Abstract
Objectives
To analyse the influence of micro- and macro-factors on self-rated health, and the role of generation on this relationship.
Methods
Cross-sectional study using data from European Health Interview Surveys from 14 European countries. Individuals were divided into four generations (“silent generation”, “baby boomers”, and “generation X” and “Y”). We conducted multilevel analyses for each generation to study the influence of individual and national explanatory variables on self-rated health.
Results
Age showed an exponential effect in older generations. Education and employment presented the strongest association with low self-rated health, especially in “baby boomers” and women (low education: OR 3.5; 95% CI 3.2–3.9). Tobacco showed a negative effect in younger generations. Overweight and low physical activity were negatively associated with self-rated health regardless of generation. Countries from the Eastern welfare system showed the highest risk of low self-rated health and this association was higher in men for “silent generation” (OR 4.7; 95% CI 3.0–7.6).
Conclusions
The influence of individual and national factors on self-rated health varies regarding generation. The target generation and the demographic structure of a country should be taken into account to develop more accurate health policies.
Similar content being viewed by others
References
Aguilar-Palacio I, Carrera-Lasfuentes P, Rabanaque MJ (2015a) Self-rated health and educational level in Spain: trends by autonomous communities and gender (2001–2012). Gac Sanit 29(1):37–43. https://doi.org/10.1016/j.gaceta.2014.07.004
Aguilar-Palacio I, Carrera-Lasfuentes P, Rabanaque MJ (2015b) Youth unemployment and economic recession in Spain: influence on health and lifestyles in young people (16–24 years old). Int J Public Health 60(4):427–435. https://doi.org/10.1007/s00038-015-0668-9
Ahmad F, Jhajj AK, Stewart DE, Burghardt M, Bierman AS (2014) Single item measures of self-rated mental health: a scoping review. BMC Health Serv Res 14:398. https://doi.org/10.1186/1472-6963-14-398
Baćak V, Ólafsdóttir S (2017) Gender and validity of self-rated health in nineteen European countries. Scand J Public Health 45(6):647–653
Badley EM, Canizares M, Perruccio AV, Hogg-Johnson S, Gignac MA (2015) Benefits gained, benefits lost: comparing baby boomers to other generations in a longitudinal cohort study of self-rated health. Milbank Q 93(1):40–72
Bambra C (2007) Going beyond The three worlds of welfare capitalism: regime theory and public health research. J Epidemiol Community Health 61(12):1098–1102. https://doi.org/10.1136/jech.2007.064295
Bambra C (2011) Health inequalities and welfare state regimes: theoretical insights on a public health ‘puzzle’. J Epidemiol Community Health 65(9):740–745. https://doi.org/10.1136/jech.2011.136333
Bianchi SM (2011) Family change and time allocation in American families. Ann Am Acad Polit Soc Sci 638(1):21–44
Bristow J (2016) The sociology of generations: new directions and challenges. Palgrave Macmillan, London
Carter MR, Kelly RK (2013) Self-reported health status, body mass index, and healthy lifestyle behaviors: differences between Baby Boomer and Generation X employees at a southeastern university. Workplace Health Saf 61(9):409–418. https://doi.org/10.3928/21650799-20130827-67 (quiz 419)
Chatterji S, Byles J, Cutler D, Seeman T, Verdes E (2015) Health, functioning, and disability in older adults–present status and future implications. Lancet 385(9967):563–575. https://doi.org/10.1016/S0140-6736(14)61462-8
Chen H, Cohen P, Kasen S (2007) Cohort differences in self-rated health: evidence from a three-decade, community-based, longitudinal study of women. Am J Epidemiol 166(4):439–446
Cogin J (2012) Are generational differences in work values fact or fiction? Multi-country evidence and implications. Int J Hum Resour Manag 23(11):2268–2294
Crumpacker M, Crumpacker JM (2007) Succession planning and generational stereotypes: should HR consider age-based values and attitudes a relevant factor or a passing fad? Public Pers Manag 36(4):349–369
Department of Economic and Social Affairs (2013) World population prospects: the 2012 revision. Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, New York
Eikemo TA, Bambra C (2008) The welfare state: a glossary for public health. J Epidemiol Community Health 62(1):3–6. https://doi.org/10.1136/jech.2007.066787
Eikemo TA, Bambra C, Judge K, Ringdal K (2008) Welfare state regimes and differences in self-perceived health in Europe: a multilevel analysis. Soc Sci Med 66(11):2281–2295. https://doi.org/10.1016/j.socscimed.2008.01.022
Eurostat (2016) European Health Interview Survey (EHIS). http://ec.europa.eu/eurostat/web/microdata/european-health-interview-survey
Ferrera M (1996) The ‘Southern model’ of welfare in social Europe. J Eur Soc Policy 6(1):17–37
Ford ES, Li C, Zhao G, Pearson WS, Tsai J, Greenlund KJ (2010) Trends in low-risk lifestyle factors among adults in the United States: findings from the Behavioral Risk Factor Surveillance System 1996–2007. Prev Med 51(5):403–407. https://doi.org/10.1016/j.ypmed.2010.08.002
Gesell I (2010) How to lead when the generation gap becomes your everyday reality. J Qual Particip 32(4):21
Hurrelmann K, Rathmann K, Richter M (2011) Health inequalities and welfare state regimes. A research note. J Public Health 19(1):3–13
Jylha M (2009) What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med 69(3):307–316. https://doi.org/10.1016/j.socscimed.2009.05.013
Lahelma E, Pietiläinen O, Ferrie J, Kivimäki M, Lahti J, Marmot M, Rahkonen O, Sekine M, Shipley M, Tatsuse T (2016) Changes over time in absolute and relative socioeconomic differences in smoking: a comparison of cohort studies from Britain, Finland, and Japan. Nicotine Tob Res 18(8):1697–1704
Lancaster LC, Stillman D (2002) When generations collide: Who they are. Why they clash. How to solve the generational puzzle at work. HarperCollins Publishers, New York City
Levickaite R (2010) Generations X, Y, Z: how social networks form the concept of the world without borders (the case of Lithuania). LIMES Cult Reg 3(2):170–183
Lynch J (2006) Age in the welfare state: the origins of social spending on pensioners, workers, and children. Cambridge University Press, Cambridge
Malmusi D, Artazcoz L, Benach J, Borrell C (2012) Perception or real illness? How chronic conditions contribute to gender inequalities in self-rated health. Eur J Pub Health 22(6):781–786. https://doi.org/10.1093/eurpub/ckr184
Meyer OL, Castro-Schilo L, Aguilar-Gaxiola S (2014) Determinants of mental health and self-rated health: a model of socioeconomic status, neighborhood safety, and physical activity. Am J Public Health 104(9):1734–1741
Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, Gortmaker SL (2011) The global obesity pandemic: shaped by global drivers and local environments. Lancet 378(9793):804–814. https://doi.org/10.1016/S0140-6736(11)60813-1
World Health Organization (2010) Global recommendations on physical activity for health. WHO, Geneva
Wu S, Wang R, Zhao Y, Ma X, Wu M, Yan X, He J (2013) The relationship between self-rated health and objective health status: a population-based study. BMC Public Health 13(1):320
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Aguilar-Palacio, I., Gil-Lacruz, A.I., Sánchez-Recio, R. et al. Self-rated health in Europe and its determinants: Does generation matter?. Int J Public Health 63, 223–232 (2018). https://doi.org/10.1007/s00038-018-1079-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00038-018-1079-5