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PURPOSE: Self-assessed poor health status is associated with increased risk of mortality in several cardiovascular conditions, but has not been investigated in patients with endocarditis. We examined health status and mortality in patients with endocarditis.METHODS: This is a re-specified substudy of the randomized POET endocarditis trial, which included 400 patients. Patients completed the single-question self-assessed health status from the Short-Form 36 questionnaire at time of randomization and were categorized as having poor or non-poor (excellent/very good, good, or fair) health status. Self-assessed health status and all-cause mortality were examined by a Cox regression model.RESULTS: Self-assessed health status was completed by 266 (67%) patients with a mean age of 68.0 years (± 11.8), 54 (20%) were females, and 86 (32%) had one or more major concurrent medical conditions besides endocarditis. The self-assessed health status distribution was poor (n = 21, 8%) and non-poor (n = 245, 92%). The median follow-up was 3.3 years and death occurred in 9 (43%) and 48 (20%) patients reporting poor and non-poor health status, respectively, and mortality rates [mortality/100 person-years, 95% confidence interval (CI)] were 18.1 (95% CI 9.4-34.8) and 5.4 (95% CI 4.1-7.2), i.e., the crude hazard ratio for death was 3.4 (95% CI: 1.7-7.0, p CONCLUSION: Self-assessed poor health status compared with non-poor health status as assessed by a single question was associated with a threefold increased long-term mortality in patients with endocarditis. POET ClinicalTrials.gov number, NCT01375257.TRIAL REGISTRY: POET ClinicalTrials.gov number, NCT01375257.

Objective: To identify the relationship between religiosity and self-rated health among older adults in Colombia. Methods: Data are drawn from the SABE (Salud, Bienestar y Envejecimiento) Colombia Study, a cross-sectional survey conducted in 2015 involving 18,871 community-dwelling adults aged 60 years and older living in urban and rural areas of Colombia. Religiosity was assessed by self-rated religiosity (how religious are you: not at all, somewhat or very). Self-rated health during previous 30 days was assessed as very good, good, fair, poor or very poor, analyzed as an ordinal variable (1-5) using weighted logistic regression, adjusting for confounders. Results: Those who were more religious were older, female, had lower socioeconomic status, and were more likely to be married. Multivariate analyses demonstrated that older adults who were more religious had better self-rated health (OR: 0.92, 95% CI: 0.86-0.99, p= 0.038); however, there was a significant interaction effect between gender and religiosity on self-rated health (p= 0.002), such that the relationship between religiosity and health was stronger in men (OR: 0.86, 95% CI: 0.79-0.94, p= 0.001) but not significant in women. Conclusion: Older adults in Colombia who consider themselves more religious, especially men, are less likely to perceive their physical health as poor compared to those who are less religious. Resumen Objetivo: Identificar la relación entre religiosidad y el auto reporte de salud entre adultos mayores en Colombia. Métodos: Los datos provienen del estudio SABE (Salud, Bienestar y Envejecimiento) Colombia, una encuesta transversal realizada en 2015 en la que participaron 18,871 adultos de 60 años o más que viven en la comunidad y provienen de zonas urbanas y rurales en Colombia. La religiosidad fue autoevaluada (qué tan religiosa eres: nada, algo o muy). La autoevaluación de la salud durante los 30 días previos se evaluó como muy buena, buena, regular, mala o muy mala, analizada como variable ordinal (1-5) usando la regresión logística ponderada, ajustando por factores de confusión. Resultados: La edad avanzada, el sexo femenino, estar casado, y tener bajo nivel socioeconómico se asociaron con ser más religiosos. Los análisis multivariados demostraron que ser más religioso se asociaba con mejor salud autoevaluada (OR= 0.92; IC 95%= 0.86-0.99; p= 0.038). Sin embargo hubo una interacción significativa entre género y religiosidad sobre la salud autoevaluada (p= 0.002), tal que la relación entre religiosidad y salud fue mas fuerte en los hombres (OR= 0.86; IC 95%= 0.79-0.94; p= 0.001), pero no fue significativa en mujeres. Conclusión: Los adultos mayores en Colombia que se consideran a sí mismos más religiosos, especialmente los hombres, tienen menos probabilidades de percibir su salud como pobre en comparación con aquellos que son menos religiosos.

Background Our paper assesses the relationship between social integration, in terms of social contact and social trust, and one’s individual health. While a large body of research already engaged with clarifying this relationship, we know little about the role one’s immigration background plays in moderating this relationship. With respect to this, we explicitly focus on how one’s immigrant status moderates the relationship between social integration and self-reported health. Previous literature has demonstrably shown that the less socially integrated individuals are, the less likely they are to report good health. Moreover, we know from social capital literature that immigrants have difficulties being socially connected in their host country. Methods With the help of the new MIGHEAL survey, we test this proposed negative relationship. We also compare the results from the MIGHEAL data with findings from the European Social Survey round 7. Our analyses follow a thorough approach testing immigrant background as potential moderating factors. We implement logistic regression models and path analysis to reveal the complex interactive relationship between social integration, immigrant status and self-reported health. Results/Conclusion Our results suggest that immigrant status does play a moderating role in the relationship between social integration and health. This role, however, is limited to the relationship between social activity and self-reported health, which points to a potential endogenous effect. Locked until 21.5.2019 due to copyright restrictions. This is a pre-copyedited, author-produced version of an article accepted for publication in [European Journal of Public Health] following peer review. The version of record is available online at: https://doi.org/10.1093/eurpub/cky206

In this paper, we study the effects of the 2008 economic crisis on general health in one of the most severely affected EU economies-Ireland. We examine the relationship between compositional changes in demographic and socio-economic factors, such as education, income, and financial strain, and changes in the prevalence of poor self-assessed health over a 5-year period (2008-2013). We apply a generalised Oaxaca-Blinder decomposition approach for non-linear regression models proposed by Fairlie (1999, 2005). Results show that the increased financial strain explained the largest part of the increase in poor health in the Irish population and different sub-groups. Changes in the economic activity status and population structure also had a significant positive effect. The expansion of education had a significant negative effect, preventing further increases in poor health. Wealthier and better educated individuals experienced larger relative increases in poor health, which led to reduced socio-economic health inequalities.

This paper develops a method to model the effect of income on self-reported health at the individual level. The model is estimated using the meta-analytic data of 68 studies from 13 countries, and is used to test two hypotheses. The first hypothesis is that income affects health at the individual level. If this is the case, the incidence of poor health will differ across people from different income groups. The second hypothesis is that income differentials are associated with differential vulnerability to poor health. If so, the influence of income on health outcomes will differ across members of different income groups in different countries.The collected data are best described by a log-linear relationship between income and self-reported health. The empirical results confirm both hypotheses. We have found that (a) income inequality affects health at the individual level; (b) the level of self-reported poor health in the bottom deciles of the income distribution increases with the level of inequality in the country's income distribution; and (c) the relative income hypothesis has a stronger explanatory power for our results than the absolute income hypothesis. These results confirm the idea that for comparisons at the individual level, relative income matters more than absolute income. These findings have important policy implications.

Contains fulltext : 90131.pdf (Publisher’s version ) (Closed access) Objective To assess the value of self-rated health assessments by examining the association between education and self-rated poor health. Methods We used the globally representative population-based sample from the 2002 World Health Survey, composed of 219 713 men and women aged 25 and over in 69 countries, to examine the association between education and self-rated poor health. In a binary regression model with a logit link function, we used self-rated poor health as the binary dependent variable, and age, sex and education as the independent variables. Findings Globally, there was an inverse association between years of schooling and self-rated poor health (odds ratio, OR: 0.929; 95% confidence interval, CI: 0.926–0.933). Compared with the individuals in the highest quintile of years of schooling, those in the lowest quintile were twice as likely to report poor health (OR: 2.292; 95% CI: 2.165–2.426). We found a dose–response relationship between quintiles of years of schooling and the ORs for reporting poor health. This association was consistent among men and women; low-, middle- and high-income countries; and regions. Conclusion Our findings suggest that self-reports of health may be useful for epidemiological investigations within countries, even in low-income settings.

The aim was to describe health literacy among the older population of Kosovo, an Albanian speaking post-war country in the Western Balkans, in the context of self-perceived health status and self-reported chronic morbidity. A cross-sectional study was conducted in Kosovo in 2011 including 1753 individuals aged a parts per thousand yen65 years (886 men, 867 women; mean age 73.4 +/- 6.3 years; response rate: 77%). Participants were asked to assess, on a scale from 1 to 5, their level of difficulty with regard to access, understanding, appraisal and application of health information. Sub-scale scores and an overall health literacy score were calculated for each participant. Information on self-perceived health status, presence and number of chronic diseases and socioeconomic characteristics was also collected. Mean values of the overall health literacy score and all sub-scale scores (access, understanding, appraisal and application) were lower among older people who reported a poorer health status or at least one chronic condition compared with individuals who perceived their health status as good or had no chronic conditions (p

FP is funded by the Chief Scientist Office of the Scottish Executive Health Department Background: Scotland's overall health record is comparatively poor for a Western European country, particularly amongst people of working age. A number of previous studies have explored why this might be the case by comparing mortality in Scotland with England and Wales. A study in the 1980s showed that the higher prevalence of deprivation in Scotland accounted for Scotland's excess mortality risk. However, more recent studies suggest that deprivation now explains less of this excess. This has led to the suggestion that there is a yet unidentified "Scottish effect" contributing to Scotland's mortality excess. Recent research has also suggested that there could be an unidentified effect influencing Scotland's higher rate of heart disease. This paper explores whether there is also an unexplained Scottish excess, relative to England, in self reports of poor health. Methods: Data came from the individual Sample of Anonymised Records, a 3% random sample of the 2001 UK census. Using logistic regression models, self reports of health (limiting illness and general health) from the working age populations (aged 25 to 64) of Scotland and England were compared. Account was taken of people's country of birth. Stratified analysis by employment status allowed further exploration of Scotland's excess. Results: People born and living in Scotland reported higher levels of poor general health and limiting illness compared to people born and living in England. Adjustment for socioeconomic position and employment status largely explained the higher rates. In the stratified analysis a Scottish excess was seen only amongst the economically inactive born and living in Scotland. For those in employment, people born and living in Scotland actually had slightly lower odds of reporting poor general health and limiting illness than people born and living in England. Conclusion: This analysis suggests that higher rates of poor self reported health in Scotland can be explained by differences in employment and socioeconomic position and so there is unlikely to be an unidentified "Scottish effect" for self reports of health. Scotland's excess of poor general health and limiting illness amongst the economically inactive is probably attributable to its economic and employment history. Publisher PDF

Background Research and policy related to reducing health inequalities has progressed separately within Ireland and Northern Ireland. This paper describes the first exploration of the socio-economic influences on health on the island of Ireland since 1922. Methods Postal survey. Results The response rate was 52%; 11,870 respondents. Men reported more long-standing illness (LLTI) or poor general health (PGH); depression was more common amongst women. Socio-economic gradients in health were evident in both jurisdictions, with the effects of household income being particularly marked. Overall, morbidity levels were significantly better in Ireland than in Northern Ireland: adjusted odds ratio Of 0.79 (95% Cl 0.71- 0.88) for LLTI; 0.64 (0.57 - 0.72) for PGH; 0.90 (0.82 - 0.99) for depression. Conclusions There is evidence of strong and similar socio-economic gradients in health throughout the island of Ireland. This would suggest joint policy approaches or at least further comparative evaluation of the initiatives in each jurisdiction.