Self-rated health and its determinants among adults in Syria: A model from the Middle East

Syrian Centre for Tobacco Studies, Aleppo, Syria.
BMC Public Health (Impact Factor: 2.26). 02/2007; 7(1):177. DOI: 10.1186/1471-2458-7-177
Source: PubMed


Self-rated health (SRH) has been widely used to research health inequalities in developed western societies, but few such studies are available in developing countries. Similar to many Arab societies, little research has been conducted in Syria on the health status of its citizens, particularly in regards to SRH. This Study aims to investigate and compare determinants of SRH in adult men and women in Aleppo, Syria.
A cross-sectional survey of adults 18 to 65 years old residing in Aleppo (2,500,000 inhabitants), Syria was carried out in 2004, involving 2038 household representatives (45.2% men, age range 18-65 years, response rate 86%). SRH was categorized as excellent, normal, and poor. Odds ratios for poor and normal SRH, compared to excellent, were calculated separately for men and women using logistic regression.
Women were more likely than men to describe their health as poor. Men and women were more likely to report poor SRH if they were older, reported two or more chronic health problems, or had high self perceived functional disability. Important gender-specific determinants of poor SRH included being married, low socioeconomic status, and not having social support for women, and smoking, low physical activity for men.
Women were more likely than men to describe their health as poor. The link with age and pre-existing chronic conditions seems universal and likely reflects natural aging process. Determinants of SRH differed between men and women, possibly highlighting underlying cultural norms and gender roles in the society. Understanding the local context of SRH and its determinants within the prevailing culture will be important to tailor intervention programs aimed at improving health of the Syrian and similar Arab societies.

Download full-text


Available from: Tanja P Mulloli, Oct 03, 2015
16 Reads
  • Source
    • "In 2010, Syria had 1.5 hospital beds and physicians available per 1,000 population, while the number of nurses and midwives was slightly greater at 1.9 (UNDP 2012). Few mental health resources were available nationally (0.5 psychiatrists/psychiatric nurses per 100,000), in contrast to the high need for mental health support, especially for women who suffer disproportionate burden of mental distress (Maziak et al. 2002; Asfar et al. 2007). Government expenditure on health as a percentage of GDP has decreased by nearly 30 % between 2000 and 2010 (from 4.9 to 3.4 %). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: To document the ongoing destruction as a result of the tragic events in Syria, to understand the changing health care needs and priorities of Syrians. Methods: A directed examination of the scientific literature and reports about Syria before and during the Syrian conflict, in addition to analyzing literature devoted to the relief and rebuilding efforts in crisis situations. Results: The ongoing war has had high direct war casualty, but even higher suffering due to the destruction of health system, displacement, and the breakdown of livelihood and social fabric. Millions of Syrians either became refugees or internally displaced, and about half of the population is in urgent need for help. Access to local and international aid organizations for war-affected populations is an urgent and top priority. Conclusions: Syrians continue to endure one of the biggest human tragedies in modern times. The extent of the crisis has affected all aspects of Syrians' life. Understanding the multi-faceted transition of the Syrian population and how it reflects on their health profile can guide relief and rebuilding efforts' scope and priorities.
    International Journal of Public Health 07/2014; 60(S1). DOI:10.1007/s00038-014-0586-2 · 2.70 Impact Factor
  • Source
    • "Globally, there is a large body of literature on the psychosocial and socioeconomic determinants of SRH. It is known to worsen as age advances, and women are more likely to report poor SRH compared to men (21–23). Limitations in physical and mental function – sleep, mobility, cognition – are strongly associated with poor SRH (24–26). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This thesis is centered on self-rated health (SRH) as an outcome measure, as a predictor, and as a marker. The thesis uses primary data from the WHO Study on global AGEing and adult health (SAGE) implemented in India in 2007. The structural equation modeling approach is employed to understand the pathways through which the social environment, disability, disease, and sociodemographic characteristics influence SRH among older adults aged 50 years and above. Cox proportional hazard model is used to explore the role of SRH as a predictor for mortality and the role of disability in modifying this effect. The hierarchical ordered probit modeling approach, which combines information from anchoring vignettes with SRH, was used to address the long overlooked methodological concern of interpersonal incomparability. Finally, multilevel model-based small area estimation techniques were used to demonstrate the use of large national surveys and census information to derive precise SRH prevalence estimates at the district and sub-district level. The thesis advocates the use of such a simple measure to identify vulnerable communities for targeted health interventions, to plan and prioritize resource allocation, and to evaluate health interventions in resource-scarce settings. The thesis provides the basis and impetus to generate and integrate similar and harmonized adult health and aging data platforms within demographic surveillance systems in different regions of India and elsewhere.
    Global Health Action 04/2014; 7(1):23421. DOI:10.3402/gha.v7.23421 · 1.93 Impact Factor
  • Source
    • "Chronic diseases, chronic pain and physical disability are significant predictors of self-rated health [11], [12], [13], [14]. Perceived health also varies according to age, gender, ethnicity, education, income, unemployment, and lifestyle factors such as smoking and physical inactivity [15], [16], [17], [18], [19], [20]. The ethnic differentials in health assessments have rarely been addressed, particularly in low and middle-income countries. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper examines the ethnic and gender differentials in high blood pressure (HBP), diabetes, coronary heart disease (CHD), arthritis and asthma among older people in Malaysia, and how these diseases along with other factors affect self-rated health. Differentials in the prevalence of non-communicable diseases among older people are examined in the context of socio-cultural perspectives in multi-ethnic Malaysia. Data for this paper are obtained from the 2004 Malaysian Population and Family Survey. The survey covered a nationally representative sample of 3,406 persons aged 50 and over, comprising three main ethnic groups (Malays, Chinese and Indians) and all other indigenous groups. Bivariate analyses and hierarchical logistic regression were used in the analyses. Arthritis was the most common non-communicable disease (NCD), followed by HBP, diabetes, asthma and CHD. Older females were more likely than males to have arthritis and HBP, but males were more likely to have asthma. Diabetes and CHD were most prevalent among Indians, while arthritis and HBP were most prevalent among the Indigenous groups. Older people were more likely to report poor health if they suffered from NCD, especially CHD. Controlling for socio-economic, health and lifestyle factors, Chinese were least likely to report poor health, whereas Indians and Indigenous people were more likely to do so. Chinese that had HBP were more likely to report poor health compared to other ethnic groups with the same disease. Among those with arthritis, Indians were more likely to report poor health. Perceived health status and prevalence of arthritis, HBP, diabetes, asthma and CHD varied widely across ethnic groups. Promotion of healthy lifestyle, early detection and timely intervention of NCDs affecting different ethnic groups and gender with socio-cultural orientations would go a long way in alleviating the debilitating effects of the common NCDs among older people.
    PLoS ONE 03/2014; 9(3):e91328. DOI:10.1371/journal.pone.0091328 · 3.23 Impact Factor
Show more