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. 2019 May 9;19(1):533.
doi: 10.1186/s12889-019-6839-5.

Self-rated health as a valid indicator for health-equity analyses: evidence from the Italian health interview survey

Beniamino Cislaghi  1 , Cesare Cislaghi  2
Affiliations

Self-rated health as a valid indicator for health-equity analyses: evidence from the Italian health interview survey

Beniamino Cislaghi et al. BMC Public Health. .

Abstract

Background: Self-rated health is widely considered a good indicator of morbidity and mortality but its validity for health equity analysis and public health policies in Italy is often disregarded by policy-makers. This study had three objectives. O1: To explore response distribution across dimensions of age, chronic health conditions, functional limitations and SRH in Italy. O2: To explore associations between SRH and healthcare demand in Italy. O3: To explore the association between SRH and household income.

Methods: Cross-sectional data were obtained from the 2015 Health Interview Survey (HIS) conducted in Italy. Italian respondents (n = 20,814) were included in logistic regression analyses. O1: associations of chronic health conditions (CHC), functional limitations (FL), and age with self-rated health (SRH) were tested. O2: associations of CHC, FL, and SRH with hospitalisation (H), medical specialist consultations (MSC), and medicine use (MU) were tested. O3: associations of SRH and CHC with household income (PEI) were tested.

Results: O1: CHC, FL, and age had an independent summative effect on respondents' SRH. O2: SRH predicted H and MSC more than CHC; age and MU were more strongly correlated than SRH and MU. O3: SRH and PEI were significantly correlated, while we found no correlation between CHC and PEI.

Conclusions: Drawing from our results and the relevant literature, we suggest that policy-makers in Italy could use SRH measures to: 1) predict healthcare demand for effective allocation of resources; 2) assess subjective effectiveness of treatments; and 3) understand geosocial pockets of health inequity that require special attention.

Keywords: Equity; Health policy; Healthcare demand; Italy; National Health Service; Self-rated health; Self-rated health as a valid indicator for health-equity analyses: evidence from the Italian Health Interview Survey.

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The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
% reporting worse health by age and chronic health conditions
Fig. 2
Fig. 2
% reporting worse health by age and limitations
Fig. 3
Fig. 3
% reporting worse health by age and chronic health conditions and/or functional limitations
Fig. 4
Fig. 4
Self-rated health by diagnosed chronic health conditions
Fig. 5
Fig. 5
Average age for population diagnosed with each medical condition, and % with worse SRH
Fig. 6
Fig. 6
Regression residuals
Fig. 7
Fig. 7
Logistic regression of the risk of being in the lowest two income quintiles by age, sex, geographic area, chronic health conditions, and self-rated health
See this image and copyright information in PMC

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