Socioeconomic inequalities, health damaging behavior, and self-perceived health in Serbia: a cross-sectional study.
OBJECTIVE
To analyze the association of socioeconomic factors with self-perceived health in Serbia and examine whether this association can be partly explained by health behavior variables.


METHODS
We used data from the 2007 Living Standards Measurement Study for Serbia. A representative sample of 13831 persons aged ≥20 years was interviewed. The associations between demographic factors (age, sex, marital status, and type of settlement), socioeconomic factors (education, employment status, and household consumption tertiles), and health behavior variables (smoking, alcohol consumption) and self-perceived health were examined using logistic regression analyses.


RESULTS
A stepwise gradient was found between education and self-perceived health for the total sample, men, and women. Compared to people with high education, people with low education had a 4.5 times higher chance of assessing their health as poor. Unemployed (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.29-2.10), inactive (OR, 2.82; 95% CI, 2.49-3.19), and the most deprived respondents (OR, 1.17; 95% CI, 1.02-1.34) were more likely to report poor self-perceived health than employed persons and the most affluent group. After adjustment for demographic and health behavior variables, the magnitudes of all associations decreased but remained clearly and significantly graded.


CONCLUSIONS
This study revealed inequalities in self-perceived health by socioeconomic position, in particular educational and employment status. The reduction of such inequalities through wisely tailored interventions that benefit people's health should be a target of a national health policy in Serbia.
Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia. drjankojankovic@yahoo.com
Janko
J
Janković
Teresa
T
Janević
Olaf
O
von dem Knesebeck
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D006304:Health Status; D054624:Health Status Disparities; D006305:Health Status Indicators; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011203:Poverty; D012309:Risk-Taking; D012649:Self Concept; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000523:psychology; D055771:Serbia; D012737:Sex Factors; D012923:Social Class; D055815:Young Adult