title: Adverse health effects of low levels of perceived control in Swedish and Russian community samples.
abstract: BACKGROUND
  This cross-sectional study of two middle-aged community samples from Sweden and Russia examined the distribution of perceived control scores in the two populations, investigated differences in individual control items between the populations, and assessed the association between perceived control and self-rated health.
  
  
  METHODS
  The samples consisted of men and women aged 45-69 years, randomly selected from national and local population registers in southeast Sweden (n = 1007) and in Novosibirsk, Russia (n = 9231). Data were collected by structured questionnaires and clinical measures at a visit to a clinic. The questionnaire covered socioeconomic and lifestyle factors, societal circumstances, and psychosocial measures. Self-rated health was assessed by standard single question with five possible answers, with a cut-off point at the top two alternatives.
  
  
  RESULTS
  32.2 % of Swedish men and women reported good health, compared to 10.3 % of Russian men and women. Levels of perceived control were also significantly lower in Russia than in Sweden and varied by socio-demographic parameters in both populations. Sub-item analysis of the control questionnaire revealed substantial differences between the populations both in the perception of control over life and over health. Logistic regression analysis revealed that the odds ratios (OR) of poor self-rated health were significantly increased in men and women with low perceived control in both countries (OR between 2.61 and 4.26).
  
  
  CONCLUSIONS
  Although the cross-sectional design does not allow causal inference, these results support the view that perceived control influences health, and that it may mediate the link between socioeconomic hardship and health.
authors.affiliation: 1Department of Medical and Health Sciences, Linköping University, Sweden. johanna.lundberg@ihs.liu.se
authors.forename: Johanna
authors.initials: J
authors.lastname: Lundberg
authors.forename: Martin
authors.initials: M
authors.lastname: Bobak
authors.forename: Sofia
authors.initials: S
authors.lastname: Malyutina
authors.forename: Margareta
authors.initials: M
authors.lastname: Kristenson
authors.forename: Hynek
authors.initials: H
authors.lastname: Pikhart
mesh_terms: D000368:Aged; D001294:Attitude to Health / Q000208:ethnology*; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008019:Life Style / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D054526:Men's Health / Q000208:ethnology; D008875:Middle Aged; D016017:Odds Ratio; D009819:Office Visits; D012042:Registries; D012426:Russia / Q000453:epidemiology; D020377:Self Efficacy; D012926:Social Control, Formal; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D016387:Women's Health / Q000208:ethnology