Work and health in a contemporary society: demands, control, and insecurity

OBJECTIVE: To examine independent associations of job strain (high demands and low control) and job insecurity with mental and physical health outcomes. DESIGN: Cross sectional general population study conducted in 2000 using a self completed questionnaire. SETTING: Two adjoining cities in south east Australia. SUBJECTS: 1188 employed professionals, aged 40-44 years, 55% (n = 655) male. MAIN OUTCOME MEASURES: Depression, anxiety, physical, and self rated health (SRH). RESULTS: Adverse job conditions were relatively prevalent as 23% of the sample reported high job strain, while 7.3% and 23% reported high and moderate job insecurity respectively. Associations between job conditions and health persisted after adjustment for gender, education, marital status, employment status, major life events, and negative affectivity (personality). When adjusted for job strain, high job insecurity was independently associated with a greater than threefold increase in odds for poor SRH, depression and anxiety (OR (95% confidence intervals) poor SRH: 3.72 (1.97 to 7.04) depression: 3.49 (1.90 to 6.41), anxiety: 3.29 (1.71 to 6.33)), and a twofold increase for physical health 2.19 (1.21 to 3.95). High job strain also showed significant independent associations with depression: 2.54 (1.34 to.4.75) and anxiety: 3.15 (1.48 to 6.70). CONCLUSION: In this relatively privileged socioeconomic group, insecure employment and high job strain showed independent, consistent, and strong associations with physical and mental health. These adverse job conditions are on the increase, particularly insecure employment, and the influence of these two work conditions are an important focus for future public health research and their prevalence and impact should be examined in other occupations.     

The Relationship Between Rural Status,Individual Characteristics,and Self‐Rated Health in the Behavioral Risk Factor Surveillance System

Purpose: To examine rural status and social factors as predictors of self‐rated health in community‐dwelling adults in the United States. Methods: This study uses multinomial logistic and cumulative logistic models to evaluate the associations of interest in the 2006 US Behavioral Risk Factor Surveillance System, a cross‐sectional survey of 347,709 noninstitutionalized adults. Findings: Self‐rated health was poorer among rural residents, compared to urban residents (OR = 1.77, 95% CI: 1.54, 1.90). However, underlying risk factors such as obesity, low income, and low educational attainment were found to vary by rural status and account for the observed increased risk (OR = 1.03, 95% CI: 0.94, 1.12). There was little evidence of effect modification by rural status, though the association between obesity and self‐rated health was stronger among urban residents (OR = 2.50, 95% CI: 2.38, 2.64) than among rural residents (OR = 2.18, 95% CI: 2.03, 2.34). Conclusions: Our findings suggest that differences in self‐rated health by rural status were attributable to differential distributions of participant characteristics and not due to differential effects of those characteristics.     

Determinants of self assessed health among Spanish older people living at home.

STUDY OBJECTIVE: To identify the main determinants of self assessed health among community dwelling elderly. PARTICIPANTS AND SETTING: A representative sample of 677 people aged 65 and over of the city of Madrid, Spain. DESIGN: Cross sectional study. Information was collected through personal interviews at the homes of the selected subjects. The five category dependent variable was grouped into two categories: good and poor self assessed health. Age, sex, social class, use of physician services, number of chronic conditions, and functional capacity, were included as main explanatory factors. Adjusted odds ratios were estimated through multiple logistic regression models. MAIN RESULTS: A total of 49.5% of subjects rated their health as good or very good. Those aged 85 and over rated their health higher than those aged 65-74 (adjusted odds ratio (OR): 0.37; 95% confidence intervals (CI): 0.18, 0.77). The adjusted OR for an increase of three chronic conditions was 3.48 (95% CI: 2.49, 4.85). Functional capacity also showed a strong independent effect (OR: 3.64; 95% CI: 1.89, 7.02). Social class was one of the main determinants for the youngest group, with those in the upper class reporting a better health perception (OR: 3.28 95% CI: 1.70, 6.35), but showed no effect in the oldest old (OR: 1.05; 95% CI: 0.57, 1.96). CONCLUSIONS: Age, chronic conditions, and functional status were the main determinants of perceived health among Spanish elderly. The effect of social class on perceived health markedly decreases with age. This study may contribute to a better utilisation and interpretation of self ratings in research and in general practice.     

Income inequality and health: multilevel analysis of Chilean communities

STUDY OBJECTIVE: The evidence supporting the effect of income inequality on health has been largely observed in societies far more egalitarian than the US. This study examines the cross sectional multilevel associations between income inequality and self rated poor health in Chile; a society more unequal than the US. DESIGN: A multilevel statistical framework of 98 344 people nested within 61 978 households nested within 285 communities nested within 13 regions. SETTING: The 2000 National Socioeconomic Characterization Survey (CASEN) data from Chile. PARTICIPANTS: Adults aged 18 and above. The outcome was a dichotomised self rated health (0 if very good, good or average; 1 if poor, or very poor). Individual level exposures included age, sex, ethnicity, marital status, education, employment status, type of health insurance, and household level exposures include income and residential setting (urban/rural). Community level exposures included the Gini coefficient and median income. Main results: Controlling for individual/household predictors, a significant gradient was observed between income and poor self rated health, with very poor most likely to report poor health (OR: 2.94) followed by poor (OR: 2.77), low (OR: 2.06), middle (OR: 1.73), high (OR: 1.38) as compared with the very high income earners. Controlling for household and community effects of income, a significant effect of community income inequality was observed (OR:1.22). CONCLUSIONS: Household income does not explain any of the between community differences; neither does it account for the effect of community income inequality on self rated health, with more unequal communities associated with a greater probability of reporting poor health.     

Psychosocial work characteristics and self rated health in four post-communist countries

STUDY OBJECTIVES: To examine whether psychosocial factors at work are related to self rated health in post-communist countries. DESIGN AND SETTINGS: Random samples of men and women in five communities in four countries were sent a postal questionnaire (Poland, Czech Republic and Lithuania) or were invited to an interview (Hungary). Working subjects (n=3941) reported their self rated health in the past 12 months (5 point scale), their socioeconomic circumstances, perceived control over life, and the following aspects of the psychosocial work environment: job control, job demand, job variety, social support, and effort and reward at work (to calculate a ratio of effort/reward imbalance). As the results did not differ by country, pooled analyses were performed. Odds ratios of poor or very poor health ("poor health") were estimated for a 1 SD increase in the scores of work related factors. MAIN RESULTS: The overall prevalence of poor health was 6% in men and 7% in women. After controlling for age, sex and community, all work related factors were associated with poor health (p<0.05). After further adjustment for perceived control, only two work related factors remained associated with poor health; the odds ratios (95% confidence intervals) for 1 SD increase in the effort/reward ratio (log transformed) and job variety were 1.51 (1.29, 1.78) and 0.82 (0.73, 1.00), respectively. Further adjustment for all work related factors did not change these estimates. There were no interactions between individual work related factors, but the effects of job control and social support at work differed by marital status, and the odds ratio of job demand increased with increasing education. CONCLUSIONS: The continuous measure of effort/reward imbalance at work was a powerful determinant of self rated health in these post-communist populations. Although the cross sectional design does not allow firm conclusions as to causality, this study suggests that the effect of the psychosocial work environment is not confined to Western populations.     

Determinants of self-rated health in a representative sample of a rural population: a cross-sectional study in Greece

Self-rated health (SRH) is a health measure related to future health, mortality, healthcare services utilization and quality of life. Various sociodemographic, health and lifestyle determinants of SRH have been identified in different populations. The aim of this study is to extend SRH literature in the Greek population. This is a cross-sectional study conducted in rural communities between 2001 and 2003. Interviews eliciting basic demographic, health-related and lifestyle information (smoking, physical activity, diet, quality of sleep and religiosity) were conducted. The sample consisted of 1,519 participants, representative of the rural population of Tripoli. Multinomial regression analysis was conducted to identify putative SRH determinants. Among the 1,519 participants, 489 (32.2%), 790 (52%) and 237 (15.6%) rated their health as "very good", "good" and "poor" respectively. Female gender, older age, lower level of education and impaired health were all associated with worse SRH, accounting for 16.6% of SRH variance. Regular exercise, healthier diet, better sleep quality and better adherence to religious habits were related with better health ratings, after adjusting for sociodemographic and health-related factors. BMI and smoking did not reach significance while exercise and physical activity exhibited significant correlations but not consistently across SRH categories. Our results support previous findings indicating that people following a more proactive lifestyle pattern tend to rate their health better. The role of stress-related neuroendocrinologic mechanisms on SRH and health in general is also discussed.     

宁夏5县农村老年人生命质量及影响因素分析

目的 了解宁夏5县农村老年人生命质量状况,并探讨其影响因素,为改善农村老年人生命质量提供参考依据.方法 选取"农村居民家庭卫生健康询问调查"2015年随访数据,采用欧洲5维健康量表(EQ-5D量表)的方法对宁夏5县2 595名农村老年人的生命质量及其影响因素进行分析.结果 调查对象中,男性1379人(占53.1％),女...     

Self ratings of health predict functional outcome and recurrence free survival after stroke

STUDY OBJECTIVE: To measure stroke victims' self rated health (SRH) status and SRH transition, and to compare how the two are prospectively associated with disability and recurrence free survival. DESIGN: Prospective case registry study with face to face follow up interviews at three months, one, two, and three years. Ascertained were SRH status and SRH transition using single question assessments, Barthel Index (BI), Frenchay Activities Index (FAI), and Mini Mental State Examination (MMSE). SETTING: A multiethnic inner city population of 234 533. PARTICIPANTS: Patients surviving the initial three months after a first in a lifetime stroke in 1995 to 1998. RESULTS: Of 690 stroke survivors 561 (81.3%) could complete the self report items. Answers to the item on SRH status did not vary significantly between the four follow up interviews. However, responses to the item on SRH transition changed significantly during follow up with three months ratings being more negative than all subsequent ratings. SRH transition, but not SRH status, showed a prospective association with long term outcome in multivariate analyses controlling for the BI, FAI, and MMSE. Compared with all other patients, patients reporting "Much worse health" at three months were more likely to be disabled ( = BI<20) at one year (OR 6.29, 95% CI 2.26 to 17.52) and their combined risk of stroke recurrence and death was increased over five years (HR 1.72, 95% CI 1.25 to 2.38). CONCLUSIONS: Items on SRH should be used with caution in populations with high rates of disability and language problems, as many participants are unable to complete them. SRH transition may be a better predictor of disability and recurrence free survival after major medical events than SRH status.     

Gender inequalities in health and health care services use in Catalonia (Spain)

BACKGROUND AND OBJECTIVES: While socio-economically derived differences in health and health services use have long been a subject of study, differences based on gender, considered as the explicative variable, have scarcely been quantified from population-based data. The aim of this investigation was to analyse inequalities in health and health care services utilisation between men and women in Catalonia (Spain). DESIGN, SETTING, PARTICIPANTS, AND MEASURES: Data from the Catalan Health Interview Survey, a cross sectional survey conducted in 1994, were used. A total of 6604 women and 5641 men aged 15 years or over were included for analysis. Health related variables studied were self perceived health, restriction of activity (past two weeks), and presence of chronic conditions; health services use variables analysed were having visited a health professional (past two weeks), an optometrist (12 months), or a dentist (12 months); and hospitalisation (past 12 months). Age standardised proportions were computed according to gender, and prevalence odds ratios (OR) were derived from logistic regression equations. MAIN RESULTS: Women more frequently rated their health as fair or poor than men (29.8% v 21.4%; OR = 1.22; 95% CI: 1.10, 1.34). More women than men reported having restricted activity days (OR = 1.86; 95% CI: 1.59, 2.18) and chronic conditions (OR = 1.74; 95% CI: 1.60, 1.89). The proportion of women visiting a health professional was slightly greater than that for men (OR = 1.20; 95% CI: 1.09, 1.31), as was the proportion of women visiting an optometrist (OR = 1.21; 95% CI: 1.11, 1.33), and a dentist (OR = 1.43; 95% CI: 1.31, 1.55). The proportion of hospitalisation was lower in women (6.6%) than in men (7.7%; OR = 0.73; 95% CI: 0.63, 0.85). When health services use was analysed according to self perceived health, women declaring good health reported a greater probability of consulting a health professional (OR = 1.35; 95% CI: 1.20, 1.52). There were no differences in respect to hospitalisation, visits to the optometrist and to the dentist. CONCLUSIONS: These results indicate a pattern close to the inverse care law, as women, who express a lower level of health and thus would need more health care, are not, however, using health services more frequently than men.     

Sense of coherence as a moderator of the effects of stressful life events on health

STUDY OBJECTIVE: To test the hypothesis that Antonovsky's concept of sense of coherence (SOC) moderates (that is, buffers) the health impacts of stressful life events in a population based sample. DESIGN: Multiple linear and Poisson regression analyses of longitudinal data from a national survey of population health were used to examine the relations among SOC, the experience of recent stressful life events (for example, family breakdown, financial crisis, physical abuse), and two outcomes, self reported health status (SRH) and self reported number of physician visits during the previous year. SETTING: General population of Canada. PARTICIPANTS: Nationally representative sample of household residents aged 30 years of age or greater surveyed in 1998 and 2000 (n = 6505). MAIN RESULTS: After controlling for age, sex, and previous health status, a significant moderating effect (t = 2.24, p = 0.025) in the expected direction was found on respondents' SRH. The mean difference in SRH between those who did and did not experience a recent stressful life event was 0.24 (95% CI: 0.16, 0.32) in people with a below average SOC and 0.04 (95% CI: -0.04, 0.11) in people with a higher than average SOC score. The postulated moderating effect of SOC was not significant (t = 1.1, p > 0.05) in predicting the number of visits to a physician. CONCLUSIONS: SOC seems to buffer the impact of recent stressful life events on SRH.     

A prospective investigation of neighborhood socioeconomic deprivation and self-rated health in a large US cohort

BackgroundNeighborhood characteristics play a critical role in health. Self-rated health (SRH) is an important indicator of quality of life and a strong predictor of premature death. Prospective study on neighborhood deprivation and SRH is limited.MethodsWe examined neighborhood socioeconomic deprivation with reporting fair/poor SRH at follow-up (2004–2006) in 249,265 men and women (age 50–71) who reported SRH as good or better at baseline (1995–1996) in the NIH-AARP Health and Diet Study. Baseline addresses were geocoded and linked to 2000 Census. Census tract level variables were used to generate a socioeconomic deprivation index by principle component analysis.ResultsResidents of more deprived neighborhoods had a higher risk of developing poor/fair SRH at follow-up, even after adjusting for individual-level factors (Odds ratio (95% confidence interval) _{Q5 vs Q1}: 1.26 (1.20, 1.32), p-trend: <0.0001). The results were largely consistent across subgroups with different demographics, health behaviors, and disease conditions and after excluding participants who moved away from their baseline address.ConclusionNeighborhood disadvantage predicts SRH over 10 years.     

The impact of area deprivation on differences in health: does the choice of the geographical classification matter?

OBJECTIVE: Many studies show the average health status in deprived areas to be poorer and the use of health care to be higher, but there is hardly any information on the impact of the geographical classification on the size of these differences. This study examines the impact of the geographical classification on the clustering of poor health per area and on the size of the differences in health by area deprivation. DESIGN: Data on self reported health regarding 5121 people were analysed using three classifications: neighbourhoods, postcode sectors and boroughs. Multilevel logistic models were used to determine the clustering of poor health per area and the size of the differences in health by area deprivation, without and subsequently with adjustment for individual socioeconomic status. SETTING: General population aged 16 years and over of Amsterdam, The Netherlands. MAIN OUTCOME MEASURES: Self rated health, mental symptoms (General Health Questionnaire, 12-item version), physical symptoms and long term functional limitations. MAIN RESULTS: The clustering of poor health is largest in neighbourhoods and smallest in postcode sectors. Health differences by area deprivation differ only slightly for the three geographical classifications, both with and without adjustment for individual socioeconomic status. CONCLUSIONS: In this study, the choice of the geographical classification affects the degree of clustering of poor health by area but it has hardly any impact on the size of health differences by area deprivation.     

Neighbourhood deprivation and regional inequalities in self-reported health among Canadians: Are we equally at risk?

Individual-level data from the Canadian Community Health Survey was combined with area-level data from the 2001 Canada Census to explore the relationship between neighbourhood deprivation and regional inequalities in self-reported health (n=120,290). While neighbourhood deprivation was a significant predictor of fair/poor health in all geographic regions (OR=1.11; 95% CI: 1.08, 1.14), living on the Atlantic and Pacific coasts exacerbated the detrimental effects of neighbourhood deprivation on the perceived health of respondents (OR=1.21; 1.28). By failing to explore regional variations in risk, we could fail to identify areas where provincial policies may interact with neighbourhood factors to reinforce health inequalities amongst deprived communities.     

Economic stress in childhood and adulthood, and self rated health: a population based study concerning risk accumulation, critical period and social mobility

ABSTRACT: BACKGROUND: Research in recent decades increasingly indicates the importance of conditions in early life for health in adulthood. Only few studies have investigated socioeconomic conditions in both childhood and adulthood in relation to health testing the risk accumulation, critical period, and social mobility hypotheses within the same setting. This study investigates the associations between economic stress in childhood and adulthood, and self-rated health with reference to the accumulation, critical period and social mobility hypotheses in life course epidemiology, taking demographic, social support, trust and lifestyle factors into account. METHODS: The public health survey in Skane (southern Sweden) in 2008 is a cross-sectional postal questionnaire study based on a random sample, in which 28,198 persons aged 18--80 years participated (55% participation). Logistic regression models were used to investigate associations between economic stress in childhood and adulthood, and self-rated health. RESULTS: Three life-course socioeconomic models concerning the association between economic stress and self-rated health (SRH) were investigated. The results showed a graded association between the combined effect of childhood and adulthood economic stress and poor SRH in accordance with the accumulation hypothesis. Furthermore, upward social mobility showed a protecting effect and downward mobility increased odds ratios of poor SRH in accordance with the social mobility hypothesis. High/severe economic stress exposures in both stages of life were independently associated with poor SRH in adulthood. Furthermore, stratifying the study population into six age groups showed similar odds ratios of poor SRH regarding economic stress exposure in childhood and adulthood in all age groups among both men and women. CONCLUSIONS: The accumulation and social mobility hypotheses were confirmed. The critical period model was confirmed in the sense that both economic stress in childhood and adulthood had independent effects on poor SRH. However, it was not confirmed in the sense that a particular window in time (in childhood or adulthood) had a specifically high impact on self rated health.     

Development and validation of an instrument to measure perceived neighbourhood quality in Taiwan

STUDY OBJECTIVE:s: Social epidemiologists have hypothesised that neighbourhood quality may exert an important contextual influence on mental and physical health. However, validated instruments do not exist for measuring neighbourhood quality in Taiwan. A self reported instrument to measure perceived neighbourhood quality in Taiwan was developed and tested. DESIGN: Community survey. SETTING: Southern Taiwan, including the metropolitan Kaohsiung area and eight surrounding communities, representing urban, suburban, and rural districts. PARTICIPANTS: A total of 1084 residents, aged 18 to 75, were surveyed during 1999 to 2000. MAIN RESULTS: Using factor analysis with varimax rotation, three subscales explained 54.8% of the variance in our 15 item Neighbourhood Quality Index: perceived social capital (Cronbach alpha=0.84), perceived security (alpha=0.78), and adequacy of services and facilities (alpha=0.67). Lower perceived neighbourhood social capital (odds ratio, OR, 1.26; 95% CI: 1.21 to 1.32), lower neighbourhood security (OR 1.37; 95% CI: 1.26 to 1.48), and inadequate neighbourhood services and facilities (OR 1.17; 95% CI: 1.06 to 1.28) were all related to higher residential dissatisfaction. CONCLUSIONS: A Neighbourhood Quality Index was developed for use in Taiwan with good internal consistency and test-retest reliability, as well as convergent validity. Future studies will examine the association between this index and measures of individual mental and physical health.     

Physical violence,self rated health,and morbidity: is gender significant for victimisation?

STUDY OBJECTIVE: To analyse gender differences in associations between physical violence and self rated health and self reported morbidity among a random sample of adults in Denmark. DESIGN AND SETTING: Two questions on self rated health and self reported morbidity respectively, were obtained from a cross sectional national health interview survey conducted among 12 028 adults (16 years +) in Denmark in 2000. A question on six different forms of physical violence was obtained from a supplementary self administered questionnaire given to the same sample. The reporting period for experienced physical violence was the past 12 months and for morbidity symptoms, the past 14 days. MAIN RESULTS: Men aged 16-24 years were significantly more likely to have experienced violence than women (OR = 3.2, 95% CI = 2.3 to 4.2). Female victims of physical violence were significantly more likely to rate their health as poor (OR = 2.02, 95% CI = 1.41 to 2.89) and to report anxiety (OR = 2.14, 95% CI = 1.35 to 3.37), depression (OR = 2.36, 95% CI = 1.55 to 3.60), and stomach ache (OR = 1.58, 95% CI = 1.01 to 2.47) than female non-victims. Male victims of physical violence were only significantly more likely to report stomach ache (OR = 1.73, 95% CI = 1.03 to 2.89) than male non-victims. CONCLUSIONS: Associations between physical violence and poor self rated health and self reported morbidity were found to be significant for women, but not for men. It is probable that gender differences in experiences of violence, as well as gender differences in health related self perception, contribute to a gender specific process of victimisation. Improved knowledge about the relation between gender specific violence and victimisation as a gender specific consequence is essential for targeting violence prevention.     

Psychological distress among Kurdish immigrants in Sweden

AIMS: To analyse whether there is an association between sex and poor self-reported health (SRH) and psychological distress in Kurdish immigrants. METHODS: This cross-sectional study is based on a sample consisting of immigrants, aged 27- 60 years, with self-reported Kurdish ethnicity (n=111, men; n=86, women) in Sweden originating from Iran and Turkey. It is based on data collected in 1996 from the first Swedish National Survey on the living conditions of immigrant groups conducted by Statistics Sweden. The prevalences of reporting poor health, sleeping difficulties, general fatigue and anxiety were estimated by sex. The association between sex and SRH and psychological distress was analysed by an unconditional logistic regression model estimating odds ratios (OR) with 95% confidence intervals. The final model was adjusted for age, marital status, education, housing and employment. Immigrant-specific migration-related variables were used to explore possible reasons for the sex differences. RESULTS: Kurdish men and women had a high prevalence of poor SRH and psychological distress. Age-adjusted odds ratios for anxiety were higher in Kurdish women. Sex differences in anxiety remained even when marital status, education, housing and employment were taken into account. CONCLUSIONS: Kurdish men and women report a high prevalence of poor SRH and indicators of psychological distress. Women had a higher risk for anxiety than men. Negative experiences of pre-migration as well as post-migration experiences, such as economic difficulties, preoccupation with the political situation in the home country, perceived discrimination, and feelings of poor control over one's life, were associated with the outcomes.     

Self-rated health and factors influencing responses among young Egyptian type 1 diabetes patients

Background

Patients diagnosed with type 1 diabetes mellitus (T1DM) face major daily challenges. Self-rated health (SRH) is a global measure of an individual's health related quality of life (HRQoL) and is based on the question, "In general, how would you rate your health?" Subjects rate their health as excellent, very good, good, poor or very poor. Our objective was to determine the HRQoL using the SRH measure and determine factors influencing responses. We hypothesized that better SRH responses were associated with shorter diabetes duration, better compliance and better glycemic control.

Methods

The standardized SRH measure was the instrument used for health related quality of life assessment. Logistic regression analysis was used to examine the association between SRH responses and selected variables.

Results

124 subjects, 64 females (51.6%) and 60 males (48.4%) were included. Average age was 13.08 (±3.19) and average diabetes duration was 5.82 (±1.60), while the mean HbA₁C was 8.02 (±1.60). The majority rated their health as good (31%), 29% rated it as excellent, 11% as very good, 14% as poor and 15% as very poor. Regression analysis showed that regular exercise was the only predictor that was independently and significantly associated with a "better" self-health rating, with an OR of 12.84, CI of 1.425-115.727 and a p value of 0.023.

Conclusion

Regular exercise among Egyptian children with T1DM is strongly associated with a "better" overall health related quality of life and should be repeatedly encouraged.

     

Self reported physical activity, public health, and perceived environment: results from a comparative European study

STUDY OBJECTIVE: The focus of physical activity promotion is moving from methods for increasing health enhancing physical activity on the individual level to higher level strategies including environmental and policy approaches. Scientific inquiry, traditionally related to individual-based strategies, requires adaptation and refinement when environmental and policy changes become more relevant. The objective of this study is to investigate the significance for behaviour and health of community-based environments that encourage physical activity. DESIGN AND SETTING: The article presents data and results from a cross sectional comparative survey of the general population in six European countries (Belgium, Finland, Germany (East and West), Netherlands, Spain, Switzerland). Specifically, the relation between perceived community-based opportunities for physical activity, self reported physical activity, and self rated health status is investigated. PARTICIPANTS: Representative samples of general populations (adults 18 years or older). Overall response rate: 53.5%. Sample sizes realised: Belgium: n = 389; Finland: n = 400; Germany (East): n = 913; Germany (West): n = 489; Netherlands: n = 366; Spain: n = 380; Switzerland: n =406. MAIN RESULTS: Analyses show that best opportunities are reported by people who are lightly to moderately physically active. People's self rated health is moderately, but significantly associated with both perceived opportunities, and physical activity itself. These predictors interact in that especially for women, the health impact of physical activity is more pronounced in case of good opportunities. CONCLUSIONS: The paper shows the potential of opportunities within residential and community environments with regard to physical activity, both for behaviour and health. Opportunities may enable the population, especially women, to develop an active lifestyle, and thus improve their health. Future studies with objective indicators for physical activity related environments should test the findings that are based on perceptions.     

Socio-demographic, environmental, lifestyle and psychosocial factors predict self rated health in Irish Travellers, a minority nomadic population

Irish Travellers are an indigenous nomadic minority group with poor life expectancy. As part of a census survey of Travellers (80% participation rate), a health status interview was conducted (n=2065, 43.5% male). In the final regression model, positive predictors of self-rated health (SRH) were having a flush toilet (OR 2.2, p=0.021), considering where one lives to be healthy (OR 1.9, p=0.017), travelling twice yearly (OR 2.3 p=0.026), taking a brisk walk weekly (OR 2.4, p=0.000) and non-smoking (OR 1.7, p=0.03). Conversely, SRH was negatively associated with age (p=0.000), activity-limiting ill health (OR 0.4, p=0.001), or chronic health condition (OR 0.4, p=0.002).