The structure of self-rated health among older adults:: the Bambui health and ageing study (BHAS)

Objective To determine factors associated with self-rated health among older adults, considering five dimensions: sociodemographic variables, social support, lifestyle risk factors, health status, and access to/use of healthcare services. Methods Of the 1, 742 older adults (2 60 years) living in the town of Bambui (southeastern Brazil), 1,516 (87.0%) participated in the study. Information was obtained by means of standardized interviews and physical and laboratory exams. Results Self-rated health as good/very good, reasonable, and poor/very poor was reported by 24.7%, 49.2%, and 26.1% of subjects, respectively. The following characteristics showed independent positive associations with worse self-rated health: social ties (dissatisfaction with social network, attendance to clubs and associations), health status (symptoms of depression/anxiety in the last two weeks, sleeplessness in the last 30 days, greater number of prescribed medications used in the last 30 days), and access to/use of healthcare services (complaints when seeking medical care, greater number of medical appointments in the last 12 months, greater number of hospital admissions in the last 12 months). An independent negative association was found with monthly family income (< 2.0 vs. greater than or equal to 4 minimum wages). Conclusions Our results show that self-rated health among older adults is multidimensional in structure, being influenced by socioeconomic conditions, social support, health status (with emphasis on mental health), and access to/use of healthcare services. This structure resembles the definition of health adopted by the World Health Organization (an individual's "physical, mental and social well-being").