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Using self-rated health in epidemiological studies: a risk for underestimating the gap between social classes?
  1. Cyrille Delpierre1,
  2. valerie Lauwers1,
  3. Geetanjali D Datta2,
  4. Thierry Lang1,
  5. Lisa Berkman3
  1. 1 INSERM U558, Toulouse, F-31073, France;
  2. 2 Harvard School of Public Health, Department of Epidemiology, France;
  3. 3 Harvard School of Public Health, Department of Society, Human Development and Health, United States
  1. E-mail: cyrildelpierre{at}yahoo.fr

Abstract

Purpose: The aim of this study was to analyse the link between physical health status and SRH, according to level of education.

Method: We used data from the National Health and Nutrition Examination Survey for the years 2001-2004. Multivariate logistic regression analyses were performed for assessing the relation between health status and SRH according to educational level.

Results: The sample consisted of 4661 men and 4593 women. Reporting functional limitation was associated more strongly with poor SRH in higher educated women than in lower educated women (OR=8.73, 95% CI: 5.87-12.98 vs OR=3.97, 95% CI: 2.93-5.38 respectively), as was reporting respiratory disease (OR=5.17, 95% CI: 3.67-7.30 vs OR=2.60, 95% CI: 1.72-3.95 respectively), cardiovascular disease (OR=9.79, 95% CI: 6.22-15.40 vs OR=3.34, 95% CI: 2.29-4.87 respectively), and dental problem (OR=4.37, 95% CI: 3.22-5.92 vs OR=2.58, 95% CI: 1.97-3.39 respectively). Reporting functional limitation was associated more strongly with poor SRH in higher educated men than in lower educated men (OR=7.71, 95% CI: 5.04-11.79 vs OR=4.87, 95% CI: 3.30-7.18 respectively), as reporting oral problems (OR=2.62, 95% CI: 1.84-3.74 vs OR=3.63, 95% CI: 2.81-4.68 respectively).

Conclusions: The impact of health problems on SRH is stronger among better educated individuals. This phenomenon could lead to an underestimate of the health inequalities across socioeconomic groups.

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