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Peru has one of the highest informal employment rates in Latin America (73%). Previous studies have shown a higher prevalence of poor self-perceived health (P-SPH) in informal than in formal workers. The aim of this study was to analyze the role of working conditions in the association between informality and SPH in an urban working population in Peru. We conducted a cross-sectional study based on 3098 workers participating in the working conditions survey of Peru 2017. The prevalence of P-SPH and exposure to poor working conditions were calculated separately for formal and informal employment and were stratified by sex. Poisson regression models were used to assess the association between P-SPH and informal employment, with crude and adjusted prevalence ratios (PR) for working conditions. Informal employment affected 76% of women and 66% of men. Informal workers reported higher exposition to poor working conditions than formal workers and reported worse SPH. Informal workers had a higher risk of P-SPH than formal workers: PR 1.38 [95% CI: 1.16–1.64] in women and PR 1.27 [95% CI: 1.08–1.49] in men. Adjustment by working conditions weakened the association in both sexes. In women, this association was only partially explained by worse working conditions; PR 1.23 [95% CI: 1.04–1.46]. Although some of the negative effect of informal employment on workers´ health can be explained by the characteristics of informality per se, such as poverty, a substantial part of this effect can be explained by poor working conditions.

Among working‐age Australian adults with a disability, we assess the association between disability‐based discrimination and both overall health and psychological distress. Using data from the 2015 Australian Bureau of Statistics Survey of Disability, Ageing and Carers we estimated the proportion of working‐age women and men (15–64 years) with disability who report disability‐based discrimination by socio‐demographic characteristics and assessed the association between disability‐based discrimination and self‐reported health and psychological distress. Nearly 14% of Australians with disability reported disability‐based discrimination in the previous year. Disability‐based discrimination was more common among people living in more disadvantaged circumstances (unemployed, low income, lower‐status occupations), younger people and people born in English‐speaking countries. Disability‐based discrimination was associated with higher levels of psychological distress (OR: 2.53, 95%CI: 2.11, 3.02) and poorer self‐reported health (OR: 1.63, 95%CI: 1.37, 1.95). Disability‐based discrimination is a prevalent, important determinant of health for Australians with disability. Disability‐based discrimination is an under‐recognised public health problem that is likely to contribute to disability‐based health inequities. Public health policy, research and practice needs to concentrate efforts on developing policy and programs that reduce discrimination experienced by Australians with disability.

Aim We aim to assess the effects of the COVID‐19 pandemic on self‐reported health and quality of life among family caregivers of children with disabilities across Europe. Design Cross‐sectional study. Methods Data from the survey by the Eurocarers and IRCCS‐INRCA were used. The data were collected between November 2020 and March 2021 from 16 European countries. Data analysis was done using regression analysis to identify family caregivers' self‐reported health and well‐being predictors. Results This study included 289 caregivers. The mean age of children was 12 years. Their family caregiver's mean age was 44, and they were mainly women. Experience of lack of freedom predicted family caregivers' poor self‐reported health and quality of life. Children's interrupted health and social services also predicted family caregivers' poor self‐reported mental well‐being. Longitudinal evidence on the pandemic's effects and a diverse view of family caregivers of children with disabilities are needed to plan effective post‐pandemic health services and nursing practice. No Patient or Public Contribution.

Background: Fear of crime is a growing social and public health problem globally, including in developed countries such as Sweden. This study investigated the impact of fear of crime on self-reported health and stress among men living in Gävleborg County. Design and Methods: The study used data collected from 2993 men through a cross sectional survey in the 2014 Health in Equal Terms survey. Descriptive and logistic regression analyses were carried out to study the relationship between fear of crime and self-reported health and stress. Results: There was a statistically significant association between fear of crime and self-reported poor health and stress among men residing in Gävleborg County. In the bivariate analysis, men who reported fear of crime had odds of 1.98 (CI 1.47- 2.66) and 2.23 (CI 1.45-3.41) respectively. Adjusting for demographic, social and economic variables in the multivariate analysis only reduced the odds ratio for self-reported poor health to 1.52 (CI 1.05-2.21) but not for self-reported stress with odds of 2.22 (1.27-3.86). Conclusions: Fear of crime among men was statistically significantly associated with self-reported poor health and stress in Gävleborg County. However, the statistically significant relationship remained even after accounting for demographic, social and economic factors, which warrants further research to better understand the role played by other variables.

Background and aims Poor quality of life is a main complaint among individuals with irritable bowel syndrome (IBS). Self-rated health (SRH) is a powerful predictor of clinical outcomes, and also reflects psychological and social aspects of life and an overall sense of well-being. This population-based twin study evaluates how IBS affects ratings of physical and mental health, and influences perceptions of hindrance of daily activity by physical or mental health. Further, we examine how IBS is related to these SRH measures. Methods The sample included 5288 Norwegian twins aged 40–80, of whom 575 (10.9%) suffer from IBS. Hierarchical regressions were used to estimate the impact of IBS on perceptions of health, before and after accounting for other chronic physical and mental health conditions. Two dimensions of SRH, physical and mental, and two aspects of functional limitations, the extent to which physical or mental health interferes with daily activities, were included as outcomes in separate models. Co-twin control analyses were used to explore whether the relationships between IBS and the four measures of SRH are causal, or due to shared genetic or shared environment effects. Results IBS was an independent predictor of poor self-rated physical health (OR = 1.82 [1.41; 2.33]), the size of this effect was comparable to that predicted by chronic somatic conditions. However, in contrast to somatic diseases, IBS was associated with the perception that poorer ratings of mental health (OR = 1.45 [1.02; 2.06]), but not physical health (OR = 1.23 [0.96; 1.58]), interfered with daily activity. The co‐twin control analyses suggest that causal mechanisms best explain the relationships between IBS with self-rated physical health and with hindrance of daily activities. In contrast, the relationship between IBS and self-rated mental health was consistent with shared genetic effects. Conclusion IBS is predictive of poor self-rated physical health. The relationship between IBS and self-rated mental health is best explained by shared genetic effects which might partially explain why mental health interferes with daily activity to a larger degree among those with IBS.

Increasing ownership of smartphones among Americans provides an opportunity to use these technologies to manage medical conditions. We examine the influence of baseline smartwatch ownership on changes in self-reported anxiety, patient engagement, and health-related quality of life when prescribed smartwatch for AF detection. We performed a secondary analysis of the Pulsewatch study (NCT03761394), a clinical trial in which 120 participants were randomized to receive a smartwatch-smartphone app dyad and ECG patch monitor compared to an ECG patch monitor alone to establish the accuracy of the smartwatch-smartphone app dyad for detection of AF. At baseline, 14 days, and 44 days, participants completed the Generalized Anxiety Disorder-7 survey, the Health Survey SF-12, and the Consumer Health Activation Index. Mixed-effects linear regression models using repeated measures with anxiety, patient activation, physical and mental health status as outcomes were used to examine their association with smartwatch ownership at baseline. Ninety-six participants, primarily White with high income and tertiary education, were randomized to receive a study smartwatch-smartphone dyad. Twenty-four (25%) participants previously owned a smartwatch. Compared to those who did not previously own a smartwatch, smartwatch owners reported significant greater increase in their self-reported physical health (  = 5.07,  < 0.05), no differences in anxiety (  = 0.92,  = 0.33), mental health (  = -2.42,  = 0.16), or patient activation (  = 1.86,  = 0.54). Participants who own a smartwatch at baseline reported a greater positive change in self-reported physical health, but not in anxiety, patient activation, or self-reported mental health over the study period.

Background: Limited research has focused on self-reported oral health in older Thai individuals. Objective: We explored the factors associated with self-reported oral health among older adults residing in rural Thailand. Methods: This cross-sectional study included males and females aged [greater than or equal to] 60 years living in Phon Thong district, Roi Et province, a rural area in northeast Thailand. This community-based study was conducted between May 2021 and December 2021. A trained interviewer administered a face-to-face interview questionnaire. Study data were analyzed using descriptive statistics, Pearson's chi-squared test, and binary logistic regression. Results: In total, 249 older individuals completed the interviews. Most study participants were aged [greater than or equal to] 67 years (55.8%), with a mean age of 66.92 years. Pearson's chi-squared test showed statistically significant associations between self-reported oral health and age (P = 0.035) and chewing ability (P = 0.005). The multivariate binary logistic regression analysis revealed significant associations between self-reported poor oral health and older age (AOR = 0.290, 95% CI: 0.091-0.925) and chewing discomfort (AOR = 4.032, 95% CI:1.119-14.56). We observed no significant associations between self-reported oral health and sex, toothbrushing frequency, and speaking ability. Conclusion: Younger respondents with chewing discomfort were more likely to self-report poor oral health. In rural areas, nonprofessional health providers can use a single-item self-reported oral health question as a simple tool for evaluating oral health status in the elderly. Moreover, dental health education programs are needed to help older individuals improve their oral self-care, access dental services, and achieve appropriate oral function. Such programs are essential for promoting good oral health in this population, particularly among \"younger\" elders. Keywords: geriatric dentistry, oral function, oral health, health promotion, self-reported oral health

Background While surveys in high-income countries show that women generally have poorer self-reported health than men, much less is known about gender differences in other regions of the world. Such data can be used to examine the determinants of sex differences. Methods We analysed data on respondents 18 years and over from the World Health Surveys 2002–04 in 59 countries, which included multiple measures of self-reported health, eight domains of functioning and presumptive diagnoses of chronic conditions. The age-standardized female excess fraction was computed for all indicators and analysed for five regional groups of countries. Multivariate regression models were used to examine the association between country gaps in self-reported health between the sexes with societal and other background characteristics. Results Women reported significantly poorer health than men on all self-reported health indicators. The excess fraction was 15 % for the health score based on the eight domains, 28 % for “poor” or “very poor” self-rated health on the single question, and 26 % for “severe” or “extreme” on a single question on limitations. The excess female reporting of poorer health occurred at all ages, but was smaller at ages 60 and over. The female excess was observed in all regions, and was smallest in the European high-income countries. Women more frequently reported problems in specific health domains, with the excess fraction ranging from 25 % for vision to 35 % for mobility, pain and sleep, and with considerable variation between regions. Angina, arthritis and depression had female excess fractions of 33, 32 and 42 % respectively. Higher female prevalence of the presumptive diagnoses was observed in all regional country groups. The main factors affecting the size of the gender gap in self-reported health were the female-male gaps in the prevalence of chronic conditions, especially arthritis and depression and gender characteristics of the society. Conclusions Large female-male differences in self-reported health and functioning, equivalent to a decade of growing older, consistently occurred in all regions of the world, irrespective of differences in mortality levels or societal factors. The multi-country study suggests that a mix of biological factors and societal gender inequalities are major contributing factors to gender gap in self-reported measures of health.

Interpreting health information and acquiring health knowledge have become more important with the accumulation of scientific medical knowledge and ideals of patient autonomy. Health literacy and its tremendous success as a concept can be considered an admission that not all is well in the distribution of health knowledge. The internet makes health information much more easily accessible than ever, but it introduces its own problems, of which health disinformation is a major one. The objective of this study was to determine whether objective and subjective health literacy are independent concepts and to test which of the two was associated more strongly with accurate judgments of the quality of a medical website and with behavioral intentions beneficial to health. A survey on depression and its treatments was conducted online (n=362). The Newest Vital Sign was employed to measure objective, performance-based health literacy, and the eHealth Literacy Scale was used to measure subjective, perception-based health literacy. Correlations, comparisons of means, linear and binary logistic regression, and mediation models were used to determine the associations. Objective and subjective health literacy were weakly associated with one another (r=0.06, P=.24). High objective health literacy levels were associated with an inclination to behave in ways that are beneficial to one's own or others' health (Exp[B]=2.068, P=.004) and an ability to recognize low-quality online sources of health information (β=-.4698, P=.005). The recognition also improved participants' choice of treatment (β=-.3345, P<.001). Objective health literacy helped people to recognize misinformation on health websites and improved their judgment on their treatment for depression. Self-reported, perception-based health literacy should be treated as a separate concept from objective, performance-based health literacy. Only objective health literacy appears to have the potential to prevent people from becoming victims of health disinformation.

Living near vegetation, often called “green space” or “greenness”, has been associated with numerous health benefits. We hypothesized that the two key components of urban vegetation, trees and grass, may differentially affect health. We estimated the association between near-residence trees, grass, and total vegetation (from the 2010 High Resolution Land Cover dataset for New York City (NYC)) with self-reported health from a survey of NYC adults (n = 1281). We found higher reporting of “very good” or “excellent” health for respondents with the highest, compared to the lowest, quartiles of tree (RR = 1.23, 95% CI = 1.06–1.44) but not grass density (relative risk (RR) = 1.00, 95% CI = 0.86–1.17) within 1000 m buffers, adjusting for pertinent confounders. Significant positive associations between trees and self-reported health remained after adjustment for grass, whereas associations with grass remained non-significant. Adjustment for air pollutants increased beneficial associations between trees and self-reported health; adjustment for parks only partially attenuated these effects. Results were null or negative using a 300 m buffer. Findings imply that higher exposure to vegetation, particularly trees outside of parks, may be associated with better health. If replicated, this may suggest that urban street tree planting may improve population health.