title: Determinants of self-rated health in elderly populations in urban areas in Slovenia, Lithuania and UK: findings of the EURO-URHIS 2 survey.
abstract: Ageing imposes extra financial burdens on social and health services in developed countries. Self-rated health (SRH) is considered to be both a reliable measurement of overall health status including morbidity and mortality and an important predictor of hospitalization, functional impairment and greater demand for health-care services in the elderly. Our aim was to identify factors associated with poor SRH in elderly populations and investigate possible differences between urban areas in Slovenia, Lithuania and UK. Data were obtained from population-based surveys from the European Urban Health Indicator System Part 2 project. The stratified representative sample (41% men and 59% women) consisted of a total of 2547 respondents aged ≥65 from the urban areas in the three countries. The prevalence of poor SRH was highest in Lithuanian urban areas. The strongest factors associated with poor SRH were low education [OR (odds ratio) 4.3, 95% CI (confidence interval) 2.5-7.3, P < 0.001], restriction of activities attributable to a chronic disease (OR 2.6, 95% CI 2.2-3.0, P < 0.001), inadequate physical activity (OR 1.7, 95% CI 1.2-2.5, P = 0.007) and poor mental health (OR 1.1, 95% CI 1.1-1.2, P < 0.001). The main factors associated with poor SRH by country included the following: living alone (Slovenia) (OR 2.0, 95% CI 1.1-3.7, P = 0,023), female sex (Lithuania) (OR 2.0, 95% CI 1.0-4.2, P = 0.058) and inadequate physical activity (UK) (OR 2.2, 95% CI 1.3-3.6, P = 0,003). Despite different levels of poor SRH, the factors associated with poor SRH were similar for the urban areas of the three countries. Factors associated with poor SRH in the urban areas could also reflect either cultural differences or specific situations for elderly in that country, which need further research.
authors.affiliation: 1 Department of noncommunicable diseases, National Institute of Public Health of Republic of Slovenia, Maribor Unit, Maribor, Slovenia.
authors.forename: Olivera
authors.initials: O
authors.lastname: Stanojevic Jerkovic
authors.affiliation: 2 Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Skirmante
authors.initials: S
authors.lastname: Sauliune
authors.affiliation: 2 Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Linas
authors.initials: L
authors.lastname: Šumskas
authors.affiliation: 3 Department of Preventive medicine and Institute of Health Research, Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Birt
authors.affiliation: 4 Chair of Family medicine, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: Janko
authors.initials: J
authors.lastname: Kersnik
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008097:Lithuania / Q000453:epidemiology; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D057566:Self Report; D012737:Sex Factors; D017524:Slovenia / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data*