Elsevier

Public Health

Volume 120, Issue 1, January 2006, Pages 70-75
Public Health

Is the disease risk associated with good self-reported health constant across the socio-economic spectrum?

https://doi.org/10.1016/j.puhe.2005.05.005Get rights and content

Summary

Background

Self-reported health is likely to be dependent on two key assessments: that of one's own health and that of the best health that could be expected. As many health outcomes are known to vary according to socio-economic position (SEP), it is possible that assessments of the best health that could be expected will vary with SEP. It is, therefore, possible that the disease risk associated with different levels of self-reported health varies according to SEP. We investigated this using data from the 1998 Health Survey for England.

Methods

Disease risk was measured as systolic blood pressure and body mass index (BMI), and SEP was measured as occupational social class. Associations between social class and the markers of disease risk were investigated in those reporting different levels of self-reported health using linear regression in order to control for age.

Results

There were statistically significant socio-economic variations in systolic blood pressure and BMI (in women only) in those who reported their health as good or very good. No such socio-economic variations in disease risk were seen amongst those reporting their health as less than good.

Conclusions

The meaning of self-reported health, in terms of disease risk, may not be comparable across the socio-economic spectrum.

Section snippets

Background

There is substantial evidence that self-reported health is strongly predictive of current and subsequent morbidity and mortality.1, 2, 3 In addition, it is well recognized that both self-reported health4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 and a variety of markers of disease risk17, 18, 19, 20, 21 vary according to markers of socio-economic position (SEP). Self-reported health is, generally, determined by a relatively simple question in research surveys, and, because of its known

Data source and participants: 1998 HSE26

The HSE has been conducted annually since 1991 and is a nationwide survey that aims to collect regular information on the nation's health.25 The 1998 survey was designed to collect information from a representative sample of individuals aged 2 years or older living in private households in England. Interviewer and nurse visits to individuals' homes resulted in the collection of a wide variety of health and social data. A total of 13,680 households were selected for invitation to take part in

Results

Of the 10,904 individuals eligible for inclusion on the basis of age, full data were available for 9887 (90.7%). The distribution of self-reported health by social class is shown in Table 1. Overall, 7547 (76.3%) individuals reported their health to be good or very good. After controlling for age, social class remained a statistically significant predictor of self-reported health in both men and women (P<0.001 in both cases).

Table 2 shows mean systolic blood pressure and BMI according to social

Discussion

Using data from the 1998 HSE, we have confirmed socio-economic variations in self-reported health, systolic blood pressure and BMI (in women only). Similar findings have been widely reported previously.4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 30, 31, 32, 33, 34 We also found strong relationships between self-reported health and both systolic blood pressure (in women only) and BMI. In addition, there was evidence of socio-economic variations in systolic blood pressure and BMI (in women

Acknowledgements

JA was supported by the Faculty of Public Health Medicine/BUPA research fellowship when this research was carried out. The 1998 HSE was conducted by the National Centre for Social Research and the Department of Epidemiology and Public Health, University College London, UK. The survey is sponsored by the Department of Health and data are distributed by the UK Data Archive, University of Essex, Colchester, UK.

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