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Social variation in self-rated health in Estonia: a cross-sectional study

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  • Leinsalu, Mall

Abstract

Over the past 40 years Estonia has experienced similar developments in mortality to other former Soviet countries. The stagnation in overall mortality has been caused mainly by increasing adult mortality. However, less is known about the social variation in health. This study examines differences in self-rated health by eight main dimensions of the social structure on the basis of the Estonian Health Interview Survey, carried out in 1996/1997. A multistage random sample (n=4711) of the Estonian population aged 15-79 was interviewed; the response rate was 78.3%. This study includes those respondents aged 25-79 (n=4011) with analyses being performed separately for men and women. The study revealed that a low educational level, Russian nationality, low personal income and for men only, rural residence were the most influential factors underlying poor health. Education had the biggest independent effect on health ratings: for women with less than an upper secondary education the odds of having poor health were almost fourfold (OR=3.88) when compared to those with a university education, and for men these odds were almost two and a half times (OR=2.32). Material resources, in this study measured by personal income, were important factors in explaining some of the educational and ethnic differences (especially for Russian women) in poor self-rated health. Overall, we found no differences between men and women in their health ratings. On the contrary, when we controlled for physical health status, emotional distress and locus of control women reported better health than men. Health selection contributed to, but did not explain the differences by structural dimension. This study also showed a strong association of poor self-rated health with three correlates--physical health status, emotional distress and locus of control, although the influence of these correlates on poor health ratings was not seen equally in the different structural dimensions.

Suggested Citation

  • Leinsalu, Mall, 2002. "Social variation in self-rated health in Estonia: a cross-sectional study," Social Science & Medicine, Elsevier, vol. 55(5), pages 847-861, September.
    • Handle: RePEc:eee:socmed:v:55:y:2002:i:5:p:847-861
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    Citations

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    Cited by:

    1. Ivan Cipin & Sime Smolic, 2013. "Socio-Economic Determinants of Health in Croatia: Insights from Four Cross-Sectional Surveys," Croatian Economic Survey, The Institute of Economics, Zagreb, vol. 15(1), pages 25-60, April.
    2. Wiktoria Wróblewska, 2010. "Stan zdrowia w Polsce - rola czynników ekonomiczno-spo³ecznych i stylu zycia.Ocena na podstawie wskaŸnika SRH i PAR," Working Papers 22, Institute of Statistics and Demography, Warsaw School of Economics.
    3. Sime Smolic, 2017. "The determinants of health among the population aged 50 and over: evidence from Croatia," Public Sector Economics, Institute of Public Finance, vol. 41(1), pages 85-108.
    4. Rainer Reile & Mall Leinsalu, 2013. "Differentiating positive and negative self-rated health: results from a cross-sectional study in Estonia," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(4), pages 555-564, August.
    5. Joanna Jurewicz & Dorota Kaleta, 2020. "Correlates of Poor Self-Assessed Health Status among Socially Disadvantaged Populations in Poland," IJERPH, MDPI, vol. 17(4), pages 1-18, February.
    6. Masood Gheasi & Noriko Ishikawa & Karima Kourtit & Peter Nijkamp, 2019. "A meta-analysis of human health differences in urban and rural environments," Letters in Spatial and Resource Sciences, Springer, vol. 12(3), pages 167-186, December.
    7. Jerneja Farkas & Majda Pahor & Lijana Zaletel-Kragelj, 2011. "Self-rated health in different social classes of Slovenian adult population: nationwide cross-sectional study," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 56(1), pages 45-54, February.
    8. Bíró, Anikó & Prinz, Dániel, 2020. "Healthcare spending inequality: Evidence from Hungarian administrative data," Health Policy, Elsevier, vol. 124(3), pages 282-290.
    9. Cem Mete, 2008. "Economic Implications of Chronic Illness and Disability : In Eastern Europe and the Former Soviet Union," World Bank Publications - Books, The World Bank Group, number 6538.
    10. Habicht, Jarno & Kunst, Anton E., 2005. "Social inequalities in health care services utilisation after eight years of health care reforms: a cross-sectional study of Estonia, 1999," Social Science & Medicine, Elsevier, vol. 60(4), pages 777-787, February.
    11. Habibov, Nazim N. & Afandi, Elvin N., 2011. "Self-rated health and social capital in transitional countries: Multilevel analysis of comparative surveys in Armenia, Azerbaijan, and Georgia," Social Science & Medicine, Elsevier, vol. 72(7), pages 1193-1204, April.
    12. Catherine Gaumé & Guillaume Wunsch, 2010. "Self-Rated Health in the Baltic Countries, 1994–1999," European Journal of Population, Springer;European Association for Population Studies, vol. 26(4), pages 435-457, November.
    13. Wiktoria Wróblewska, 2012. "Nierówności społeczne w stanie zdrowia w Polsce – analiza na podstawie samooceny stanu zdrowia oraz poziomu wykształcenia," Collegium of Economic Analysis Annals, Warsaw School of Economics, Collegium of Economic Analysis, issue 28, pages 65-84.

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