Incongruence between self-rated health and chronic disease risk amongst rural Nicaraguan women experiencing an epidemiological transition
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Date
2021-05
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The Ohio State University
Abstract
Self-rated health (SRH), a subjective measure of health status, is used in national health surveys, including in low-and middle-income countries experiencing epidemiological transitions, as a proxy for overall health. However, the extent to which SRH reflects risk of emerging chronic disease in such settings remains unclear. We test the relationship between SRH and objective measures of risk for cardiometabolic diseases among 200 rural Nicaraguan women, where the rate of these diseases is on the rise. SRH was measured with a Likert scale (bad to excellent). Measures of chronic disease risk included BMI, waist-to-height ratio, blood pressure, and blood glucose. Using international cut-offs, women were categorized as within the normal range (0) or above it (1). These data were combined to create a chronic disease risk index (CDRI) (range 0-4). For SRH, responses were 7.5% bad, 61% regular, 24.5% good, 4% very good, 3% excellent.For CDRI, 4.5% scored a 0, 39.5% scored a 1, 35.5% scored a 2, 17% scored a 3, 3.5% scored a 4. Using an OLS regression that included potential correlates of SRH and chronic disease risk, we found no association between SRH and CDRI (beta=0.057, p=0.48). Of the additional correlates considered, only mental health status (SRQ-20) was significantly associated with SRH (beta=.27, p=0.001). Results indicate that SRH was a poor predictor of cardiometabolic disease risk in this setting and raise questions as to the use of SRH as a proxy for overall health in contexts experiencing epidemiological transitions.
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Keywords
Nicaragua, Epidemiological Transition, Nutritional Transition, Self-Rated Health, Cardiometabolic Disease