The Moderating Role of Neighborhood Disadvantage on the Link Between Functional Limitations and Self-rated Health

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2023 Apr 5

PMID 37018346

Authors

Jeong Ha Steph Choi

Daniel H Jung

Affiliations

Soon will be listed here.

Abstract

Background: Self-rated health is an important health outcome and determinant of health. Improvements to our understanding on self-rated health could help design plans and strategies to improve self-rated health and achieve other preferred health outcomes. This study examined whether the link between functional limitations and self-rated health varies by neighborhood socioeconomic status.

Methods: This study used the Midlife in the United States study linked with the Social Deprivation Index developed by the Robert Graham Center. Our sample consist of noninstitutionalized middle to older adults in the United States (n = 6,085). Based on stepwise multiple regression models, we computed adjusted odds ratios to examine the relationships between neighborhood socioeconomic status, functional limitations, and self-rated health.

Results: Respondents in the socioeconomically disadvantaged neighborhoods were older, had higher percentage of females, non-White respondents, lower educational attainment, lower perceived neighborhood quality, and worse health status with greater number of functional limitations than those in socioeconomically advantaged neighborhoods. Results showed a significant interaction was found where neighborhood-level discrepancies in self-rated health was biggest among individuals with highest number of functional limitations (B = -0.28, 95% CI[0.53, -0.04], p = 0.025). Specifically, individuals with the highest number of functional limitations from the disadvantaged neighborhoods had higher self-rated health compared to those from advantaged neighborhoods.

Conclusions: Our study findings highlight that neighborhood discrepancy in self-rated health is underestimated particularly among those with severe functional limitations. Moreover, when interpreting self-rated health status, values should not be taken face value, and should be considered together with the environmental conditions of where one resides.

Citing Articles

A Scoping Review and Assessment of the Area-Level Composite Measures That Estimate Social Determinants of Health Across the United States.

Hassett T, Stuhlsatz G, Snyder J Public Health Rep. 2024; 140(1):67-102.

PMID: 39663655 PMC: 11569672. DOI: 10.1177/00333549241252582.

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