Factors Associated with Self-rated Health of Rural Population: A Report from the Prospective Observational Study

Self-rated health (SRH) is a single question asking people to assess his or her overall health status, and is a widely used indicator of person’s perception of his or her own health 1, 2 ). Although a number of studies have focused on the topic 3–6 ), SRH is still an important study topic to enhance the quality of life among people. Especially, there are not suffi cient data on factors associated with self-rated health in rural areas in Japan. Therefore, we previously performed a pilot retrospective study on the topic by using the Kyusyu Asakura Project (KAP) data 7 ). The KAP is an observational cohort study of all users who underwent an annual health check-up at a public clinic in Asakura City (Kyushu region, Western Japan) from 2009 to 2016. KAP included a questionnaire survey, and the items were age, sex, somatometry, family budget conditions, family structure, SRH, whether or not attending a hospital or clinic regularly, medication related to life-related disease, eating habits, exercise habits, Geriatric Depression Scale 5 (GDS5) 8 ). As the results of the pilot study, there were statistically signifi cant differences in regular hospital or clinic attendance between the high and low SRH groups, while there were no signifi cant differences in eating or exercise habits between the two SRH groups. To confi rm the results of the retrospective analysis 7 ), we revised the questionnaire adding additional items such as subjective symptoms, comorbid diseases, smoking habit, and drinking habit, and performed the prospective study by using the KAP data from April 2012 to January 2013. As the same as the retrospective study, we defi ned the subjects who responded yes to the above-mentioned SRH related question as high SRH group, and no as low SRH group. And then, we compared the data between high and low SRH groups. We used t-test for continuous value, and chi-square test for discontinuous value. A P-value less than 0.05 was considered statistically signifi cant. We used IBM SPSS statistics 20 as statistics software. After excluding one hundred fi fty fi ve subjects whose SRH related data was missing from the present analysis, we analyzed the data of 818 subjects (155 men aged less than 65, 189 women aged less than 65, 230 men aged 65 and over, 244 women aged 65 and over). The characteristics and results of the study subjects are shown in Table 1. Two thirds of the subjects have a high SRH (67.4%). More subjects in high SRH group were involved in farming. The subjects in low SRH group were more likely to have some subjective distress symptoms including headache, dizziness, general fatigue, pain in the lower back, shoulder or neck, insomnia, or constipation. The subjects in low SRH group were likely to have heart disease, diabetes mellitus, hypertension or hyperlipidemia. Although there were no signifi cant differences in eating, smoking or drinking habits between the two SRH groups in all the four categories, the subjects in high SRH group had exercise habits. There are statistically signifi cant differences in GDS5 scores between high and low SRH groups. Our results of the prospective study added several new evidences to the retrospective study. As mentioned above, there are signifi cant differences in the prevalence of some subjective distress symptoms including headache, dizziness, general fatigue, pain in the lower back, shoulder or neck, insomnia, or constipation between high and low SRH groups. Paying attention to and controlling such distress symptoms possibly contributes to good SRH and quality of life. Also, our results suggested that the presence of chronic health problems for the persons is strongly related to low SRH. It is natural that the persons think their own health conditions are not good. As previously stated in the J Rural Med 2014; 9(1): 40–42