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.

Neighborhoods are composed of physical, social, and cultural environmental factors that influence health and health behaviors. These factors include chronic stressors that are associated with premature mortality. Determining the role of neighborhoods on health is challenging due to individual exposure to multiple types of stressors, and discerning effects of individual stressors from co-occurring neighborhood stressors. This dissertation investigates the role of neighborhood and individual stressors on physical activity, self-rated health, and depressive symptoms in the environmental justice community of Chelsea, Massachusetts. We interview 354 Chelsea residents aged 18 years and older using open- and closed-ended questions that address health-related topics and perceptions of the environment. We use GIS-based methods to map resident-defined neighborhoods and their relation to attributes of the physical environment, and regression models to quantify relationships between neighborhood factors and individual stressors with health outcomes. We also incorporate responses to open-ended interview questions to develop physical activity outcomes. We report positive associations between exposure to neighborhood factors and adverse outcomes. Noise, feeling unsafe, and low social cohesion display positive correlations with poor self-rated health and depressive symptoms. Proximity to resident-preferred parks is positively correlated with physical activity, while knowledge of rape or sexual assault is inversely associated with physical activity. Individual stressors, such as health conditions and disability, are positively associated with all adverse outcomes. Including neighborhood factors and individual stressors in the same model does not change any associations. We conclude that neighborhood factors are independent sources of chronic stress that influence health and health behaviors. In the literature, the outcomes we study are associated with premature mortality. This fact, coupled with the associations we see between our outcomes and neighborhood factors, suggest that aspects of neighborhoods can increase risk for premature mortality. Health could also be improved on an individual level by providing resources to buffer against the negative effects of disability and reported financial problems, such as a sudden loss of income or food insecurity. Environmental policies related to neighborhood conditions should consider the effects of neighborhoods factors on health as a systematic method of improving health.

No description available.

The frequently studied concept of social capital has often been related to health, but theconceptualisationand measurement of the conceptisanon-goingdebate. The main aim of this thesis is to study the relationship of four different indicators of social capital; informal social capital, formal social capital, trust towards institutions and trust towards others, with self-rated physical health and self-rated mental health in Iceland in 2009, shortly after a harsh economic crash. Insomnia symptoms will be studied as a possible mediator or moderator in the relationship. Furthermore, longitudinal data on informal social capital will be used to see the causal effect of social capital on health and to see if informal social capital decreased after the economic collapse. Population-based panel data from Iceland in 2007 and 2009 will be used to perform both cross-sectional analysis (n = 3,243) and longitudinal analysis (n = 3,131). The main results are that the four indicators of social capital all relate differently to physical and mental self-rated health, and insomnia symptoms seem to mediate the relationship between social capital and health, especially physical health. Surprisingly, informal social capital did increase during the economic collapse. The panel analysis further suggests that having poor informal social capital has causal effects on poor self-rated mental health when adjusted for symptoms of insomnia, age, gender, family status, education and smoking.

Orientador: Anita Liberalesso Neri / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-16T19:36:47Z (GMT). No. of bitstreams: 1 White_HarrietJane_M.pdf: 1085400 bytes, checksum: e369eff02a7b34fb4c09790e4f1664ff (MD5) Previous issue date: 2010 / Resumo: Objetivos: investigar relações entre estado nutricional indicado pelo IMC, perda de peso não-intencional, condições funcionais para a alimentação e autoavaliações de saúde bucal e de saúde global em mulheres e homens idosos recrutados na comunidade. Métodos: participaram 689 idosos (470 mulheres; 65 a 90 anos, M = 72,28 + 5,40; renda familiar mensal de < 1 > 10 salários mínimos, M = 4,72 + 5,27), selecionados da amostra probabilística do Estudo FIBRA Campinas. Foram feitas medidas de peso, altura e IMC e aplicadas questões de autorrelato para medida das demais variáveis. Resultados: Vinte e oito por cento pontuaram para obesidade, 14,39% para pré-obesidade e 14,83% para baixo peso; 24,86% tinham perdido peso no ano anterior; 30% da amostra tinham problemas de mastigação; 20% tinham pelo menos 3 problemas funcionais para alimentação; 72,41% pontuaram alto em autoavaliação da saúde bucal, 58,86% em autoavaliação da saúde global. Mais mulheres e mais idosos de 65 a 74 anos pontuaram para obesidade; mais idosos de baixa renda perderam peso e tinham problemas funcionais para a alimentação. Piores condições funcionais para a alimentação e renda inferior a 5 SM mostraram-se fortemente associados com autoavaliações negativas de saúde bucal e de saúde global, sendo esta mais afetada do que a primeira. Conclusão: Autoavaliações negativas de saúde tendem a associar-se com autocuidado deficitário, que pode agravar os problemas de mastigação, deglutição e paladar e as comorbidades provavelmente associadas. A pobreza potencializa esses prejuízos, por relacionar-se com problemas de acesso e de qualidade dos serviços de saúde. / Abstract: Objectives: to investigate the relation between nutritional status indicated by BMI, unintentional weight loss, functional conditions of feeding and self-rated oral health and global health in elderly women and men recruited in the community. Methods: 689 elderly participated (470 women; 65 -90 years old, M = 72,28 + 5,40; familiar monthly income from < 1 > 10 minimum wages, M = 4,72 + 5,27), selected from a random sample of Study FIBRA-Campinas about frailty. It was taken weight measurements, height and BMC and applied questions of self report to measure the rest of the variables. Results: Twenty-eight percent scored for obesity, 14,39% for pre-obesity and 14,83% for low weight; 24,86% had lost weight last year; chewing problems were the most frequent (30% of the samples); 20% had at least 3 functional problems for feeding; 72,41% showed high score of self-rated oral health, 58,86% in global health. More women and elderly from 65 to 74 years old scored obesity; more elderly with low incomes lost weight and had functional problems for feeding. The worst functional conditions for feeding and incomes below 5 minimum salaries were strongly associated with negative self-rated oral health and global health, and the last one being more affected than the first one. Conclusion: Negative self-assessments of health tends to associate to low self-care, that can aggravate chewing problems, taste and swallowing, and the probably comorbidities associated. The poverty powers the damage, because it has relations with access problems and health quality services. / Mestrado / Mestre em Gerontologia

Hälsoutveckling i Sverige går framåt, men den självskattade hälsan är låg. Självskattning är ett mått som baseras på individens egen uppfattning av sin hälsa. Hälsa är en subjektiv uppskattning där varje individ har sin syn på upplevelse av hälsa. Autonomi, social gemenskap och begriplighet är olika dimensioner av hälsobegreppet som baseras på patienters upplevelse av hälsa. Många mätinstrument inom sjukvården idag har för avsikt att mäta hälsa genom frånvaro av symtom. Syftet med denna studie var att undersöka hur patienter på en allmänpsykiatrisk öppenvårdsmottagning självskattar sin hälsa utifrån dimensionerna autonomi, social gemenskap och begriplighet. Metoden som användes var en tvärsnittsstudie med kvantitativ ansats. En enkätundersökning utfördes under tre veckor. Resultatet baseras på 49 stycken enkäter. Resultatet visar att autonomidimensionen skattades lägst medelvärde samt att deltagarna skattade högst medelvärde på påståendet ”kan bry mig om andra”. Slutsatsen i denna studie visar att det låga värdet inom dimensionen autonomi kan bero på sjuksköterskornas arbetsklimat och medicinska synsätt. Implikationer i vården som fynden kan medföra kan vara en ökad medvetenhet kring självskattad hälsa både hos patienter och hos sjuksköterskor. / Health development in Sweden is advancing, but the self-rated health is low. Self-assessment is a measure based on the individual's own perception of their health. Health is a subjective estimate where each individual has his views on the experience of health. Autonomy, social community and understandability are different dimensions of the concept of health based on the patients' experience of health. Many measuring devices in healthcare today intends to measure  health by the absence of symptoms. The purpose of this study was to ask how patients in a general psychiatric outpatient clinic self-rate their health on the basis of the dimensions of autonomy, social community and comprehensibility. The method used was a cross-sectional study with quantitative approach. A survey was conducted over three weeks. The result is based on 49 questionnaires. The result shows that the autonomy dimension were estimated lowest average and that the participants estimated highest average on the claim "can care about others." The conclusion of this study is that one reason to low value in the dimension autonomy may depend on the nurses' working environment and medical approaches. Implications of care is that the findings may lead to an increased awareness of self-rated health among both patients and nurses.

The number of persons who are not employed has increased in Sweden since the early 1990s. Unemployment has been found to influence health, especially when unemployment rates are low. The extent to which unemployment affects health when unemployment is high is less clear, and this needs to be further studied. To improve health in the population, the health care system should offer equal access to health care according to need. It is important to study whether the employment status hinders the fulfilment of this goal. This thesis is based on four papers: Paper I and II aimed at analysing self-rated health versus mortality risk in relation to employment status, during one period of low unemployment and one period of high unemployment. Paper III and IV assessed the use of medical health care services and unmet care needs among persons who were unemployed or otherwise not employed. The goal was to analyse what health problems lead people to either seek or abstain from seeking care, and what factors encumber or facilitate this process. The overall results indicate that being unemployed or outside the labour force was associated with an excess risk of poor self-rated health, symptoms of depression, mental and physical exhaustion and mortality. The differences in self-rated health between the unemployed and employed were larger when unemployment levels were high, than when they were low. More groups of the unemployed were also afflicted with poor health when unemployment was high. Thus, poor health among the unemployed seems to be a public health problem during high levels of unemployment. Lack of employment was related to abstaining from seeking care, despite perceiving a need for care, and this was related to psychological symptoms. To deal with the needs of the unemployed and others who are outside the labour force it would be useful to develop and implement interventions within the health care system. These should focus on psychological and psychosocial problems. Future research should analyse how to facilitate health-promoting interventions among persons who are not anchored in the labour market.