title: Self-rated health and associated factors among older South Africans: evidence from the study on global ageing and adult health.
abstract: BACKGROUND
  Population ageing has become significant in South African society, increasing the need to improve understandings of health and well-being among the aged.
  
  
  OBJECTIVE
  To describe the self-reported ratings of overall health and functioning, and to identify factors associated with self-rated health among older South Africans.
  
  
  METHODS
  A national population-based cross-sectional survey, with a sample of 3,840 individuals aged 50 years and older, was completed in South Africa in 2008. Self-reported ratings of overall health and functioning were measured using a single self-reported health state covering nine health domains (used to generate the Study on Global Ageing and Adult Health (SAGE) composite health state score). Disability was measured using the World Health Organization Disability Assessment Schedule II (WHODAS-II) activities of daily living (ADLs), instrumental activities of daily living (IADLs), perceptions of well-being, and the World Health Organization Quality of Life index/metric (WHOQoL).
  
  
  RESULTS
  Overall, more than three quarters (76.8%) of adults rated their health as moderate or good. On balance, men reported very good or good health more often than women (p<0.001). Older people (aged 70 years and above) reported significantly poorer health status than those aged 50-59 (adjusted odds ratio (AOR) 1.52; 95% confidence interval (CI) 1.00-2.30). Indians and Blacks were significantly more likely to report poorer health status at (AOR = 4.01; 95% CI 1.27-12.70) and (AOR = 0.42; 95% CI 0.18_0.98; 30 p < 0.045), respectively, compared to Whites. Respondents with primary education (AOR = 1.83; 95% CI 1.19-2.80) and less than primary education (AOR = 1.94; 95% CI 1.37-2.76) were more likely to report poorer health compared to those with secondary education. In terms of wealth status, those in low wealth quintile (AOR = 2.02; 95% CI 1.14-3.57) and medium wealth quintile (AOR = 1.47; 95% CI 1.01-2.13) were more likely to report poorer health status than those in high wealth quintile. Overall, the mean WHODAS-II score was 20%, suggesting a low level of disability. The mean WHOQoL score for females (Mean = 51.5; SD = 12.2) was comparable to that of males (Mean = 49.1; SD = 12.6).
  
  
  CONCLUSIONS
  The depreciation in health and daily functioning with increasing age is likely to increase demand for health care and other services as people grow older. There is a need for regular monitoring of the health status of older people to provide public health agencies with the data they need to assess, protect, and promote the health and well-being of older people.
authors.affiliation: a HIV/AIDS/STI/and TB (HAST), Human Sciences Research Council South Africa.|b Office of the Deputy-Vice Chancellor , Nelson Mandela Metropolitan University , Port Elizabeth , South Africa.
authors.forename: Nancy
authors.initials: N
authors.lastname: Phaswana-Mafuya
authors.affiliation: a HIV/AIDS/STI/and TB (HAST), Human Sciences Research Council South Africa.|c School of Human and Community Development , University of the Witwatersrand , Johannesburg , South Africa.
authors.forename: Karl
authors.initials: K
authors.lastname: Peltzer
authors.affiliation: a HIV/AIDS/STI/and TB (HAST), Human Sciences Research Council South Africa.
authors.forename: Witness
authors.initials: W
authors.lastname: Chirinda
authors.affiliation: a HIV/AIDS/STI/and TB (HAST), Human Sciences Research Council South Africa.
authors.forename: Zamakayise
authors.initials: Z
authors.lastname: Kose
authors.affiliation: a HIV/AIDS/STI/and TB (HAST), Human Sciences Research Council South Africa.
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Hoosain
authors.affiliation: a HIV/AIDS/STI/and TB (HAST), Human Sciences Research Council South Africa.
authors.forename: Shandir
authors.initials: S
authors.lastname: Ramlagan
authors.affiliation: d Department of Social Work, School of Human and Community Development , University of the Witwatersrand , Johannesburg , South Africa.
authors.forename: Cily
authors.initials: C
authors.lastname: Tabane
authors.affiliation: a HIV/AIDS/STI/and TB (HAST), Human Sciences Research Council South Africa.
authors.forename: Adlai
authors.initials: A
authors.lastname: Davids
keywords: ADLs; IADLs; SAGE; South Africa; WHODAS-II; WHOQoL; adult health; ageing; disability; quality of life; self-reported health