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Determinants of Poor Self-Rated Health in Late Life

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The authors examined the determinants of poor self-rated health by use of data from the Duke University site of the Established Populations for Epidemiologic Studies of the Elderly (EPESE). Study participants were community residents, 65 years of age or older, selected from five contiguous counties in the north-central Piedmont area of North Carolina. Poorer self-rated health was correlated cross-sectionally with depressive symptomatology, poor functional status, chronic disease, lower income, less education, being married, younger age, being hospitalized within the past year, and current smoking habit. The authors emphasize the importance of a comprehensive model for understanding the components of the construct of self-rated health and propose possible explanations for the significant correlates of self-rated health.

Section snippets

Sample

The data for this investigation were collected for the Established Populations for Epidemiologic Studies of the Elderly (EPESE) Project at Duke University Medical Center in 1986–1987. This is a population-based, stratified random sample, with black and rural older adult subjects oversampled. At baseline, this study sample consisted of 4,162 community residents 65 years of age or older, selected from five contiguous counties in and around Durham, NC (Durham, Granville, Vance, Warren, and

RESULTS

The characteristics of the weighted sample at baseline are described in Table 1. Approximately 15% of the sample rated their health as excellent and another 13%, poor. Over half (52.5%) of the sample never smoked, and over 80% do not consume alcohol. Nearly 10% have a suggestion of clinical depression. Over one-fourth (25.6%) of the sample reported more than three functional disabilities, and over 85% have at least one chronic disease.

Table 2 displays the linear regression analysis for the

DISCUSSION

Slightly over half of this EPESE sample from the Piedmont area of North Carolina rated their overall health as good or excellent. This proportion was similar to the New Haven EPESE sample (58.8%) and lower than the Iowa EPESE (72.6%).

This study confirms the work of previous investigators demonstrating the association of poor self-rated health with depression, poorer functional status, poorer physical health status (chronic diseases), lower income, less education, past hospitalization, and

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    The research on which this publication was based was performed pursuant to grant N01-AG-1-2102 from the National Institute on Aging, in support of the Established Populations for Epidemiologic Studies of the Elderly (Duke). Funding for the second author was provided by the John A. Hartford–Eugene A. Stead Scholarship.

    The content of this publication does not necessarily reflect the views or policies of the U.S. Department of Health and Human Services.

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