Social participation and self-assessment of health status among older people in Brazil

Abstract To estimate the prevalence of social participation (exposure) and its association with positive self-assessment of overall health status (SAH) (outcome) among 7,712 Brazilian elderly interviewed in the National Health Survey 2013. A cross-sectional study that used Propensity Score (PS) to improve comparability between the group exposed and no exposed to social participation. Poisson regression was performed to determine the prevalence and association of interest using crude and adjusted by inverse probability of selection of PS. Social participation was reported by 25.1% (CI95%: 23.4-26.9) and was lower among poor older people, who depend on public transportation and live in more precarious contexts. Most did not SAH positively, but the proportion was higher when they had social participation (48.0%; CI95%: 46.0-51.0). There was a positive association of social participation with SAH positive. The association using the adjusted model (PR: 1.15; CI95%: 1.08-1.22) attenuated the estimated in the crude model. Elderly exposed were 15% more likely to provide a positive SAH. Despite low levels in Brazil, there was a positive association between of social participation and SAH, confirming that engagement in such activities provides important gains for the health and quality of life.

摘要 本研究旨在评估2013年全国健康调查中受访的7712名巴西老年人群的社会参与（暴露因素）流行率，及其与总体健康状况正向自我评估（Self-Assessment of Health，SAH，结局指标）之间的关联。本研究为横断面研究，采用倾向得分（Propensity Score，PS）法提升社会参与暴露组与非暴露组间的可比性。本研究采用泊松回归模型，分别通过粗模型以及经倾向得分选择逆概率校正后的模型，计算目标流行率与关联强度。报告存在社会参与行为的老年人群占比为25.1%（95%置信区间：23.4~26.9），该比例在贫困老年人、依赖公共交通出行以及生活环境较为窘迫的群体中更低。多数老年人未做出正向健康自评，但在存在社会参与行为的群体中，正向自评比例更高（48.0%；95%置信区间：46.0~51.0）。社会参与与正向健康自评存在正向关联。经校正后的模型（患病率比Prevalence Ratio，PR：1.15；95%置信区间：1.08~1.22）所得关联强度弱于粗模型。暴露于社会参与的老年人做出正向健康自评的概率高出15%。尽管巴西老年人群的社会参与水平较低，但社会参与与正向健康自评之间仍存在正向关联，证实参与此类活动可对健康与生活质量带来重要增益。