Introdução: A autoavaliação de saúde é um indicador da saúde geral e do bem-estar dos indivíduos e populações, resultado de uma percepção integrada sobre a saúde, incluindo aspectos biopsicossociais. Porém, há a necessidade de um melhor entendimento destes e de outros fatores associados e o estabelecimento de um modelo de causalidade. Além disto, faltam estudos avaliando as diferenças entre os países e contextos sociais, assim como a sua variação ao longo do tempo. Objetivos: 1) Descrever o estado de saúde de adultos não idosos, inferido por autoavaliação, entre países e regiões com diferentes perfis socioeconômicos; 2) Analisar os fatores contextuais e individuais associados à autoavaliação da saúde; 3) Analisar a tendência temporal dos valores da autoavaliação da saúde no período de 1990 a 2015. Métodos: Foram estudados indivíduos adultos (20-59 anos) a partir de bases de dados de pesquisas de âmbito nacional para o período de 1991 a 2013. Foram incluídas pesquisas que continham a pergunta central do estudo, sobre como o indivíduo avalia a sua saúde, totalizando 92 bases de dados. As variáveis em estudo segundo grupos serão: macroecômicas (PIB per capita e coeficiente de Gini); sociodemográficas e econômicas (idade, sexo, estado civil, trabalho, renda, escolaridade, urbano/rural); e variáveis de estilo de vida, acesso aos serviços de saúde, presença e tipos de doenças, e limitações físicas e/ou mentais conforme as informações disponíveis em cada estudo. Utilizou-se análise com modelos de efeitos mistos, através do software STATA 13.0. As bases de dados utilizadas são todas de acesso livre. Resultados: A frequência de autoavaliação da saúde ruim/muito ruim variou de 2,6 por cento na América do Norte a 14,2 por cento no Oriente Médio e Norte da África. A autoavaliação da saúde se mostrou associada com a presença de doenças crônicas, sendo pior naqueles indivíduos que as possuem. A autoavaliação da saúde melhora com o aumento da escolaridade e da renda e piora com o aumento da idade, sendo pior também no sexo feminino e nos indivíduos que não trabalham. Piora também quanto maior o número de limitações físicas e/ou mentais e é melhor naqueles indivíduos com estilo de vida mais saudável. As variáveis contextuais explicam parte da variância, sendo seu efeito mais pronunciado nas mulheres. O estado de saúde autoavaliado se reduziu ao longo dos anos. Conclusão: A autoavaliação da saúde é determinada por diversos fatores, tanto objetivos como subjetivos, demonstrando ser um bom parâmetro para a avaliação do estado geral de saúde de uma população. / Introduction: The self-rated health is an indicator of overall health and well-being of individuals and populations, the result of an integrated perception of health, including biopsychosocial aspects. However, there is a need for a better understanding of these and other associated factors, and the establishment of a causal model. Furthermore, there are few studies evaluating the differences between countries and social contexts and their variation over time. Objectives: 1) To describe the health status of non-elderly adults, inferred by self-assessment, between countries and regions with different socio-economic profiles; 2) analyze the contextual and individual factors associated with self-rated health; 3) To analyze time trends of self-rated of values from 1990 to 2015. Methods: We studied adults (20-59 years) from national research databases for the period 1991-2013. Were included studies that contained the central question of the study, about how the individual evaluates their health, totaling 92 databases. The variables second groups will be: economics (GDP per capita and Gini coefficient); sociodemographic and economic (age, sex, marital status, work, income, education, urban / rural); and lifestyle variables, access to health services, presence and types of diseases, and physical and/or mental limitations as the information available in each study. We used analysis using mixed models, using STATA 13.0. The databases used are all freely accessible. Results: The frequency of self-rated poor health / very poor ranged from 2.6 per cent in North America to 14.2 per cent in the Middle East and North Africa. The self-rated health was associated with the presence of chronic diseases, and worse in those individuals who possess them. The self-rated health improves with increasing education and income and worsens with increasing age also being worse among women and individuals who are not working. Worsening also the greater the number of physical and/or mental and is better in individuals with healthy lifestyle. The contextual variables explain part of the variance, and its most pronounced effect on women. The self-rated health status was reduced over the years. Conclusion: The self-rated health is determined by several factors, both objective and subjective, proving to be a good parameter for assessing the general health of a population.

Purpose/aim The aim is to examine the distribution of hotel ownerships and star-rated levels in different regions. This thesis depends on the analysis of the examination to find out if the change of investment behaviors can decrease or avoid the adverse effects of bureaucracy in the Chinese hotel industry. Design/methodology/approach Data has been collected through the third-party electronic distribution channel. The analysis includes a description of the samples and statistical tests. Findings The analysis showed that there is a connection between hotel ownerships, star-rated levels, and different regions. The adverse effects of bureaucracy in the second-tier cities and third-tier cities are stronger than that in the first-tier cities and tourist cities. The state-owned hotels also can do the enterprise transformation in the tourist cities to avoid or decrease the adverse effects of the bureaucracy. Originality/value The original idea is using the hotel ownerships distribution in different regions to find out the different levels of adverse effects of the bureaucracy in different regions. This thesis should be a meaningful contribution to knowledge development.

No description available.

Self-rated health (SRH) is an outcome commonly studied by demographers, epidemiologists, and sociologists of health, typically measured using an ordinal scale. SRH is analyzed in cross-sectional and longitudinal studies for both descriptive and inferential purposes, and has been shown to have significant validity with regard to predicting mortality. Despite the wide spread use of this measure, only limited attention is explicitly given to its unique attributes in the case of longitudinal studies. While self-rated health is assumed to represent a latent continuous and dynamic process, SRH is actually measured discretely and asymmetrically. Thus, the validity of methods ignoring the scale of measurement remains questionable. We compare three approaches to modeling SRH with repeated measures over time: linear multilevel models (MLM or LGM), including corrections for non-normality; and marginal and conditional ordered-logit models for longitudinal data. The models are compared using simulated data and illustrated with results from the Health and Retirement Study. We find that marginal and conditional models result in very different interpretations, but that conditional linear and non-linear models result in similar substantive conclusions, albeit with some loss of power in the linear case. In conclusion, we suggest guidelines for modeling self-rated health and similar ordinal outcomes in longitudinal studies. / text

Abstract Background: Many studies have demonstrated that health is a function of relative and not absolute income within populations. Canadian studies are not conclusive. There is a need for further investigation of the ‘relative income’ hypothesis in the Canadian population. Objectives: The primary objective of this research was to test the “relative income” hypothesis across Canadian health regions. The second objective was to extend the first hypothesis to consider rural versus urban populations in Canada. Methods: This research involved ecological analyses. The source of the data was the Canadian Community Health Survey, CCHS 2005 cycle 3.1. The units of analysis were health regions of Canada. Health of a region was estimated as the percentage of people who rated their health as good or excellent. The primary exposure variable was the ratio of people whose personal income was less than $15,000 relative to those reporting more than $80,000. Correlation analyses and multiple linear regressions were performed to ascertain the relationship between income inequality and health status in populations, adjusting for important covariates. Results: The measure of relative income inequality alone appeared to explain 18 per cent of the variability in the measure of health status in populations. However, after adding the measure of absolute income to the model, although 29 per cent of the variability was explained, the independent contribution of the inequality measure became non-significant. Linear regression models suggested that the absolute income variable alone could explain 30 per cent of the variance in the health status of populations. Other variables with a statistically significant contribution to the final multiple regression model were education and alcohol consumption. Rural/urban status did not change the individual relationship between relative income inequality or absolute income and the measure of health status in populations. Conclusion: Across Canadian health regions, health status in populations was a function of absolute income but not relative income. Regions with higher levels of education had better levels of self-rated health. A larger percentage of heavy drinkers was also correlated with lower population health status. The study findings have implications for public health, economic policies, and social policies. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2008-09-17 15:32:27.341

Abstract Objectives The relationship between work-life conflict and self-rated health is widely researched but whether the association differs according to educational level has received less attention. This study investigated the association of work-life conflict with self-rated health taking gender, education, working conditions and socio-demographic characteristics into account. Methods The cross-sectional data came from the ELSA-Brasil (2008-2010), a cohort study of civil servants 35-74 years old from six states of Brazil. Complete information was available for 12121 individuals (48% men). Work-life conflict was measured by four indicators representing different aspects, i.e. work-to-family time-based, work-to-family strain-based, family-to-work and lack of leisure time. Multiple logistic regression analyses stratified by gender and educational level were performed. Results More frequent work-life conflict was associated with poor self-rated health in all the indicators. The magnitude of association was greater for women and the same occurred with the higher educated respondents. An exception is in the family-to-work indicators where it affected lower educated women more than higher educated. Conclusions There is an association between work-life conflict and self-rated health and it differs according to work-life conflict indicator. Stratifying by gender and educational level presents an important addition to research in the field of work-life conflict.

Objectives: The overall aim was to investigate determinants and consequences of global non-comparative self-ratings of health (SRH). Concerning determinants, the aim was more specifically to investigate the association between age, year of investigation, stress-theory based psychobiological variables, and SRH. Materials and methods: Papers I and IV were based on eight ongoing population-based cohort studies, with sampling performed 1973-2003. The study-population consisted of 11,880 men and women, aged 25-99 years, providing 14,470 observations. Papers II and III were based on a longitudinal study of 212 adult, healthy, women and men. Results: In women, SRH declined linearly with age and year of investigation, after adjustment for influence of covariates, while in men the association was based on a third degree polynomial function. The most important covariates were complaint score, sick-leave or disability pension, and leisure time physical activity. The final model explained 76.2% of the variance in women and 74.5% in men. SRH was directly associated with psychological resources and inversely associated with psychological strain, in healthy, adult, women and men. In men with SRH which decreased to fair or poor, higher levels of prolactin and lower levels of testosterone were observed at follow-up as compared to baseline. There were no associations between endocrine variables and SRH in women. There was a significant inverse association between SRH and mortality, disability pension, and sick-leave during follow-up, in women and men, adjusted for covariates. Associations between SRH and mortality were robust during the follow-up period. Conclusions: Age and year of investigation were associated with SRH, but differently in women and men. Psychological resources and psychological strain were consistently associated with SRH, but there were no robust associations between endocrine measures and SRH. SRH was associated with mortality, disability pension, and sick-leave, during follow-up. The association between SRH and mortality was robust during the follow-up period

Thesis (M.S.)--Boston University PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Objective: To determine ifself-rated health modifies the effect ofbaseline walking limitation on 5- and 10-year mortality in older women with early stage breast cancer Design: Secondary analysis of a multicenter 10-year prospective study of older women with early stage breast cancer Setting: Sixty-two clinical centers in four geographic areas Participants: 585 women aged 65 years or older with Stage I to IIIa breast cancer who were followed by annual telephone calls for up to 10 years. Measurements: Baseline self-rated health, ability to walk several blocks, age, race, marital status, financial status, social support, comorbid conditions, body mass index, tumor stage, estrogen receptor (ER) status, initial therapy, and emotional health. The main outcome was all-cause mortality at 5 and 10 years as determined by National Death Index and Social Security Death Index. Results: Subjects at baseline were 17% age 80+, 48% stage II-IIIa, 25% ER negative, 42% with ≤1 comorbid condition. At the time of breast cancer diagnosis, 39% of women reported low self-rated health, and 28% reported limitations in walking several blocks. Those with low self-rated health and walking limitation had higher mortality rates than those with high self-rated health and without walking limitation (28.1% vs. 12.7% at 5 years, p = 0.0002; 67.8% vs. 34.9% at 10 years, p < 0.0001). In the adjusted regression model, risk of dying from any cause by 10 years was higher for women aged 80+ (HR 3.87, 95% CI 2.45, 6.11); age 70-79 (HR 1.54, 95% CI 1.06, 2.24); with inadequate finances (HR 1.73, 95% CI 1.13, 2.65); and with the combination of low self-rated health and walking limitation at baseline (HR 1.48, 95% CI 1.02, 2.15). Conclusion: In this study of older women with breast cancer, the combination of low self-rated health and limitation in walking several blocks at diagnosis was a predictor of all-cause mortality at 10 years of follow-up; this finding was independent of age, comorbidity, tumor characteristics, and treatment. These self-report measures can be easily assessed in clinical practice and may represent an effective strategy to improve treatment decision-making in older adults with cancer.

This study was done to examine the relationship between self-rated health and social/community relations. Due to advances in modern medicine, multifactorial diseases are more prevalent than acute infectious diseases and a greater understanding of the impact sociological variables has on health is of great importance. In prior research, self-rated health has been demonstrated to be a robust predictor of mortality, even when controlling for other variables known to impact health. Presence of a strong social network and attachments to community have been shown to be protective of self-perceptions of health. The Health and Living study was conducted in the Bear River Health District located in northern Utah in 2004 utilizing a mail survey. The relationship between self-rated health and social network indicators in addition to community attachment variables was evaluated statistically. Demographic variables were also analyzed. Church attendance, number of friends, income, age, and education were found to be statistically significant.

Remarriage has gained special attention in the past couple of decades from clinicians, researchers, and educators because of the unique issues faced by individuals entering such a relationship. Recognition of these issues increased marriage practitioners' hope that a shift in the social climate had led individuals to prepare for remarriage through various means. This study sought to, one, gain a current perspective on remarriage preparation; two, learn how individuals rate the helpfulness of preparation; and three, note any differences in remarital quality (remarital satisfaction and adjustment) and perceptions of preparedness between individuals who did or did not participate in preparation. Data were analyzed from the Utah Newlywed Study. Results showed that most individuals prepared by talking to others or read ing written information, and most individuals who participated in some form of preparation found it helpful. Despite a high number of participants who reported remarriage preparation as helpful, nonparticipants were more plentiful than participants. The majority of those who did not participate reported preparation as unnecessary. Remari tal quality varied based on the preparation form considered. Based on the resu lts, it was suggested that marriage practitioners should do more to increase individuals' views that preparation is valuable, as those who participated generally found it to be helpful.