E, Weber-Baghdiguian L. Self-reported health and gender: the role of social norms. Soc Sci Med. 2016;153:220–9.CrossRef
16.
Zajacova A, Huzurbazar S, Todd M. Gender and the structure of self-rated health across the adult life span. Soc Sci Med. 2017;187:58–66.CrossRef
17.
Hosseinpoor AR, Williams JS, Amin A, IAd C, Beard J, Boerma T, et al. Social determinants of self-reported health in women and men: understanding the role of gender in population health. PLoS One. 2012;7(4):1–9.CrossRef
18.
Blaxter M. Self-definition of health status and consulting rates in primary care. Q J Soc Aff. 1985;1(2):131–71.
19.
Wu S, Wang R, Zhao Y, Ma X, Wu M, Yan X, et al. The relationship between self-rated health and objective health status: a population-based study. BMC Public Health. 2013;13(320):1–9.
20.
Haddock CK, Poston WS, Pyle SA, Klesges RC, Weg MWV, Peterson A, et al. The validity of self-rated health as a measure of health status among young military personnel: evidence from a cross-sectional survey. Health Qual Life Outcomes. 2006;4:57.
21.
Cohen G, Forbes J, Garraway M. Interpreting self reported limiting long-term illness. Br Med J. 1995;311:722–4.CrossRef
22.
Sutton M, Carr-Hillb R, Gravellea H, Riceb N. Do measures of self-reported morbidity bias the estimation of the determinants of health care utilisation? Soc Sci Med. 1999;49:867–78.CrossRef
23.
Gr W. Self-rated health in general practice: a plea for subjectivity. Br J Gen Pract. 2015;65(632):110–1.CrossRef
24.
25.
26.
Misselbrook D. W is for wellbeing and the WHO definition of health. Br J Gen Pract. 2014;64(628):582.CrossRef
27.
Boyd KM. Disease, illness, sickness, health, healing and wholeness: exploring some elusive concepts. Medical Humanities. 2000;26(1):9–17.CrossRef
28.
Sodergren M, Sundquist J, Johansson SE, Sundquist K. Physical activity, exercise and self-rated health: a population-based study from Sweden. BMC Public Health. 2008;8:352.CrossRef
29.
Reyes-Ortiz CA, Pelaez M, Koenig HG, Mulligan T. Religiosity and self-rated health among Latin American and Caribbean elders. Int J Psychiatry Med. 2007;37(4):425–43.CrossRef
30.
Darker CD, Donnelly-Swift E, Whiston L, Moore F, Barry JM. Determinants of self-rated health in an Irish deprived suburban population – a cross sectional face-to-face household survey. BMC Public Health. 2016;16(1):767.CrossRef
31.
Stanojević Jerković O, Sauliūnė S, Šumskas L, Birt CA, Kersnik J. Determinants of self-rated health in elderly populations in urban areas in Slovenia, Lithuania and UK: findings of the EURO-URHIS 2 survey. Eur J Pub Health. 2017;27(suppl_2):74–9.
32.
PAd S. Individual and social determinants of self-rated health and well-being in the elderly population of Portugal. Cadernos de Saúde Pública. 2014;30:2387–400.CrossRef
33.
Jordan K, Ong BN, Croft P. Previous consultation and self reported health status as predictors of future demand for primary care. J Epidemiol Community Health. 2003.
34.
Manning WG, Newhouse JP, Ware JE. The status of health in demand estimation; or beyond excellent, good, fair, and poor. In: Fuchs V, editor. Economic aspects of health. New York: NBER; 1982.
35.
George PP, Heng BH, Molina JADC, Wong LY, Lin NCW, Cheah JTS. Self-reported chronic diseases and health status and health service utilization - results from a community health survey in Singapore. Int J Equity Health. 2012;11(44):1–7.
36.
Hunt SM, McKenna SP, McEwen J, Williams J, Papp E. The Nottingham health profile: subjective health status and medical consultations. Soc Sci Med A. 1981;15(3, Part 1):221–9.PubMed
37.
Atella V, Brindisi F, Debe P, Rosati FC. Determinants of access to physician services in Italy: a latent class seemingly unrelated probit approach. Health Econ. 2004;13:657–68.CrossRef
38.
Wilkinson R. Unhealthy societies: the afflictions of inequality. London: Rutledge; 1996.
39.
Lahelma E, Martikainen P, Laaksonen M, Aittomaki A. Pathways between socioeconomic determinants of health. J Epidemiol Community Health. 2004;58(4):327–32.CrossRef
40.
Ecob R, Davey Smith G. Income and health: what is the nature of the relationship? Soc Sci Med. 1999;48(5):693–705.CrossRef
41.
Mantzavinis GD, Trikalinos TA, Dimoliatis ID, Ioannidis JP. Self-reported health in high and very high incomes. Qual Life Res. 2006;15(3):547–58.CrossRef
42.
European Commission. Eurostat: European health interview survey (EHIS wave 2). Methodological manual. Luxembourg: European Commission; 2013.
43.
Koponen P, Aromaa AJRol, European survey experiences, recommendations. Teoksessa Aromaa AKP, Tafforeau J, Vermeire C, Primatesta P, Marmot M, Kurth B, Gargiulo L, Lehto-Järnstedt US, Räty, S . Health surveys: evaluation, B rKj. Survey Design and methodology in national health interview and health examination surveys 2017;16.
44.
Fabrizi E, Ferrante MR, Pacei S, Trivisano C. Hierarchical Bayes multivariate estimation of poverty rates based on increasing thresholds for small domains. Comput Stat Data Anal. 2011;55:1736–47.CrossRef
45.
InGr T. Income composition and inequalities in Hungary,1987–20031. TÁRKI Social Report. 2005;3:72–92.
46.
Desesquelles AF, Egidi V, Salvatore MA. Why do Italian people rate their health worse than French people do? An exploration of cross-country differentials of self-rated healthq. Soc Sci Med. 2009;68:1124–8.CrossRef
47.
Kelly BD, Sorin GM, Barry JM, Whiston L, Donnelly-Swift E, Darker C. Community-based, cross-sectional study of self-reported health in post-recession Ireland: what has changed? QJM. 2018.
48.
Patrick DL, Y-p C. Measurement of health outcomes in treatment effectiveness evaluations: conceptual and methodological challenges. Med Care. 2000;38(9):II14–25.PubMed
49.
Black N, Varaganum M, Hutchings AJBQS. Relationship between patient reported experience (PREMs) and patient reported outcomes (PROMs) in elective surgery. 2014;23(7):534–542.
50.
Hodson M, Andrew S, Roberts CMJB. Towards an understanding of PREMS and PROMS in COPD. Breathe. 2013;9(5):358–64.CrossRef
51.
Nilsson E, Orwelius L, Kristenson M. Patient-reported outcomes in the swedish national quality registers. J Intern Med. 2016;279(2):141–53.
Metadata
Title
Self-rated health as a valid indicator for health-equity analyses: evidence from the Italian health interview survey
Authors
Beniamino Cislaghi
Cesare Cislaghi
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-6839-5

Other articles of this Issue 1/2019

BMC Public Health 1/2019 Go to the issue

Research article

Time series non-Gaussian Bayesian bivariate model applied to data on HMPV and RSV: a case of Dadaab in Kenya

Study protocol

The effect of mild sleep deprivation on diet and eating behaviour in children: protocol for the Daily Rest, Eating, and Activity Monitoring (DREAM) randomized cross-over trial

Research article

Preferences for an HIV prevention mobile phone app: a qualitative study among men who have sex with men in China

Research article

Examining income-related inequality in health literacy and health-information seeking among urban population in China

Research article

Factors associated with the use of health services by elderly men in Brazil: a cross-sectional study

Research article

Wanting to or having to – a qualitative study of experiences and attitudes towards migrant screening for tuberculosis in Norway