多水平视角下探讨老年人自评健康的影响因素

目的 调查四川省简阳市老年人自评健康状况，分析其影响因素。方法 利用简阳市2015年居民家庭健康入户调查数据，选取60岁及以上老年人为研究对象，采用三水平（乡镇、家庭、个体）模型分析老年人自评健康状况。结果 6 525名老年人中，2 013人（30.9%）自评健康为好，3 389人（51.9%）自评健康一般，1 123人（17.2%）自评健康为差。多水平模型结果显示，老年人自评健康在乡镇和家庭水平上存在聚集性，个体水平的年龄、学历、婚姻状况、慢性病、两周患病、抑郁、吸烟、饮酒、主动获取保健知识、预防保健服务的利用，家庭水平的家庭关系、居住条件是影响老年人自评健康的因素。结论 影响自评健康的因素较多，应重点关注文化程度低、居住状况差、客观健康状况差、卫生保健意识差、社会支持差、存在抑郁心理的老年人。促进社区老年人的身心健康，需要综合考虑地区、家庭和个体三个层面的干预措施。

Analysis on the influencing factors of self-rated health among the elderly by using multilevel model

Objective To investigate the self-rated health status and influencing factors among the elderly in Jianyang City. Methods Based on the household health survey in 2015, the elderly aged 60 years and over were included in the analysis. Multi-level logistic model based on the level of town, family and individual was applied to examine the factors influencing the elderly's self-rated health. Results Among the 6 525 old people included in the study, 2 013(30.9%) individual evaluated their health status as good, 3 389(51.9%) as general, 1 123(17.2%) as poor. Multilevel model indicated that the self-rated health clustered in town and family level. Age, education, marriage, chronic disease, reporting illness within 2 weeks, depression, smoking, drinking, acquiring health knowledge, utilization of preventive service, family relationship and living condition were influencing factors of self-rated health in old people. Conclusions The self-evaluated health is affected by various factors.More attention should be paid to the elderly with low education level, poor living condition, poor health situation, lack of health care awareness, weak social support and depression. Comprehensive interventions on the level of region, family and individual should be considered to promote the health condition of the elderly.