Associations between negative self-rated health and macro-structural, social and health vulnerability in elderly people: Fibra Study, Campinas, Brazil

Anita Liberalesso Neri, Monica Sanches Yassuda, André Fattori, Maria Elena Guariento, Flávia Silva Arbex Borim

Abstract


Purpose: This study was aimed at investigating associations between negative self-rated health and macro-structural (access and use of medical, hospitalar and odontological services, as well as consumption of medicines), social (sex, age, schooling, individual income, living arrangements, expectancy of care, and social participation), and health indicators (chronic diseases, signals and symptoms, functional problems to feeding, cardiovascular risk, frailty, depressive symptoms, and cognitive status) in Brazilian elderly recruited in the community.
Methods: Participants were 2.597 seniors (65,7% women), aged 65 and above (M=72,4±5,6), without cognitive deficit suggestive of dementia. They integrated the probabilistic samples from 7 Brazilian cities selected by convenience. The variables were assessed by self-report, anthropometric and performance instruments and measures.  
Results: Multivariate analyses of regression showed significant associations (p≤0,05) between self-rated health and having 3 or more signals and symptoms (OR=2,42), 3 or more functional problems to feeding (OR=2,30), individual income ≤ 3 MW (OR=2,17), no visits to the dentist in the last year (OR=2,09), consumption of 3 or more medicines (OR=2,02), 3 or more chronic illnesses (OR=2,00), illiteracy (OR=1,58), more than 4 nights of hospitalization (OR=1,17), and use of public health services (OR=1,06).
Conclusions: In multiple interaction, macro-structural, social and health indicators of vulnerability can generate a vicious cycle of deleterious influences over old people´s quality of life, which tend to reflect in negative self-rated health.


Keywords


Aging health; Self-rated health; Aged, socioeconomic factors; Health vulnerability; Living conditions.

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DOI: http://dx.doi.org/10.15448/2357-9641.2014.2.21011

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