title: Levels and distribution of self-rated health in the Kazakh population: results from the Kazakhstan household health survey 2012.
abstract: BACKGROUND
  The high and fluctuating mortality and rising health inequalities in post-Soviet countries have attracted considerable attention. However, there are very few individual-level data on distribution of health outcomes in Central Asian countries of the former Soviet Union. We analysed socioeconomic predictors of two self-rated health outcomes in a national survey in Kazakhstan.
  
  
  METHODS
  We used data from the 2012 Kazakhstan Household Health Survey on 12,560 respondents aged 15+. Self-rated health, self-reported worsening of health, and a range of socio-demographic variables were collected in an interview. The self-rated health outcomes were dichotomized and logistic regression was used to estimate their associations with education, income, ownership of a car, second house and computer, marital status, ethnicity and urban/rural residence.
  
  
  RESULTS
  The prevalence of poor/very poor self-rated health was 5.3%, and 11.0% of participants reported worse health compared to 1 year ago. After controlling for age, sex and region, all socio-demographic factors were related to self-rated health. After adjusting for all variables, education and car ownership showed the most consistent effects; the odds ratio of poor health and worsening of health were 0.43 (95% confidence interval 0.32-0.58) and 0.54 (0.44-0.68) for university vs. primary education, respectively, and 0.64 (0.51-0.82) and 0.68 (0.58-0.80) for car ownership, respectively. Unmarried persons, ethnic Russians and urban residents also had increased prevalence of poor health in multivariable models.
  
  
  CONCLUSIONS
  Despite the limitations of using subjective health measures, these data suggest strong associations between two measures of self-rated health and a number of socioeconomic characteristics. Future studies and health policy initiatives in Kazakhstan and other Central Asian countries should take social determinants of health into account.
authors: Centre for Life Sciences, Nazarbayev University, 53 Kabanbay batyr ave,, Astana 010000, Kazakhstan. asupiyev@nu.edu.kz.
authors: Adil
authors: A
authors: Supiyev
authors: Talgat
authors: T
authors: Nurgozhin
authors: Zhaxybay
authors: Z
authors: Zhumadilov
authors: Almaz
authors: A
authors: Sharman
authors: Michael
authors: M
authors: Marmot
authors: Martin
authors: M
authors: Bobak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006262:Health; D006304:Health Status; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D007623:Kazakhstan; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D016017:Odds Ratio; D011203:Poverty; D057566:Self Report; D012959:Socioeconomic Factors; D014586:USSR; D055815:Young Adult