TY - JOUR
T1 - To what extent do socioeconomic inequalities in SRH reflect inequalities in burden of disease?
T2 - The HELIUS study
AU - Galenkamp, Henrike
AU - van Oers, Hans
AU - Stronks, Karien
N1 - Funding Information: This work was supported by the Dutch Heart Foundation (2010T084), the Netherlands Organization for Health Research and Development (ZonMw: 200500003), the European Union (FP-7: 278901), and the European Fund for the Integration of non-EU immigrants (EIF: 2013EIF013). The study reported here was additionally supported by a grant from the Netherlands Organisation for Scientific Research (NWO: 319-20-002). Publisher Copyright: © 2019 The Author(s) 2019. Published by Oxford University Press on behalf of Faculty of Public Health. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/1/1
Y1 - 2021/1/1
N2 - BACKGROUND: Self-rated health (SRH), an attractive measure for health monitoring, shows persistent inequalities with regard to socioeconomic status (SES). However, knowledge on the extent to which inequalities in SRH reflect inequalities in disease burden is lacking. METHODS: Data come from the multi-ethnic HEalthy LIfe in an Urban Setting study (Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish or Moroccan origin, N = 19 379, aged 18-70). SES was defined by educational and occupational level. Disease burden was operationalized as chronic diseases, physical and mental functioning (measured with SF-12) and depressive symptoms (measured with PHQ-9). We applied logistic regression analyses and reported average marginal effects (AME). RESULTS: Dutch origin participants with low educational or low occupational level had higher probabilities of reporting fair/poor SRH, compared to the highest levels (AME = 0.20 95% CI: 0.13;0.27; and 0.12 (0.09;0.15), respectively). Associations were attenuated after adjusting for all disease burden indicators, to AME = 0.03 (0.01;0.04) and AME = 0.02 (-0.00;0.04). In all the non-Dutch origin groups, a larger part of the inequalities remained after adjustment. CONCLUSION: Socioeconomic inequalities in SRH are for a large part explained by higher disease burden in lower socioeconomic groups, but less so in those with non-Dutch origin. Future research should examine if our conclusions also hold for trend data on inequalities in SRH.
AB - BACKGROUND: Self-rated health (SRH), an attractive measure for health monitoring, shows persistent inequalities with regard to socioeconomic status (SES). However, knowledge on the extent to which inequalities in SRH reflect inequalities in disease burden is lacking. METHODS: Data come from the multi-ethnic HEalthy LIfe in an Urban Setting study (Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish or Moroccan origin, N = 19 379, aged 18-70). SES was defined by educational and occupational level. Disease burden was operationalized as chronic diseases, physical and mental functioning (measured with SF-12) and depressive symptoms (measured with PHQ-9). We applied logistic regression analyses and reported average marginal effects (AME). RESULTS: Dutch origin participants with low educational or low occupational level had higher probabilities of reporting fair/poor SRH, compared to the highest levels (AME = 0.20 95% CI: 0.13;0.27; and 0.12 (0.09;0.15), respectively). Associations were attenuated after adjusting for all disease burden indicators, to AME = 0.03 (0.01;0.04) and AME = 0.02 (-0.00;0.04). In all the non-Dutch origin groups, a larger part of the inequalities remained after adjustment. CONCLUSION: Socioeconomic inequalities in SRH are for a large part explained by higher disease burden in lower socioeconomic groups, but less so in those with non-Dutch origin. Future research should examine if our conclusions also hold for trend data on inequalities in SRH.
KW - HELIUS study
KW - chronic diseases
KW - mental health
KW - self-rated health
KW - socioeconomic inequalities
UR - http://www.scopus.com/inward/record.url?scp=85096884251&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/pubmed/fdz173
DO - https://doi.org/10.1093/pubmed/fdz173
M3 - Article
C2 - 31838505
SN - 1741-3842
VL - 42
SP - e412-e420
JO - Journal of public health (Oxford, England)
JF - Journal of public health (Oxford, England)
IS - 4
ER -