Browsing by Subject "self-rated health"

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  • Rapeli, Lauri; Mattila, Vesa Mikko; Papageorgiou, Achillefs (2020)
    Turnout and party choice are widely held to be habitual, but little attention has been paid to factors that disrupt the pattern. Good health is an important determinant of political behaviour and a key component in the quality of life. Based on the developmental theory of turnout, we hypothesize that declining health lowers voting propensity over the life course. We employ issue ownership theory to assume that declining health increases the likelihood of voting for leftist parties. Using the British Household Panel Survey data, we show how deteriorating health significantly lowers the propensity to vote, but if a person in poor health votes, she is more likely to support Labour than the Conservatives. As expected by the developmental theory, major life events, such as declining health, affect voting propensity. Results also support issue ownership theory: declining health increases Labour voting which implies that British voters turn to the party that owns the health issue when the issue becomes salient.
  • Karppinen, Helena; Pitkala, Kaisu H.; Kautiainen, Hannu; Tilvis, Reijo S.; Valvanne, Jaakko; Yoder, Kathe; Strandberg, Timo E. (2017)
    Objective: To explore changes in self-reported disabilities, health, comorbidities and psychological wellbeing (PWB) in aged cohorts over two decades. Design, setting and subjects: Cross-sectional cohort studies with postal surveys were conducted among community-dwelling people aged 75, 80, 85, 90 and 95 years in 1989 (n = 660), 1999 (n = 2598) and 2009 (n = 1637) in Helsinki, Finland. Main outcome measures: Self-reported items on disability, self-rated health (SRH), diagnoses and PWB were compared between cohorts of the same age. Standardized mortality ratios (SMRs) were calculated for each study year to explore the representativeness of the samples compared to general population of same age. Results: A significantly lower proportion of the 75-85-year-olds of the later study years reported going outdoors daily, although this group had improvements in both SRH and PWB scores. The number of comorbidities increased over time among 75-85-year-olds. The only significant change that could be verified among 90- and 95-year-olds between 1999 and 2009, was the lower proportion of participants going outdoors daily. The trend of leveling-off in disabilities was not explained by the SMRs (0.90, 0.71 and 0.60 for 1989, 1999 and 2009). Conclusions: The latest older people's cohorts showed an end to previously reported improvements in disabilities, despite having favorable trends in SRH and PWB. Primary care may be faced with increasing need of appropriate services for their senior members.
  • Junna, Liina (Helsingfors universitet, 2017)
    Self-rated health (SRH) is a frequently used survey indicator of general health. It is periodically utilised in the study of educational health disparities. Several researchers have, however, suggested that systematic population sub group differences in health self-ratings (reporting heterogeneity) may results in SRH reflecting a different health status, or aspects of health, for different educational groups. Previous studies imply that the associations between SRH and other indicators of health may be strengthened by higher education. However, the studies disagree on the strength and the scope of the interaction effect. Comparability is also an issue due to, for example, the variation in the selected health indicators by which SRH is assessed. No such studies have so far been conducted in Norther Europe. The purpose of this Master’s thesis is to address educational SRH reporting heterogeneity. Using quantitative methods, this thesis analyses which aspects of health are included in dichotomised poor or very poor SRH ratings, and whether education moderates the relationship between SRH and the indicators of health. The selected health indicators represent five health dimensions identified in previous studies: clinical health, functional health, health behaviours, mental health and bodily symptoms and experiences. The analyses are conducted using logistic regression and regression –based nonlinear decomposition methods. The study utilises the Health 2000 data (n= 5586) for the household and institution dwelling population over the age of 30 residing in mainland Finland. The data is nationally representative and consists of a clinical- and mental health examination, and survey sections. Overall, a high volume of somatic complaints was found strongly associated with poor self-rated health for all educational groups. Other significant contributors were functional health, diagnosed mental health conditions, and to some extent diagnosed diseases. An educational interaction effect was found for cardiovascular disease, subjective functional limitations in everyday tasks, and high volume of somatic complaints. In all cases education strengthened the association. However, for the majority of the indicators, SRH was associated with, no interaction effect was found. Compared to those respondents with a higher education, those with lower educational attainments more often reported poor SRH, but the selected health indicators and demographic variables explained virtually the whole difference. The study then, to some extent, concurs with earlier findings of higher education strengthening some of the associating between poor SRH and other indicators of health. However, the effect was statistically significant only when comparing basic education to higher educational attainments, and it was less systematic than some of the previous studies have suggested.
  • Kemppainen, Teemu Tapio; Elovainio, Marko Juhani; Kortteinen, Matti Mikael; Vaattovaara, Mari Kaarina (2020)
    Involuntary staying, or a desire to move without the possibility to do so, is an under-studied topic. In this study, we examine involuntary staying among the residents of post-Second World War Finnish housing estates; we study its frequency, association with self-rated health and role in the relationship between neighbourhood disadvantage and self-rated health. Involuntary staying and poor health are expected to be associated through long-term stress related to housing and health-based selection in inconvenient housing outcomes. Furthermore, we address the self-perceived reasons for involuntary staying and the interaction between involuntary staying and household income. Two types of involuntary staying are distinguished, depending on whether a resident wants to move within or away from the current neighbourhood. The survey data (n = 7369) from a stratified cluster sample of the residents of 70 Finnish housing estate neighbourhoods are combined with the corresponding geo-referenced register data on these neighbourhoods’ sociodemographic characteristics. Of the residents, 35% are found to be involuntary stayers, and over half of the involuntary stayers want to move away from their current neighbourhoods. Financial concern is the most common self-perceived reason for involuntary staying. Both types of involuntary staying are associated with low self-rated health after adjusting for potential confounders. Being trapped in the current neighbourhood partially mediates the adjusted association between neighbourhood disadvantage and self-rated health. The association between self-rated health and involuntary staying is not modified by household income. In conclusion, involuntary staying is common in the study population and furthers the understanding about neighbourhood inequalities in health.
  • Pekurinen, Virve; Willman, Laura; Virtanen, Marianna; Kivimaki, Mika; Vahtera, Jussi; Valimaki, Maritta (2017)
    Wellbeing of nurses is associated with patient aggression. Little is known about the differences in these associations between nurses working in different specialties. We aimed to estimate and compare the prevalence of patient aggression and the associations between patient aggression and the wellbeing of nurses in psychiatric and non-psychiatric specialties (medical and surgical, and emergency medicine). A sample of 5288 nurses (923 psychiatric nurses, 4070 medical and surgical nurses, 295 emergency nurses) participated in the study. Subjective measures were used to assess both the occurrence of patient aggression and the wellbeing of nurses (self-rated health, sleep disturbances, psychological distress and perceived work ability). Binary logistic regression with interaction terms was used to compare the associations between patient aggression and the wellbeing of nurses. Psychiatric nurses reported all types of patient aggression more frequently than medical and surgical nurses, whereas nurses working in emergency settings reported physical violence and verbal aggression more frequently than psychiatric nurses. Psychiatric nurses reported poor self-rated health and reduced work ability more frequently than both of the non-psychiatric nursing groups, whereas medical and surgical nurses reported psychological distress and sleep disturbances more often. Psychiatric nurses who had experienced at least one type of patient aggression or mental abuse in the previous year, were less likely to suffer from psychological distress and sleep disturbances compared to medical and surgical nurses. Psychiatric nurses who had experienced physical assaults and armed threats were less likely to suffer from sleep disturbances compared to nurses working in emergency settings. Compared to medical and surgical nurses, psychiatric nurses face patient aggression more often, but certain types of aggression are more common in emergency settings. Psychiatric nurses have worse subjective health and work ability than both of the non-psychiatric nursing groups, while their psychiatric wellbeing is better and they have less sleep problems compared to medical and surgical nurses. Psychiatric nurses maintain better psychiatric wellbeing and experience fewer sleep problems than non-psychiatric nurses after events of exposure to patient aggression. This suggest that more attention should be given to non-psychiatric settings for maintaining the wellbeing of nurses after exposure to patient aggression.
  • Öhman, H.; Karppinen, H.; Lehti, Tuuli; Knuutila, Mia T; Tilvis, R.; Strandberg, T.; Kautiainen, Hannu; Pitkälä, K. H. (2021)
    Background: Life expectancy has increased markedly in the past decades. Thus, it is of great importance to understand how people are ageing and if the trajectories of health and disability are changing over time. This study aimed to examine trends in functional abilities and health in independent cohorts of people aged 75-95 over three decades. Methods: This Helsinki Ageing Study consists of repeated cross-sectional postal surveys examining independent cohorts of old people (75, 80, 85 and 90+ years old). This study combined data from four waves (1989, 1999, 2009 and 2019). Results: In the most recent wave, there was an increase in the portion of participants who were able to walk outdoors easily (75-year-olds p=0.03, 80-year-olds p=0.002, 85-year-olds pp for linearity for the study year effect, all adjusted for sex). Fewer people in the youngest age group (75-year-olds) needed daily help from another person in 2019 compared to the earlier waves (p=0.02 for linearity for the study year). Over the past three decades, the proportions of self-reported good mobility have risen 8.7% (95% confidence interval (CI) 2.3-15.1) in 75-year-olds, 11.7% (95% CI 3.9-19.6) in 80-year-olds and 20.1% (95% CI 10.7-29.4) in 85-year-olds, after adjusting for sex. Furthermore, in 2019, more people rated their health as good and scored better in psychological well-being than in the previous waves among 75-, 80- and 85-year-olds. However, no improvements were found among 90+-year-olds in any of these variables. Conclusions: People between 75 and 85 years old are presently feeling and functioning better than their predecessors. This may be an important objective for both economics and health policy.
  • Finne, Maria (Helsingfors universitet, 2017)
    The proportion of older adults has dramatically increased in developed countries due to longer life expectancy. The wellbeing of this group has large economic implications. Self-rated health (SRH) is a globally used method to measure both physical and psychosocial health and in some conditions considered as a better indicator than medical records. The main aim of this thesis was to study whether socioeconomic (SES) factors as well as nutritional intake are associated with physical and psychosocial SF-36 score change during a ten year period. Helsinki Birth Cohort Study (HBCS) consists of 8760 participants who were born at Helsinki University Central Hospital between 1934 and 1944. HBCS is a longitudinal study where data has been collected along the life span. In this thesis material was used from the baseline clinical visit (years 2001-2004) and the follow-up clinical visit (years 2011-2013). During the follow-up, 1094 participants (men n=478, women n=616) were traceable and took part in the follow-up visit which makes the participants 67 to 77 years old at that point. At the baseline clinical examination (n=2003), diet was assessed with a validated food-frequency questionnaire from which the Baltic Sea diet score (BSDS) was calculated. Higher scores indicated better adherence to the Baltic Sea diet. Self-rated psychosocial and physical wellbeing was assessed with the Short Form 36 scale (SF-36) in 2001-2004 and 2011-2013. The difference between baseline and follow-up SF-36 psychosocial and physical measurement was calculated. Socioeconomic indicators included degree of education, length of education and the average monthly taxable income. Men and women were studied separately. Also the group of those still in work life at baseline were evaluated separately from those who were already retired. Associations between BSDS and the SES factors were also tested. The statistical analysis program SPSS version 22 was used to calculate associations between the SES factors and BSDS with psychosocial and physical change. Linear regression method was used for the analyses. In addition, a comparison of the follow-up SF-36 scores according to socioeconomic factors were examined with ANOVA post hoc Tukey HSD test. Degree of education was positively associated with changes in psychosocial functioning at old age among men (p=0.009), whereas length of education associates positively among women (p=0.027). Both degree and length of education were positively associated with psychosocial functioning within the group that was still in work life at baseline. Change in physical functioning was not associated with SES or BSDS. Adherence to the BSD was not significantly associated with either of the SF-36 measurement factors but was related to higher income. Degree of education and length of education seem to indicate the direction of psychosocial functioning in early old age. Physical degeneration during late adulthood is normal and is less predictable by SES factors. BSDS did not predict physical or psychosocial wellbeing among this population but was positively associated with income among the participant.