Determinants of and inequalities in self-perceived health in Ukraine
Determinants of and inequalities in self-perceived health in Ukraine
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DOI：
10.1016/s0277-9536(01)00361-6
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发表时间：
2002-12-01
影响因子：
5.4
通讯作者：
Rose, R
中科院分区：
文献类型：
--
作者：
Gilmore, ABC;McKee, M;Rose, R
乌克兰是前苏联加盟共和国中人口第二多的国家，自过渡以来，其经济状况甚至比俄罗斯还要糟糕。尽管前苏联解体对俄罗斯健康的影响已经得到了调查，但人们对它对其他后苏联加盟共和国的影响知之甚少。我们报告了2000年3月在乌克兰进行的一项横断面研究。使用多阶段随机抽样技术，完成了1600次访谈(回复率为72%)，对具有代表性的乌克兰成年人进行了全国抽样。我们调查了自我感知健康的社会经济和心理社会决定因素，这已被证明是衡量整体健康和预测死亡率的有效和可靠的衡量标准。使用Logistic回归计算身体健康不佳的优势比。乌克兰人自评健康状况较差，25%的男性和43%的女性认为自己的健康状况较差或非常差。这比俄罗斯记录的水平更糟糕，也比西欧的水平糟糕得多。健康方面存在明显的性别、地域和社会经济不平等。与男性相比，女性自评健康状况较差的风险更高(OR 3.58，2.50-5.14)，生活在农村的女性与城市女性相比(OR 3.24，1.30-8.07)。社会经济因素(OR1.64，1.01-2.67)和心理社会因素(OR1.89，1.15-3.11)被确定为独立的健康决定因素。对生活的控制被发现是低社会地位对健康的负面影响的原因。良好的家庭关系可防止健康状况不佳。研究结果表明，日益不确定的政治和经济环境导致的控制权减少、物质财富的减少以及变革的压力，可能都是导致过渡期间预期寿命下降的原因之一。(C)2002爱思唯尔科学有限公司。保留所有权利。
Ukraine is the second most populous of the former Soviet Republics and since transition its economy has fared even more poorly than Russia. Although the impact of the collapse of the former Soviet Union on health in Russia has been investigated, little is known of its impact in other post-Soviet republics. We report a cross-sectional study undertaken in Ukraine in March 2000. A multi-stage random sampling technique was used and 1600 interviews completed (72% response rate) with a representative national sample of Ukrainian adults. We investigated socioeconomic and psychosocial determinants of self-perceived health, which has been shown to be a valid and reliable measure of overall health and predictive of mortality. Odds ratios for less than good physical health were calculated using logistic regression. The self-rated health of Ukrainians was poor, 25% of men and 43% of women rated their health as poor or very poor. This is worse than levels recorded in Russia and considerably worse than levels seen in western Europe. Marked gender, geographical and socioeconomic inequalities in health were recorded. Women are at increased risk of poor self-rated health compared with men (OR 3.58, 2.50-5.14) as are women living in villages compared with those in cities (OR 3.24, 1.30-8.07). Socioeconomic factors including poor material situation (OR 1.64, 1.01-2.67), and psychosocial factors including low control over life (OR 1.89, 1.15-3.11) were identified as independent health determinants. Control over life was found to account for the negative impact of low social position on health. Good family relations protected against poor health. The findings suggest that a decrease in control, arising from an increasingly uncertain political and economic environment, a reduction in material wealth and the stress of change may all have contributed to the decline in life expectancy seen with transition. (C) 2002 Elsevier Science Ltd. All rights reserved.