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Self-rated health and indicators of SES among the ageing in three types of communities

Health Promotion Unit, Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute (KTL), Helsinki, Finland, olli.nummela{at}ktl.fi

Tommi T. Sulander

Health Promotion Unit, Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute (KTL), Helsinki, Finland

Heikki S. Heinonen

Health Promotion Unit, Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute (KTL), Helsinki, Finland

Antti K. Uutela

Health Promotion Unit, Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute (KTL), Helsinki, Finland

Aims: This paper examines associations between self-rated health, three indicators of SES (self-reported education, disposable household income, adequacy of income) and three types of communities (urban, densely or sparsely populated rural areas) among ageing men and women in the Province of Päijät-Häme, Southern Finland. There is a lack of knowledge regarding the magnitude of community type when examining the relation between subjective health and SES. Methods: Cross-sectional questionnaire data gathered in the spring of 2002 for a prospective follow-up of community interventions were used. These data, together with a number of clinical and laboratory measurements, yielded the baseline for a 10-year community intervention study. A representative stratified (age, gender, area) sample of men and women living in the province and belonging to the birth cohorts 1926—1930, 1936—1940, and 1946—1950 was obtained from the National Population Registry. The target sample was 4,272, with 2,815 persons responding (66% response rate). Results: Positive associations between indicators of SES and self-rated health were observed in all three community types. After adjusting for other factors, adequacy of income showed the strongest (positive) association with self-rated health in urban areas in all age groups. A similar pattern of associations, with varying statistical significance, though, was found in the two rural areas. Conclusions: This study supports the view that while actual income is positively correlated to health, adequacy of income is an even stronger predictor of it. Thus, there was a significant link between better financial standing and good health among ageing people, especially in urban areas.

Key Words: Adequacy of income • ageing • community intervention • self-rated health • urban—rural dimension

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