Depressive symptoms and self-rated health among Brazilian older adults: baseline data from the ELSI-Brazil study

Objective: To investigate whether having a higher number of depressive symptoms is associated with negative self-rated health (SRH) even in the absence of illness. Methods: This is a secondary analysis of baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), conducted in 2015-2016, using a national sample of 9,412 people aged 50 or over. SRH was dichotomized into poor or very poor and very good or excellent, good, or average. Depressive symptoms were assessed through the eight-item Center for Epidemiologic Studies Depression Scale (CES-D8). Sociodemographic variables, information about unhealthy behaviors, and the number of chronic conditions were also analyzed. Results: Having depressive symptoms was strongly associated with poor or very poor SRH both in the unadjusted and adjusted analyses. The magnitude of the association was reduced when the number of chronic illnesses was included in the multivariate analysis, along with the other sociodemographic variables and unhealthy behaviors (OR 1.35, 95%CI 1.31-1.39). Conclusion: Having depressive symptoms may contribute towards having a poorer perception of health, even in the absence of health conditions. SRH is a multidimensional construct that can accurately reflect a person's state of general mental health.

Mediating role of activities of daily living and self-rated health in chronic disease-caused depressive symptoms among the elderly / 预防医学

Objective@#To investigate the mediating role of activities of daily living (ADL) and self-rated health in chronic disease-caused depressive symptoms among the elderly, so as to provide insights into depression control among the elderly. @*Methods@#Basic features, depressive symptoms, number of chronic diseases, ADL and self-rated health of the elderly at ages of 60 years and older were collected from the China Health and Retirement Longitudinal Study 2018. Multiple linear regression model was created using the Process program to examine the mediating role of ADL and self-rated health in number of chronic disease-caused depressive symptoms, and the significance of the mediating role was tested using the Bootstrap test. @*Results@#A total of 5 892 elderly participants were enrolled, with a mean age of (68.42±6.23) years and including 2 744 men (46.57%). The participants had a median depressive symptom score of 8 (interquartile range, 10) points, a median number of chronic diseases of 1 (interquartile range, 1), a median ADL score of 12 (interquartile range, 3) points, and a median self-rated health score of 3 (interquartile range, 1) points. Mediation analysis showed that number of chronic diseases affected depressive symptoms via the independent mediating role of ADL (β=0.163, 95%CI: 0.120-0.206) and self-rated health (β=0.303, 95%CI: 0.259-0.351), and affected depressive symptoms via the chain mediating role of ADL and self-rated health (β=0.057, 95%CI: 0.043-0.074) among the elderly, and the gross mediating role consisted of 58.44% of total effects. @*Conclusions@#The number of chronic diseases may incease the risk of depressive symptoms through aggravating the impairment of ADL and decreasing self-rated health levels among the elderly.

Relationship between family intergenerational contact, depressive symptoms and self-reported health status in the elderly / 预防医学

Objective@#To explore the relationship between family intergenerational contact, depressive symptoms and self-rated health status in the elderly, so as to provide insights into promoting health of the elderly and actively coping with population aging. @*Methods@#Demographic information, intergenerational contact frequency, self-rated health status and depressive symptoms in the elderly at ages of 65 years and older were collected through the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Structural equation model was established to analyze the effects of intergenerational contact on self-rated health and the mediating role of depressive symptoms between family intergenerational contact and self-rated health in the elderly. @*Results@#Totally 15 497 elderly participants were enrolled, with 6 727 males (43.41%) and 8 770 females (56.59%), and there 12 583 individuals lived with family members (81.19%). The median age was 85.00 (interquartile range, 16.00) years. The scores of self-rated health and depressive symptoms were (3.39±0.87) and (2.22±0.56), respectively. The results of structural equation model analysis showed that after adjusting for age, gender and residence, frequent intergenerational contact had a direct positive effect on self-rated health (effect size=0.038, P<0.001), and could improve the depressive symptoms (effect size=0.089, P<0.001) in the elderly. In addition, depressive symptoms had a negative effect on self-rated health in the elderly (effect size=-0.422, P<0.001).@* Conclusions @#Frequent intergenerational contact can improve the self-rated health status in the elderly, and indirectly improve the self-rated health level by alleviating depressive symptoms.

Letramento em saúde bucal e variáveis associadas a autopercepção de saúde bucal em adultos e idosos usuários da atenção básica: um estudo exploratório / Oral health literacy and variables associated with self-rated oral health in adults and elderly users of primary health care: an exploratory study

Resumo Introdução A Autopercepção da Saúde Bucal (ASB) é uma importante variável subjetiva associada à procura por serviços odontológicos e determinada por diversos fatores. Objetivo O objetivo deste trabalho foi investigar associações entre a ASB, o Letramento em Saúde Bucal (LSB) e covariáveis, em usuários da Atenção Básica. Método A amostra foi composta por 366 adultos e idosos, moradores em territórios adscritos a uma unidade de equipe de Saúde da Família (eSF) do município de Piracicaba, que procuraram por tratamento odontológico no ano de 2019 e que aceitaram participar da pesquisa. Aplicou-se o instrumento Health Literacy in Dentistry (HeLD-14) para avaliação do LSB, bem como um questionário para investigar características sociodemográficas e da ASB. Ademais, exames intrabucais foram realizados. Realizaram-se análises de regressões logísticas simples e múltipla, para se avaliar o nível de associação entre a variável ASB e as variáveis preditoras. Resultados Pacientes com menor escore de LSB, pior Autopercepção da Saúde Geral e com mais de um dente perdido tiveram, respectivamente, 2,73 (IC95%: 1,62-4,61), 14,24 (IC95%: 7,41-27,38) e 2,93 (IC95%: 1,76-4,89) vezes mais chance de apresentar pior ASB (p<0,05). Conclusão A ASB é um constructo associado a diversas variáveis não clínicas, incluindo o LSB.

Abstract Background The Self-Rated Oral Health (SROH) is an important subjective variable associated with the demand for dental services and determined by several factors. Objective The objective of this work was to investigate associations between SROH, Oral Health Literacy (OHL) and covariates in Primary Care users. Method The sample consisted of 366 adults and elderly living in territories assigned to a Family Health team unit in the municipality of Piracicaba who sought dental treatment in 2019 and who agreed to participate in the research. The Health Literacy in Dentistry instrument (HeLD-14) was applied to assess OHL, as well as a questionnaire to investigate sociodemographic and SROH characteristics. In addition, clinical dental examinations were performed. Simple and multiple logistic regression analyzes were performed to assess the level of association between the SROH variable and the predictor variables. Results Patients with lower OHL score, worse Self-Rated Health and with more than one missing tooth had, respectively, 2.73 (95% CI: 1.62-4.61), 14.24 (95% CI: 7.41-27.38) and 2.93 (95% CI: 1.76-4.89) times more likely to have worse SROH (p <0.05). Conclusion The SROH is a construct associated with several non-clinical variables, including OHL.

Self-rated health status and its influencing factors of medical staff in Lanzhou City / 环境与职业医学

Background Because of high working intensity, high responsibility, and unexpected situations, health care workers may suffer great work pressure, which may lead to health damage. Objective To explore the self-rated health status and its influencing factors such as demographic and occupational-related factors of medical staff in Lanzhou. Methods In-service medical staff were selected by using cluster random sampling method from 18 public hospitals in Lanzhou City and were investigated with a self-made questionnaire and the Self-rated Health Measurement Scale (SRHMS). SRHMS includes 48 items in 10 dimensions, which are divided into three sub-scales of physical health, mental health, and social health, and another independent dimension is overall health. The scores were converted into a percentage scale and expressed as the percentage of measured score to full score; a higher score indicated better health, and >70% was considered good health status. t test, Kruskal-Wallis H test, and Spearman correlation were used to analyze the scores of SRHMS and the demographic and occupational-related factors affecting the scores of physical, mental, and social health sub-scales. Results A total of 2989 valid questionnaires were recovered. There were statistically significant differences in total score and the scores of physical, mental, and social health among medical staff of different age, educational background, length of service, and weekly working hours groups (P < 0.05). The percentage of total score to full score in the medical staff was 71.41%, but the scores of physical, mental, and social health sub-scales and total scale of selected participants were all lower than the corresponding domestic norms (t=−3.323, −12.283, −7.157, −9.659, P < 0.05); the percentage of psychological symptoms and negative emotions in mental health scale to full score was the lowest, only 58.39%. Educational background, length of service, and weekly working hours were negatively correlated with physical health score (r=−0.061, −0.060, −0.165, P < 0.05); professional title was positively correlated with mental health score (r=0.045, P < 0.05), while educational background and weekly working hours were negatively correlated with it (r=−0.051, −0.172, P < 0.05). Monthly income, professional title, and length of service were positively correlated with social health score (r=0.040, 0.049, 0.071, P < 0.05), while educational background and weekly working hours were negatively correlated with it (r=−0.038, −0.110, P < 0.05). Conclusion The self-rated health status of selected medical staff in Lanzhou is generally good, but lower than that of the norm, especially the mental health score is the lowest. The self-rated health score of total scale is correlated with education, length of service, professional title, and working time per week.

Impact of loss of a spouse on self-rated health among middle-aged and elderly populations in China / 预防医学

Objective@#To evaluate the impact of loss of a spouse on self-rated health among middle-aged and elderly populations in China, so as to provide insights into health promotion among middle-aged and elderly populations with loss of a spouse. @*Methods@#Based the 2018 China Health and Retirement Longitudinal Study (CHARLS) database, married and separated individuals or individuals with loss of a spouse at ages of 45 years and older and with monthly household consumption of no less than 100 yuan were enrolled. Subjects' age, gender, educational levels, marital status, monthly household consumption, number of chronic diseases and self-rated health were collected. Subjects were classified according to loss of a spouse, and the impact of loss of a spouse on self-rated health was evaluated among middle-aged and elderly populations using propensity score matching (PSM). In addition, heterogeneity test was performed to evaluate the gender- and educational level-stratified impacts.@*Results@#Totally 3 272 valid subjects were enrolled, including 1 618 men (49.45%) and 1 654 women (50.55%), and there were 512 subjects with loss of a spouse (15.65%). There were 656 subjects with very good self-rated health (20.05%), 622 with good health (19.01%), 1 534 with fair health (46.88%), 376 with poor health (11.49%) and 84 with very poor health (2.57%). There were 3 152 couples with successful nearest neighbor matching, and there was no significant difference between the subjects with and without loss of a spouse after adjustment for variables (P>0.05), while the overall fitting degree of the model was good following matching. PSM showed that the self-rated health became poor following loss of a spouse among middle-aged and elderly populations, with average treatment effect (ATT) of 0.055 to 0.061, and a remarkably negative effect of loss of a spouse on self-rated health was seen in women, with ATT of 0.192 to 0.223, while no remarkable effect was seen in men. Loss of a spouse showed a remarkably negative effect on self-rated health among individuals receiving junior and senior high educations, with ATT of 0.048 to 0.057, but presented no remarkable effect on self-rated health among individuals receiving primary educations. @*Conclusions @#Loss of a spouse presents a negative effect on self-rated health among middle-aged and elderly populations, and remarkably negative effects are seen among women and individuals receiving high educational levels.

Contextual influence on poor self-rated health in patients with Chagas disease: multilevel study / Influência contextual na pior autopercepção em saúde de portadores de Doença de Chagas: estudo multinível

Abstract Chagas disease (CD) is recognized by the World Health Organization as one of the thirteen most neglected tropical diseases in the world. Self-perceived health is considered a better predictor of mortality than objective measures of health status, and the context in which one lives influences this predictor. This study aimed to evaluate the prevalence and individual and contextual factors associated with poor self-rated health among CD patients from an endemic region in Brazil. It is a multilevel cross-sectional study. The individual data come from a cross-section of a cohort study named SaMi-Trop. Contextual data was collected from publicly accessible institutional information systems and platforms. The dependent variable was self-perceived health. The analysis was performed using multilevel binary logistic regression. The study included 1,513 patients with CD, where 335 (22.1%) had Poor self-rated health. This study revealed the influence of the organization/offer of the Brazilian public health service and of individual characteristics on the self-perceived health of patients with CD.

Resumo A Doença de Chagas (DC) é reconhecida pela Organização Mundial da Saúde como uma das treze doenças tropicais mais negligenciadas do mundo. A autopercepção de saúde é considerada um melhor preditor de mortalidade do que medidas objetivas do estado de saúde, e o contexto em que se vive influencia esse preditor. O objetivo deste estudo foi avaliar a prevalência e os fatores individuais e contextuais associados à pior autopercepção em saúde de pacientes com DC de uma região endêmica do Brasil. É um estudo transversal multinível. Os dados individuais vêm de um corte transversal de um estudo de coorte denominado SaMi-Trop. Os dados contextuais foram coletados a partir de plataformas e sistemas de informações institucionais acessíveis ao público. A variável dependente foi a autopercepção de saúde. A análise foi realizada por meio de regressão logística binária multinível. Participaram do estudo 1.513 pacientes com DC, sendo 335 (22,1%) com pior autopercepção de saúde. Este estudo revelou a influência da organização/oferta do serviço público de saúde brasileiro e de características individuais na autopercepção de saúde de pacientes com DC.

Factores asociados a la salud autoevaluada en personas costarricenses: resultados para la cohorte de jubilación de CRELES / Factors associated with self-rated health in Costa Ricans: results for the CRELES retirement cohort

Resumen Introducción: La salud autoevaluada se ha considerado como una medida subjetiva del estado de salud general. El objetivo de este estudio consistió en identificar factores asociados a la salud autoevaluada en personas adultas costarricenses. Métodos: la muestra provino de un estudio de corte transversal que incluyó 992 hombres y 1570 mujeres participantes de una nueva corte de jubilación del proyecto Costa Rica: Estudio de Longevidad y Envejecimiento Saludable, referido como CRELES-RC. La salud autoevaluada se midió a través de una sola pregunta sobre la valoración del estado de salud, con cinco opciones de respuesta: excelente, muy buena, buena, regular y mala. Se calcularon odds ratios (OR) para cuantificar la contribución de las enfermedades crónicas y otros factores con una mala salud autoevaluada. Resultados: por un lado, los modelos de regresión logística determinaron que la salud autoevaluada se asocia con la zona de residencia, el nivel educativo, la percepción de la situación económica, la actividad física, el apoyo emocional y la presencia de enfermedad crónica. Por otro lado, las personas con alguna enfermedad crónica, excepto cáncer, evidenciaron una peor salud autoevaluada; la relación más fuerte se presentó con la artritis, la enfermedad pulmonar y la diabetes. Conclusiones: el estudio identificó que la zona de residencia, la actividad física, el nivel educativo, el apoyo emocional y la enfermedad crónica podrían afectar la salud de las personas.

Abstract Introduction: Self-rated health has been considered a subjective measure of general health status. We aim was identified factors associated with self-rated health in the Costa Ricans adult population. Methods: a population cross-sectional study with a total of 992 men and 1570 women representing a new retirement cohort participating in the project Costa Rica: Longevity and Healthy Aging Study and referred to as CRELES-RC. Self-rated health was measured through a single question on the assessment of health status that considers five options: excellent, very good, good, fair and poor. Odds ratios (OR) were calculated to quantify the contribution of chronic diseases and other factors to poor self-rated health. Results: The logistic regression models determined that self-rated health is associated with the area of residence, educational level, perception of the economic situation, physical activity, emotional support and the presence of chronic disease. People with a chronic disease, except cancer, indicate poorer self-rated health. The strongest relationship was with arthritis, lung disease, and diabetes. Conclusions: the study allowed to identify that the area of residence, education, physical activity, emotional support and chronic illness could affect people's health.

Socioenvironmental factors and behaviors associated with negative self-rated health in Brazil

Abstract The purpose of this study is to determine the factors associated with negative self-rated health in Brazil. The sample consisted of 5,259 adults from five representative capitals of the five regions of Brazil. Data collection was achieved in the following municipalities: Palmas (North Region), João Pessoa (Northeast Region), Goiânia (Central-West Region), Vitória (Southeast Region) and Florianópolis (South Region). For the analysis of the data, Binary Logistic Regression for determine the factors associated with negative self-rated health was used. Negative self-rated health was identified in 31.43% of Brazilians. The factors that were significantly associated were bad air quality, does not have public spaces for leisure, older age group, insufficient salary to cover expenses, a rare practice of physical exercises, does not perform healthy eating, active commuting for study or employment and commuting time for above 30 minutes, dissatisfaction with health services and still, not working, not looking for a job and finally, reside in some Brazilian regions. The study presents the importance of socioenvironmental and behavioral factors for the self-rated health of Brazilian adults, as well as it shows high rates of negative self-rated health compared to other studies.

Resumo O objetivo deste estudo foi determinar os fatores associados à percepção negativa de saúde no Brasil. A amostra foi composta por 5.259 adultos de cinco capitais representativas das cinco regiões do Brasil. A coleta de dados foi realizada nos seguintes municípios: Palmas, João Pessoa, Goiânia, Vitória e Florianópolis. Para analisar os dados, utilizou-se da Regressão Logística Binária para determinar os fatores associados. Identificou-se percepção negativa de saúde em 31,43% dos brasileiros. Os fatores que foram significativamente associados foram: má qualidade do ar, não possuir espaços públicos de lazer, faixa etária mais avançada, salário insuficiente para cobrir despesas, prática rara de exercícios físicos, não realizar alimentação saudável, deslocamento ativo para estudo ou emprego, tempo de deslocamento acima de 30 minutos, insatisfação com os serviços de saúde, não trabalhar e não estar procurando emprego e, por fim, residir nas regiões Sul, Sudeste e Nordeste do Brasil. O estudo apresenta a importância de fatores socioambientais e comportamentais para a percepção da saúde de adultos brasileiros e mostra altos índices de percepção negativa de saúde em comparação com outros estudos.

Factors related to ikigai among older residents participating in hillside residential community-based activities in Nagasaki City, Japan / Journal of Rural Medicine

Objective: The present study aims to investigate the factors related to self-rated ikigai (purpose in life) among older residents participating in hillside residential community-based activities in Nagasaki City.Methods: A self-administered anonymous questionnaire survey was carried out with older residents participating in two hillside residential community-based activities in Nagasaki City, Japan. The questionnaire included questions on sociodemographic information (age, sex, family structure, education, and self-rated economic satisfaction), self-rated health, mental health status measured using Geriatric Depression Scale-15 (GDS-15), and self-rated ikigai score that was estimated using a visual analog scale.Results: A total of 32 older residents (7 males, 25 females) participated in the questionnaire survey. Although self-rated ikigai score was not associated with sociodemographic factors, there were associations between the score, self-rated health (P=0.001), and mental health (GDS-15) (P=0.015). Statistically significant correlations between self-rated ikigai score and social participation (ρ=0.426, P=0.017), self-rated health (ρ=−0.485, P=0.007), and mental health (GDS-15) (ρ=−0.523, P=0.007) were observed.Conclusion: Increasing social participation may increase individual ikigai, preventing poor self-rated health and low mental health status in older people. Maintaining their social participation in the community might be effective for the health promotion of older residents in hillside residential areas of Nagasaki City.

Autorreporte de salud de los adultos mayores en México, 2012-2018 / Autorrelato de saúde em idosos no México, 2012-2018 / Self-assessed health of older adults in Mexico, 2012 - 2018

El objetivo de esta investigación fue analizar los efectos de determinados factores sociodemográficos y de la salud en las trayectorias del autorreporte de salud de las personas mayores en México. Con datos del Estudio Nacional de Salud y Envejecimiento en México 2012-2018, se estimaron las trayectorias mediante modelos de estados latentes de Markov. Los resultados indican que, tanto en mujeres como en hombres hay tres trayectorias, las cuales fueron constantes incluso ajustando por variables sociodemográficas y de la salud. Sin embargo, el arreglo residencial, la multimorbilidad o los síntomas depresivos tuvieron efectos negativos sobre la probabilidad de un autorreporte de salud positivo. Estos resultados sugieren que, si bien debe profundizarse el análisis de los factores asociados con las trayectorias del autorreporte de salud, los arreglos residenciales, las múltiples enfermedades crónicas o la depresión tienen efectos longitudinales en la salud autoevaluada de los adultos mayores en México.

O objetivo desta pesquisa é analisar os efeitos de certos fatores sociodemográficos e de saúde nas trajetórias de autorrelato de saúde de idosos no México. Com dados do Estudo Nacional de Saúde e Envelhecimento no México 2012-2018, as trajetórias foram estimadas usando modelos de estado latente de Markov. Os resultados indicam que existem três trajetórias, tanto para mulheres quanto para homens, que foram constantes mesmo ajustando para variáveis sociodemográficas e de saúde. No entanto, arranjo residencial, multimorbidade ou sintomas depressivos tiveram efeitos negativos sobre a probabilidade de um autorrelato positivo de saúde. Esses resultados sugerem que, embora a análise dos fatores associados às trajetórias definidas deva ser aprofundada, arranjos residenciais, múltiplas doenças crônicas ou depressão têm efeitos longitudinais na autoavaliação da saúde de idosos no México.

The objective of this research was to analyze the effects of certain sociodemographic and health factors on the self-assessed health trajectories of older adults in Mexico. With data from the Mexican Health and Aging Study 2012-2018, trajectories were estimated using Markov latent state models. The results indicate that, in both women and men, there are three trajectories which were constant, even adjusting for sociodemographic and health variables. However, residential arrangement, multimorbidity, or depressive symptoms had negative effects on the likelihood of a positive self-report of health. These results suggest that, although the factors associated with the defined trajectories of self-rated health, should be analyzed further, residential arrangements, multiple chronic illnesses or depression have longitudinal effects on the self-assessed health of older adults in Mexico.

Association between chronic diseases, multimorbidity and insufficient physical activity among older adults in southern Brazil: a cross-sectional study

ABSTRACT BACKGROUND: Being active has been shown to have beneficial effects for the health of individuals with chronic diseases. However, data on the association between multimorbidity and physical activity are limited. OBJECTIVE: To investigate the association between chronic diseases, multimorbidity and insufficient physical activity among older adults in southern Brazil, according to sex. DESIGN AND SETTING: Cross-sectional population-based and household-based study derived from the second wave (2013-2014) of the EpiFloripa Aging Cohort Study. METHODS: Insufficiency of physical activity (outcome) was ascertained using the long version of the International Physical Activity Questionnaire (≤ 150 minutes/week). Eleven self-reported chronic diseases were identified. Multimorbidity was defined from the number of chronic diseases (none; 2 or 3; or 4 or more). The adjustment variables were age, schooling, marital status, income, smoking, alcohol consumption and cognition. Additionally, each chronic disease was adjusted for the others. Associations were tested using logistic regression (crude and adjusted). RESULTS: Among the 1197 participants (≥ 63 years), women (54.0%) were more likely than men (39.6%) to be insufficiently active. In the adjusted analysis, women and men with depressive symptoms, and men with diabetes, were more likely to be insufficiently active than those without symptoms. Multimorbid women were more likely to be insufficiently active, and the magnitude of the effect was strongest for 4 or more diseases. CONCLUSION: This study indicates that the associations were sex-specific. Depressive symptoms and multimorbidity were associated with insufficient physical activity among women, while diabetes was associated with insufficient physical activity among men.

Uso de antidepressivos e percepção de saúde entre adultos de 40 anos ou mais: estudo longitudinal / Antidepressive use and self-rated health among adults of 40 years and older: longitudinal study

RESUMO Os efeitos dos antidepressivos sobre a qualidade de vida dos usuários ainda é controverso. O objetivo do estudo foi verificar a relação entre o uso de antidepressivos e a autopercepção de saúde em população de 40 anos ou mais. Trata-se de um estudo longitudinal, de base populacional, em município de médio porte no Brasil com coleta de dados em 2011 e 2015. A variável dependente foi a autopercepção da saúde (2015) e a independente foi a utilização de medicamentos antidepressivos, categorizada em "usavam somente em 2011", "usavam somente em 2015", "usavam em 2011 e 2015" e "não usavam". A associação entre o uso de antidepressivos e autopercepção de saúde foi verificada pela Regressão de Poisson com variância robusta. Fizeram parte do estudo 885 pessoas. A autopercepção negativa da saúde esteve presente em 44% da população estudada. A prevalência do uso de antidepressivos foi 17,6% em 4 anos. O uso de antidepressivos esteve associado à autopercepção negativa da saúde para os indivíduos que estavam em uso somente no ano de 2015 na população geral (RP 1,082; IC 95% 1,004-1,166). Não foi verificada relação entre uso antidepres-sivos e autopercepção da saúde, salvo para os que utilizavam antidepressivos apenas em 2015.

SUMMARY Antidepressants are one of the fastest growing classes of prescription drugs in the world and their effects on users' quality of life are still controversial. The aim of the study was verify the relationship between antidepressant use and self-rated health in a population aged 40 years or older. This was a population-based longitudinal study with adults of 40 years or older in a medium-sized municipality in Brazil with data collection in 2011 and 2015. The dependent variable was self-rated health (2015) and the independent the use of antidepressant medications, categorized as "used only in 2011", "used only in 2015", "used in 2011 and 2015" and "not used". The Poisson regression with robust variance was used to verify the association between antidepressant use and self-rated health. The study included 885 people. Negative self-rated health was present in 44% of the study population. The prevalence of antidepressant use was 17.6% over 4 years. The use of antidepressants was associated with negative self-rated health for individuals who were only using 2015 in the general population (PR 1.082; 95% CI 1.004-1.166). There was no relationship between antidepressant use and self-rated health, except for those who used antidepressants only in 2015.

Association between community socioeconomic status and adults' self-rated health in China / 北京大学学报(医学版)

OBJECTIVE@#To examine whether community socioeconomic status is associated with self-rated health independent of individual socioeconomic status for urban and rural residents, and to provide policy implications for improving the health status of the socioeconomically underdeveloped communities in China.@*METHODS@#Based on the baseline data of China Family Panel Studies (CFPS) in 2010, principal component analysis was used to construct community socioeconomic index (SEI) based on average years of schooling, average income and average wealth at the community level. Community SEI was defined as the standardized first principal component score. In combination with the adult data from CFPS 2012 follow-up data, the multilevel Logistic regression model was used to analyze whether the community socioeconomic status had an independent contextual effect on the self-rated health of urban residents and rural residents after controlling individual-level socioeconomic status.@*RESULTS@#In the final analysis, 31 321 adult residents in 577 communities were included, of whom 8 423 were urban residents and 22 898 were rural residents. Community SEI ranged from -2.41 to 3.16, with a mean of 0 and a stan-dard deviation of 1. As the community SEI increased, the incidence of deprivations in different dimensions decreased, indicating the community socioeconomic status increased. The multilevel Logistic model controlling for both individual sociodemographic factors and community socioeconomic status showed that as the community SEI increased, the probability of poor self-rated health decreased, which indicated community SEI had a contextual effect on poor self-rated health. The contextual effect of community SEI on poor self-rated health was statistically significant for the rural residents (OR=0.84, 95%CI: 0.76-0.94) but not statistically significant for the urban adults (OR=0.94, 95%CI: 0.83-1.06).@*CONCLUSION@#After controlling for individual socioeconomic status, community socioeconomic status was associa-ted with poor self-rated health for rural residents independent of individual socioeconomic status. Therefore, in order to improve the health status of the rural population, it needs not only individual-based health interventions, but also community-based health interventions.

Health literacy and depression in women with type 2 diabetes mellitus

OBJECTIVES: The prevalence of diabetes mellitus has recently increased in Taiwan, and depression is common among these patients. Moreover, a lack of health literacy may lead to depression. In this study, we explored the correlation between health literacy and depression in diabetic women. METHODS: In this cross-sectional study, 152 women with type 2 diabetes mellitus were recruited from the outpatient clinic of a regional teaching hospital in Taiwan. The data were collected through medical records and a self-reported structured questionnaire, which included items on basic attributes, self-rated health status, the Center for Epidemiologic Studies Depression Scale (CES-D), and Chinese Health Literacy Scale for Diabetes (CHLSD). The results were analyzed using descriptive statistical analyses, bivariate correlation tests, and linear regression analyses. RESULTS: One hundred thirty-five valid questionnaires were obtained. Approximately 20% of the participants had a higher tendency toward depression as per their CES-D score, and the CHLSD results showed that 13.33% had poor health literacy. There was a negative correlation between health literacy and depressive tendencies after adjusting for self-rated health status, economic satisfaction status, employment status, and education level using multivariate linear regression analyses. For each 1-point rise in the CHLSD score, the CES-D score decreased by 0.17 points (z=−2.05, p=0.042). CONCLUSIONS: A negative correlation was identified between health literacy and depression. Self-rated health status, economic satisfaction, employment status, and higher education level are factors that also affect depressive tendency among diabetic women.

Relationship between self-rated health status and physical activity in obese South Indian patients

Background: Regular physical activity can improve people's overall health and reduce various risks for morbidity and mortality due to a sedentary lifestyle. Although the evidence linking obesity with many chronic diseases is well established, the relationship with self-rated health is not clear. The study aimed to assess the relationship between physical activity and self-rated health and how it is related to obesity.Methods: The cross-sectional study included 132 individuals above18 years, of both genders, with BMI above 25kg/m2. Data was collected using a structured proforma which included apart from demographic parameters, anthropometry parameters, self-reported physical activity, health status and stress levels of the subjects. Chi-square test/Fisher's exact test was used to assess the association between BMI, physical activity and self-rated health.Results: A total of 132 subjects were included with a mean age of 48.44±11.23 years, with an almost equal proportion of males and females. The mean of BMI was 29.54±3.99. Most of them reported having normal physical activity (61.36%) with only 3% of them having high physical activity. The self-rated health of the subjects revealed 45.45% of them is having fair health and 43.18% of them having poor health. The mean a number of hours spent by sitting/sedentary activity in a week were 32.32±21.09.Conclusions: The study findings revealed that the irrespective of the degree of physical activity both overweight and obese subjects rated their health fair to poor.

Disparity in self-rated health between male and female elderly: a Fairlie decomposition analysis / 中华疾病控制杂志

Objective To investigate the disparity and factors of self-rated health between male and female elderly so as to provide evidence for narrowing the disparity and promoting health equity. Methods We extracted data from China Health and Retirement Longitudinal Study in 2013. Fairlie decomposition was adopted to analyze the disparity of self-rated health between 3 744 male and female elderly who were 65 and older. Results The male elderly reported a significantly higher ratio of good health than the female elderly(47.1% vs 41.6%, 2=11.74, P<0.001). Fairlie decomposition analysis revealed that lifestyle, income and educational level were significant influencing factor for self-rated health (all P<0.05), which could explain 73.98%, 17.48% and 16.70% of the overall disparity in self-rated health among the elderly. Conclusions There is a disparity between male and female elderly’s self-rated health. The self-rated health of male elderly is better than that of female elderly. It would contribute to the equity of male and female elderly’s health by promoting publicity of health education and advocating healthy lifestyle of female elderly.

Survey of self-rated health and associated factors analysis of elderly hypertensive patients in community clinics / 上海交通大学学报（医学版）

Objective: To understand the status of self-rated health of elderly hypertensive patients in some community clinics in Shanghai, and analyze the influence factors. Methods:The elderly patients with hypertension in three community clinics in Shanghai were investigated with the basic information questionnaire and the Self-rated Health Rating Scale (SRHMS). The influence factors of self-rated health of these people were ana-lyzed by multiple linear stepwise regression. Results:A total of 458 elderly patients with hypertension were enrolled. The total score of SRHMS and the scores of its 3 subscales, i.e., physiological health, mental health, and social health, were 347.91±32.97, 142.29±13.03, 116.95±12.65, and 88.66±11.83, respectively. Totally, 88.4% of the patients were at good level of self-rated health. The results of multiple linear stepwise regression showed that age, primary occupation, daily times of taking antihypertensive drugs, marital status and life satisfaction were independent influence factors of the total score of SRHMS in the elderly patients with hypertension. Conclusion:The self-rated health level of elderly hypertension patients in the community clinics in Shanghai is good, and age, original occupation, daily times of taking antihypertensive drugs, marital status and life satisfaction are the influence factors.

Effect of group cognitive behavior intervention on self-rated health of middle school students with e-motional disorder / 中华行为医学与脑科学杂志

Objective To explore the effect of group cognitive behavior intervention on self-rated health of middle school students with emotional disorders. Methods From January 2018 to June 2018,79 middle school students with emotional disorders were randomly divided into intervention group ( 41 cases) and control group (38 cases) according to the single or double number of medical records. The control group only received drug treatment,while the intervention group received group cognitive behavior intervention on the basis of drug treatment. All the students in the two groups completed the self-rated health measurement scale before intervention (T0),after intervention (T1) and 8 weeks after intervention (T2). Results (1) There were no significant differences in total health score and dimension score between the two groups before intervention (both P<0. 05). (2)The repeated measurement variance analysis showed that there was a signif-icant group × time interaction effect on total health score and dimensions(P>0. 05). (3) The group effect of physical health was not significant (P>0. 05). The group effect of total mental health, social health and health score at T1 and T2 time points were significant (all P>0. 05). (4)Compared with before intervention, mental health ((123. 34±9. 33),( 122. 63± 9. 11)),social health ((102. 89 ± 7. 28),( 101. 89± 7. 73)) and total health score ((370. 34±17. 99),(367. 63±17. 89)) of intervention group at T1 and T2 increased ( all P<0. 05),while that of control group increased only at T1 (all P<0. 05). Conclusion Group cognitive behavioral intervention has no obvious effect on physical health of middle school students with emotional dis-orders. And group cognitive behavioral intervention can effectively improve their mental health,social health and overall health level,and the long-term effect is better.

Social capital as a mediator of the influence of socioeconomic position on health: Findings from a population-based cross-sectional study in Chandigarh, India

Background: Social capital has been recognized as part of the WHO's Social Determinants of Health model given that social connections and relationships may serve as resources of information and tangible support. While the association between socioeconomic position and health is relatively well established, scant empirical research has been conducted in developing countries on the association between social capital and health. Objective: Based on the WHO's Social Determinants of Health framework, we tested whether social capital mediates the effect of socioeconomic position on mental and physical health. Methods: A population-based study was conducted among a representative sample (n = 1563) of men and women in Chandigarh, India. We used standardized scales for measuring social capital (mediator variable) and self-rated mental and physical health (outcome variable). Results: A socioeconomic position index (independent variable) was computed from education, occupation, and caste categories. Mediation model was tested using path analysis in IBM SPSS-Amos. Participants' mean age was 40.1 years. About half of the participants were women (49.3%), and most were relatively well educated. The results showed that socioeconomic position was a significant predictor of physical and mental health. Social capital was a significant mediator of the effect of socioeconomic position on mental health but not physical health. Conclusion: Besides removing socioeconomic barriers through poverty alleviation programs, interventions to improve social capital, especially in economically disadvantaged communities, may help in improving population health.