J Epidemiol Community Health

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Journal of Epidemiology and Community Health 2006;60:364-372; doi:10.1136/jech.2005.039883
Copyright © 2006 by the BMJ Publishing Group Ltd.

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THEORY AND METHODS

What does self rated health measure? Results from the British Whitehall II and French Gazel cohort studies

Archana Singh-Manoux1,2, Pekka Martikainen3, Jane Ferrie2, Marie Zins1, Michael Marmot2, Marcel Goldberg1

1 INSERM, U687, HNSM, Saint-Maurice Cédex, France
2 Department of Epidemiology and Public Health, University College London, UK
3 Population Research Unit, Department of Sociology, University of Helsinki, Finland

Correspondence to:
Correspondence to:
Dr A Singh-Manoux
INSERM, U687, HNSM, 14 rue du Val d’Osne, 94415 Saint-Maurice Cédex, France; Archana.Singh-Manoux{at}st-maurice.inserm.fr

Objectives: To investigate the determinants of self rated health (SRH) in men and women in the British Whitehall II study and the French Gazel cohort study.

Methods: The cross sectional analyses reported in this paper use data from wave 1 of the Whitehall II study (1985–88) and wave 2 of the Gazel study (1990). Determinants were either self reported or obtained through medical screening and employer’s records. The Whitehall II study is based on 20 civil service departments located in London. The Gazel study is based on employees of France’s national gas and electricity company (EDF-GDF). SRH data were available on 6889 men and 3403 women in Whitehall II and 13 008 men and 4688 women in Gazel.

Results: Correlation analysis was used to identify determinants of SRH from 35 measures in Whitehall II and 33 in Gazel. Stepwise multiple regressions identified five determinants (symptom score, sickness absence, longstanding illness, minor psychiatric morbidity, number of recurring health problems) in Whitehall II, explaining 34.7% of the variance in SRH. In Gazel, four measures (physical tiredness, number of health problems in the past year, physical mobility, number of prescription drugs used) explained 41.4% of the variance in SRH.

Conclusion: Measures of mental and physical health status contribute most to the SRH construct. The part played by age, early life factors, family history, sociodemographic variables, psychosocial factors, and health behaviours in these two occupational cohorts is modest.


Keywords: self rated health; stepwise regression




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