Predictors of poor self-rated health at area level in the Eastern Regional Health Authority: a multilevel analysis

Abstract

In this analysis, employing 2002 data from SLAN Survey of Lifestyles, Attitudes and Nutrition and mortality data from the Eastern region of the Republic of Ireland, we examined predictors of area level variability in self-rated health across 101 electoral divisions (ED)s. Overall 11.5% of 1500 participants reported fair or poor health. We found area level variation in poor self-rated health (0.0357 (SE 0.160), p = 0.03), which was related significantly to area-level standardised mortality ratio. Odds of poor self-rated health, adjusted for age and sex were 1.55 (95% CI 0.89, 2.71) in average SMR areas and 2.61 (95% CI 1.38, 4.92) in high SMR areas compared to low SMR areas. Adjusted models for age, sex, general medical services eligibility, an established proxy for income, problems in the neighbourhood and smoking rates largely explained any variability, suggesting a strong role for individual disadvantage in predicting health status, regardless of area, in Ireland.