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Subjective Health Assessments Among Older Adults in Mexico

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Abstract

The validity of the general self-rated health (SRH) assessment is well established; however, there are empirical questions as to the utility of health assessment measures that employ more refined comparisons. The aim of this study is to examine subjective health assessment measures in comparison to the most widely used SRH measure (Global SRH) among men and women. We investigate agreement between these measures, by gender, and their correspondence with objective health conditions using a sample of adults over the age of 60 from the 2006 La Encuesta Nacional de Salud y Nutrición (ENSANUT). ENSANUT is a nationally representative, repeated cross-sectional Mexican survey (n = 5511) and advantageous given its inclusion of three distinct subjective health assessment questions including: global self-rated health, self-rated heath today, and 12-month self-rated health. First, we descriptively examine demographic characteristics of the sample and the degree of correspondence between health ratings. Then, we explore congruence between objective health conditions and subjective-health ratings within each SRH measure. We estimate three ordered logistic regression models testing responses on a three-point scale and use predicted probabilities for interpretation. Our findings reaffirm the role of physical health conditions as strong predictors of poor SRH and highlight the significance of mental health as a determinant of subjective health in this sample of older Mexican adults. We caution that future research examining older adults’ health should carefully consider the type of subjective health assessment used.

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Notes

  1. Unemployed includes those who answered they did not have work or had not had work for more than 2 weeks. Employed includes those who answered they work or have worked in the past 2 weeks.

  2. http://hdr.undp.org/sites/default/files/mexico.do.

  3. Social Security includes responses for other, particular, or civil servant insurance schemes due to limited sample sizes in these categories.

  4. Respondents classified as underweight, roughly 2% of the sample, were excluded.

  5. We tested models that included the objective health conditions separately and tested the correlation of the conditions and obesity, but found no issues of multicollinearity, and generated the same substantive conclusions from the models with a summary indicator of conditions. The strongest correlation was between high cholesterol and hypertension at 0.223. Regression results are available from the authors.

  6. When we tested the three measures separately we found that they were highly correlated and yielded a high alpha, yet were not collinear with other health conditions. Therefore we consider them as a summed unit.

Abbreviations

SRH:

Self-rated health

SES:

Socioeconomic status

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Authors and Affiliations

  1. Department of Health Sciences, University of Missouri, 501 Clark Hall, Columbia, MO, 65211, USA

    Alison Reynolds & Claire E. Altman

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  1. Alison Reynolds
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  2. Claire E. Altman
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Correspondence to Claire E. Altman.

Appendix

Appendix

See Table 6, Figs. 1, 2, and 3.

Table 6 Spanish and English health question translation, ENSANUT 2006
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Reynolds, A., Altman, C.E. Subjective Health Assessments Among Older Adults in Mexico. Popul Res Policy Rev 37, 825–850 (2018). https://doi.org/10.1007/s11113-018-9472-6

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