title: Does Multi-morbidity Mediate the Effect of Socioeconomics on Self-rated Health? Cross-country Differences.
abstract: BACKGROUND
  This study explored cross-country differences in how multi-morbidity explains the effects of socioeconomic characteristics on self-rated health.
  
  
  METHODS
  The study borrowed data from the Research on Early Life and Aging Trends and Effects. Participants were 44,530 individuals (age > 65 years) who were sampled from 15 countries (i.e. United States, China, India, Russia, Costa Rica, Puerto Rico, Mexico, Argentina, Barbados, Brazil, Chile, Cuba, Uruguay, Ghana and South Africa). Multi-morbidity was measured as number of chronic medical conditions. In Model I, main effects of socioeconomic factors on self-rated health were calculated using country-specific logistic regressions. In Model II, number of chronic conditions were also added to the models to find changes in coefficients for demographic and socioeconomic factors.
  
  
  RESULTS
  In the United States, number of chronic medical conditions explained the effect of income on subjective health. In Puerto Rico, number of chronic medical conditions explained the effect of marital status on subjective health. In Costa Rica, Argentina, Barbados, Cuba, and Uruguay, number of chronic medical conditions explained gender disparities in subjective health. In China, Mexico, Brazil, Russia, Chile, India, Ghana and South Africa, number of chronic medical conditions did not explain the effect of demographic or socioeconomic factors on subjective health.
  
  
  CONCLUSIONS
  Multi-morbidity explains the effect of demographic and socioeconomic factors on subjective health in some but not other countries. Further research is needed.
authors.affiliation: Department of Psychiatry, School of Medicine, University of Michigan, Michigan, USA ; Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Michigan, USA.
authors.forename: Shervin
authors.initials: S
authors.lastname: Assari
authors.affiliation: Department of Psychiatry, School of Medicine, University of Michigan, Michigan, USA ; Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Michigan, USA.
authors.forename: Maryam Moghani
authors.initials: MM
authors.lastname: Lankarani
keywords: Chronic medical conditions; physical health; sociodemographics; subjective health