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To evaluate the extent to which a person’s educational attainment moderates the relationship between his or her objective markers of health and self-rated health (SRH).

I use 10 years’ worth of data from the National Health and Nutrition Examination Survey (NHANES 1999–2009; N = 30,823) to examine how diagnosed medical conditions, health behaviors, and biomarkers are differentially associated with SRH by educational attainment. I use regression analysis to evaluate these relationships.

Results show that while medical conditions are negatively associated with SRH equally across education levels, behaviors and biomarkers have stronger association with SRH among individuals with greater education. Those with more education are more likely to have had their blood pressure and cholesterol checked in recent months. They are also more likely to correctly identify themselves as overweight when their body mass index exceeds 25.

The chapter’s findings indicate that education may play a role in how people interpret and evaluate their own health. Real differences in how people evaluate their health can impact the conclusions that researchers can draw when comparing SRH between education groups. In addition these results can motivate further research in the causes of health disparities. Self-evaluation of health can potentially influence how people monitor and manage their health. Differences in self-evaluation between levels of educational attainment could contribute to disparities in health and mortality.

This chapter examines the relationship between self-rated health, objective markers of health, and education in a novel framework.

Purpose: This study examines the relationship between marital satisfaction and sexual satisfaction, as well as other contributing factors, in the lives of older American adults.

Design/methodology/approach: Data from a restricted sample (N = 1,278) from the second wave of the National Social Life, Health, and Aging Project (NSHAP) was analyzed. Regression models were used to examine associations with marital satisfaction.

Findings: Within ordinary least squares regression gender, education level, mental health, self-rated happiness, the absence of sexual quality, physical satisfaction, and emotional satisfaction were each statistically significant. Females reported higher marital satisfaction than males. Higher educated individuals expressed less satisfaction within their marriages than those with less formal education. Those that rated their mental health, happiness, and physical and emotional satisfaction high also reported higher marital satisfaction. Participants that reported an absence of sexual quality generally rated their marital satisfaction lower.

Originality/value: Most studies focus on the experiences of younger and middle-aged adults, often excluding older adults. Further, while there have been efforts to focus more research on the relationships of adults in midlife to late life, sexuality is still largely ignored.

The purpose of this paper is to examine the association between immigrants’ sense of community belonging and self-rated general and mental health status in Canada as well as estimate how this relationship is moderated by sex differences.

This cross-sectional study used pooled data from seven cycles of the Canadian Community Health Survey (N = 98,011) conducted between 2005 and 2018. Data were pooled to increase the sample size of the immigrant population. The surveys covered content areas such as well-being, sociodemographic, chronic diseases, self-rated general and mental health. A binary logistic regression fitted the model. Both univariate and multivariate analyses were performed between predictor variables and immigrants’ self-rated general and mental health. Descriptive statistics and adjusted odds ratios and 95% confidence intervals were estimated. Sex differences were also assessed.

This study found that slightly more than half of the respondents were female (53.2%). Generally, immigrants with a weak sense of community belonging were more likely to rate their general and mental health as poor although the association is stronger in mental health. Also factors such as older age, lower educational level, those single or never married, smoking status, physical inactivity, overweight or obesity and life stress were predictors of both poor self -rated general and mental health among immigrants. Sex differences in these risk factors were also noted.

This study has several limitations that should be noted. The first limitation is the fact that causality cannot be deduced due to the cross-sectional nature of our pooled data. Secondly, responses from this data are subject to recall bias given that the data were self-reported. Therefore, the interpretation of these results must be done with caution. Further, questions regarding the primary exposure variable of this study were restrictive. The definition of the local community which forms part of the one-item community belonging question did not define what is meant by local community, and as such, the question might be subject to different interpretations (i.e. urban or rural geography?). Lastly, this study’s findings did not stratify immigrants into countries or continents of origin. Immigrants from some countries or continents may be more prone to mental health than others.

This study shows a link between weak immigrants’ sense of community belonging and poor self-rated general and mental health status in Canada and provides suggestive evidence of how contextual factors influence health outcomes differently in society.

A large extant literature examines the association between unemployment and self-rated health. Most of these studies reveal that unemployment diminishes self-rated health. Another strand of this literature, albeit sparse, suggests that the relationship between unemployment and self-rated health is gendered. The purpose of this paper is twofold: first, to examine whether unemployment is correlated with self-rated health in Ghana; and second, to explore whether and to what extent men differ from women on the basis of this relationship.

The authors used data from the Wave 6 of World Values Survey in Ghana (n=1552) and probit and instrumental variable probit regressions to empirically examine the association between unemployment and self-rated health in Ghana.

The results confirm that unemployment is negatively correlated with self-rated health among Ghanaians. Specifically, the unemployed are about 6.84–7.20 percent less likely to report good health status in a pooled sample. Further, after correcting for endogeneity, unemployed men are about 26.68 percent less likely to report good health. However, the association is not statistically significant for unemployed women.

The study contributes to the literature by providing empirical evidence from Ghana.

Although established theoretical models suggest that race differences in physical health are partially explained by exposures to environmental toxins, there is little empirical evidence to support these processes. We build on previous research by formally testing whether black–white differences in self-rated physical health are mediated by the embodiment of environmental toxins.

Using cross-sectional data from the National Health and Nutrition Examination Surveys (2007–2008), we employ ordinary least squares regression to model environmental toxins (from urine specimens) and overall self-rated health as a function of race and ethnicity. We employ the Sobel test of indirect effects to formally assess mediation.

Our results show that non-Hispanic black respondents tend to exhibit higher levels of total toxins, lead, and cadmium in their urine and poorer physical health than non-Hispanic whites, even with adjustments for age, gender, and socioeconomic status (SES). Our mediation analyses suggest that blacks may exhibit poorer physical health than whites because they tend to embody higher levels of cadmium.

Research limitations include cross-sectional data and restricted indicators of SES.

This study contributes to previous work by bridging the fields of social epidemiology and environmental inequality and by formally testing established theoretical models.

The purpose of this paper is to compare sickness presence (SP) and sickness absence (SA) regarding the strength of their relationship to health/ill‐health. In a previous Canadian study a stronger association between SP and health/ill‐health than between SA and health/ill‐health was shown.

Five Swedish data sets from the years 1992 to 2005 provided the study populations, including both representative samples and specific occupational groups (n=425‐3,622). Univariate correlations and multiple logistic regression analyses were performed. The data sets contained questions on SP and SA as well as on various health complaints and, in some cases, self‐rated health (SRH).

The general trend was that correlations and odds ratios increased regularly for both SP and SA, with SP showing the highest values. In one data set, SRH was predicted by a combination of the two measures, with an explained variance of 25 percent. Stratified analyses showed that the more irreplaceable an individual is at work, the larger is the difference in correlation size between SP and SA with regard to SRH. SP also showed an accentuated and stronger association with SRH than SA among individuals reporting poor economic circumstances.

The results support the notion that SA is an insufficient, and even misleading, measure of health status for certain groups in the labor market, which seem to have poorer health than the measure of SA would indicate.

A combined measure of sickness presence and absence may be worth considering as an indicator of both individual and organizational health status.

Introduction. This study examined the association between self-rated physical and oral health, cigarette smoking, and history of criminal justice contact (i.e., never arrested; arrested, but never incarcerated; or incarcerated in reform school, detention, jail, or prison) among African American men and women. Methods. We conducted descriptive statistical, linear regression, and multinomial regression analyses of the African American subsample (n = 3,570) from the National Survey of American Life (2001–2003). Results. Overall, African American women reported lower arrest rates and histories of incarceration than African American men. Additionally, we found that criminal justice contact was associated with lower self-rated physical health and oral health and higher levels of smoking for both men and women. African American women who had been arrested and detained in facilities other than jail had more chronic health problems than their male counterparts. Furthermore, having been arrested or spent time in a reform school, detention center, jail, or prison significantly increased the odds of African American men being a current smoker. Lastly, among African American women, those who had any level of criminal justice contact were likely to be current smokers and former smokers compared to those without a history of criminal justice contact. Conclusion. Addressing the health of African Americans with criminal justice contact is a critical step in reducing health disparities and improving the overall health and well-being of African American men and women. Furthermore, attention to differences by gender and specific types of criminal justice contact are important for a more precise understanding of these relationships.

This study tests the first two tenets of the fundamental causes theory – that socioeconomic status influences a variety of risk factors for poor health and that it affects multiple health outcomes – by examining the associations between adverse socioeconomic circumstances and five measures of health.

We employ bivariate and logistic regression analyses of data from the Centers Disease Control and Prevention 2011 Behavioral Risk Factor Surveillance Survey (BRFSS) to test the individual and cumulative associations between three measures of socioeconomic position and five measures of health risk factors and outcomes.

The analysis demonstrates support for the fundamental causes theory, indicating that measures of adverse socioeconomic conditions have independent and cumulative associations with multiple health outcomes and risk factors among U.S. adults aged 18–64.

The findings of this chapter are generalizable to adults aged 18–64 living in the United States and may not apply to individuals living outside the United States, older Americans, and children.

Adverse socioeconomic circumstances are not only associated with self-rated health but are also associated with the two leading causes of death in the United States (cancer and heart disease) and risk factors that contribute to these causes of death (smoking and high blood pressure). Improving access to socioeconomic resources is critical to reducing health disparities in leading causes of death and health risk factors in the United States.

The purpose of this paper is to investigate general psychosocial work conditions and specific workplace health promotion (WHP) measures in relation to employee health and sickness absence in Swedish municipal social care organizations.

In a random sample of 60 out of the 290 municipalities in Sweden, 15,871 municipal social care employees working with elderly and disabled clients were sent a questionnaire concerning psychosocial work environment, WHP, and self-rated health. The responses (response rate 58.4 per cent) were complemented by register data on sickness absence (>14 days). All data were aggregated to employer level.

A structural equation modelling analysis using employer-level data demonstrated that employers with more favourable employee ratings of the psychosocial work conditions, as well as of specific health-promoting measures, had better self-rated health and lower sickness absence level among employees.

The results from this representative nationwide sample of employers within one sector indicate that employers can promote employee health both by offering various health-specific programmes and activities, such as work environment education, fitness activities, and lifestyle guidance, as well as by forming a high-quality work environment in general including developmental and supportive leadership styles, prevention of role conflicts, and a supportive and comfortable social climate.

This study with a representative nationwide sample demonstrates: results in line with earlier studies and explanations to the challenges in comparing effects from specific and general WHP interventions on health.

This study explores whether and how Internet usage improves the subjective health of middle-aged and older adults by analyzing the mediating role of social engagement and heterogeneity of different living arrangements.

Based on data from the China Health and Retirement Longitudinal Study, the ordinary least squares (OLS) method is adopted to explore the relationship between Internet usage and the subjective health of middle-aged and older adults. Propensity score matching method (PSM) is used to alleviate self-selection bias in the samples. The bootstrap method is adopted to test the mediating role of social engagement, and generalized structural equation modeling (GSEM) is employed to resolve endogeneity. A permutation test is adopted to examine the heterogeneous effects of Internet usage on different living arrangements.

Internet access can help relieve depression among middle-aged and older adults and enhance their self-rated health, leading to perceived changes in health status. However, Internet usage is not directly associated with health satisfaction among middle-aged and older adults. Nevertheless, Internet usage can enhance middle-aged and older adults' subjective health by facilitating social engagement and significantly influences middle-aged and older adults living with their children.

This study reveals the underlying role of Internet usage among older adults and provides insights for governments and families to help middle-aged and older adults actively adapt to a digital society and improve their health.