Socioeconomic factors, material inequalities, and perceived control in self-rated health: cross-sectional data from seven post-communist countries

This study examined the association between perceived control and several s ocioeconomic variables and self-rated health in seven post-communist countr ies (Russia, Estonia, Lithuania, Latvia, Hungary, Poland, Czech Republic). Questionnaire interviews were used to collect data on self-rated health in the last 12 months, education, marital status, perceived control based on n ine questions, and material deprivation based on availability of food, clot hing and heating. For each population, two ecological measures of material inequalities were available: an inequality score estimated from the survey data as the distance between the 90th and 10th percentiles of material depr ivation, and Gini coefficient from published sources. Data on 5330 men and women aged 20-60 were analysed. Prevalence of poor health (worse than avera ge) varied between 8% in Czechs and 19% in Hungarians. The age-sex-adjusted odds ratio for university vs primary education was 0.36 (0.26-0.49); odds ratios per 1 standard deviation increase in perceived control and in materi al deprivation were 0.58 (95% CI 0.48-0.69) and 1.51 (1.40-1.63), respectiv ely. The odds ratio for an increase in inequality equivalent to the differe nce between the most and the least unequal populations was 1.49 (0.88-2.52) using the material inequality score and 1.41 (0.91-2.20) using the Gini co efficient. No indication of an effect of either inequality measure was seen after adjustment for individuals' deprivation or perceived control. The re sults suggest that, as in western populations, education and material depri vation are strongly related to self-rated health. Perceived control appeare d statistically to mediate some of the effects of material deprivation. The non-significant effects of both ecological measures of inequality were eli minated by controlling for individuals' characteristics. (C) 2000 Elsevier Science Ltd. All rights reserved.