Abstract
Background
Self-reported health status has become a conventional measure of health status at the population level. Further, the literature supports its use as a valid indicator of morbidity and mortality. However, relatively little attention has been paid to how self-reported health status changes over time or the factors affecting change. This paper explores the factors affecting health status change over time using data from a neighbourhood health survey.
Methods
Two rounds (2001; 2003) of health survey data (n=671) were collected across 4 distinct neighbourhoods in Hamilton, Ontario. Logistic regression analysis is used to predict change in self-reported health status between the two time periods as well as determinants of change using a range of compositional, contextual and collective characteristics of individuals as potential explanatory variables.
Results
Results reveal that approximately one third of participants experienced a change in health status between the two survey years. Interestingly, the key factors affecting change in health status are compositional characteristics of individuals (e.g., smoking, health care use) as opposed to contextual (e.g., neighbourhood of residence) or collective (e.g., marital status). Contrary to published literature, the current study does not reveal any significant links between a change in health status and either gender or age.
Conclusion
These results inform our understanding of both the stability of health ratings over time and the determinants of health status change. Further research should be undertaken to enhance this understanding; in particular, studies with larger sample sizes, longer time frames and more sensitive indicators of composition, context and collective are needed.
MeSH terms: Health status, health determinants, change in health status, neighbourhoods
Résumé
Contexte
L’état de santé autoperçu est devenu une mesure classique de l’état de santé de l’ensemble d’une population. De plus, les études en confirment la validité comme indicateur de morbidité et de mortalité. Cependant, on s’est relativement peu intéressé à la façon dont l’état de santé autoperçu change avec le temps, ni aux facteurs d’un tel changement. Cet article porte sur les facteurs de changement de l’état de santé avec le temps et utilise les données d’une enquête sur la santé au niveau du quartier.
Méthode
Des données d’enquête sur la santé (n=671) ont été recueillies en deux séries (2001 et 2003) dans quatre quartiers de la ville de Hamilton, en Ontario. Pour prédire le changement de l’état de santé autoperçu entre les deux périodes, ainsi que les déterminants du changement, nous avons analysé par régression logistique une gamme de caractéristiques compositionnelles, contextuelles et collectives des sujets de l’enquête susceptibles d’être des variables explicatives.
Résultats
Environ le tiers de participants a éprouvé un changement d’état de santé entre les deux années de l’enquête. On notera à ce sujet que les principaux facteurs de changement de l’état de santé sont les caractéristiques compositionnelles des sujets (le tabagisme, l’utilisation des services de santé) par opposition à leurs caractéristiques contextuelles (le quartier où ils habitent) ou collectives (l’état civil). Contrairement aux résultats d’autres études sur la question, celle-ci n’indique aucun lien significatif entre un changement de l’état de santé et le sexe ou l’âge.
Conclusion
Ces résultats améliorent à la fois notre connaissance de la stabilité des estimations de la santé au fil du temps et des déterminants du changement de l’état de santé. Il faudrait pousser la recherche pour accroître cette connaissance, en particulier par des études d’échantillons plus importants, sur de plus longues durées et avec des indicateurs plus sensibles des caractéristiques compositionnelles, contextuelles et collectives.
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