Sociodemographic and work-related determinants of self-rated health trajectories: a collaborative meta-analysis of cohort studies from Europe and the US

Abstract

Self-rated health is a major indicator of an individual's overall health status, but its development during midlife to old age, as well as influence of sociodemographic and work-related factors on it, are poorly understood. We used longitudinal individual-level data to examine trajectories of self-rated health and their determinants in 38,163 participants (median age 50 (range 36-66) years at baseline) of the English Longitudinal Study of Ageing, the Finnish Longitudinal Study on Aging Municipal Employees, and the French GAZ and ELectricit & eacute; study from Europe and the Health and Retirement Study from the US. A group-based latent trajectory analysis showed that self-rated health was constantly good for over half of the participants, constantly suboptimal for about 11-21%, and it was changing, either improving or declining, for the rest. Pooled evidence suggests that being single (summary odds ratio 1.20, 95% confidence interval 1.07-1.35), medium educational attainment (1.26, 1.16-1.37), medium occupational class (1.22, 1.10-1.34), and exposure to high physical job demands (1.18, 1.08-1.29) were associated with declining self-rated health. Suboptimal self-rated health was more prevalent among those in low occupational class (1.81, 1.56-2.10), and those who experienced high physical job demands (1.52, 1.33-1.74). In these European and US populations, 23-40% of people experienced suboptimal or declining health trajectories. In conclusion, large variation in development of self-rated health from midlife to old age was observed and it was partly determined by sociodemographic and work-related factors.