title: Are area-level and individual-level socioeconomic factors associated with self-rated health in adult urban citizens? Evidence from Slovak and Dutch cities.
abstract: Evidence shows that living in disadvantaged areas is associated with poor health. This may be due to the socioeconomic (SE) characteristics of both these residents and the areas where they live. Evidence regarding this on Central European (CE) countries is scarce. Our aim was to assess whether the prevalence of poor self-rated health (SRH) was higher in deprived urban areas, whether this can be explained by individual SE status (SES) and whether this differed between Slovakia and the Netherlands per age group. We examined the association of urban-level data and individual-level SE factors from different urban areas in different countries (Slovakia, the Netherlands) using comparable urban health indicators and area indicators. We also obtained unique data from the EU-FP7 EURO-URHIS 2 project. Multilevel logistic regression showed that poor SRH was associated with area deprivation in both countries. Regarding age by country, poor SRH occurred more frequently in the more deprived areas for the younger age group (≤64) in the Netherlands but for the older age group (≥65 years) in Slovakia. Moreover, Slovak citizens reported poor SRH significantly more often than Dutch residents. Individual SES was significantly associated with poor SRH in both age groups and both countries for most area-level SE measures. Individual SES is associated with SRH more strongly than area deprivation. Therefore, it is important to account for relative deprivation at an individual level when considering health-enhancing activities. Moreover, the effect of urban-area deprivation seems to differ between CE and WE countries.
authors.affiliation: 1 Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovak Republic.|2 Department of Social Medicine, Faculty of Medicine, Institute of Public Health, Safarik University, Kosice, Slovak Republic.|3 Slovak Public Health Association - SAVEZ, Kosice, Slovak Republic.
authors.forename: Martina
authors.initials: M
authors.lastname: Behanova
authors.affiliation: 4 Department of Community and Occupational Health, University Medical Centre Groningen, University of Groningen, The Netherlands.
authors.forename: Sijmen A
authors.initials: SA
authors.lastname: Reijneveld
authors.affiliation: 1 Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovak Republic.|2 Department of Social Medicine, Faculty of Medicine, Institute of Public Health, Safarik University, Kosice, Slovak Republic.|3 Slovak Public Health Association - SAVEZ, Kosice, Slovak Republic.
authors.forename: Iveta
authors.initials: I
authors.lastname: Nagyova
authors.affiliation: 1 Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovak Republic.|2 Department of Social Medicine, Faculty of Medicine, Institute of Public Health, Safarik University, Kosice, Slovak Republic.|3 Slovak Public Health Association - SAVEZ, Kosice, Slovak Republic.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Katreniakova
authors.affiliation: 5 Department of Epidemiology and Information, Municipal Health Service, Utrecht, The Netherlands.
authors.forename: Erik J C
authors.initials: EJC
authors.lastname: van Ameijden
authors.affiliation: 6 Department of Epidemiology Municipal Health Service, Amsterdam, The Netherlands.
authors.forename: Henriëtte
authors.initials: H
authors.lastname: Dijkshoorn
authors.affiliation: 1 Graduate School Kosice Institute for Society and Health, Safarik University, Kosice, Slovak Republic.|4 Department of Community and Occupational Health, University Medical Centre Groningen, University of Groningen, The Netherlands.
authors.forename: Jitse P
authors.initials: JP
authors.lastname: van Dijk
mesh_terms: D000328:Adult; D000368:Aged; D002947:Cities / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012111:Residence Characteristics / Q000706:statistics & numerical data; D057566:Self Report; D018154:Slovakia / Q000453:epidemiology; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult