Relationship between self rated health and ADL status among stroke victims in the NC–EPESE population

Self rated health (SRH), an important measure in epidemiological studies, is also proven a strong predictor of survival and future health outcomes. As a chronic disease construct, it reportedly consists of three factors: disease, disability and functional (ADL) limitations. Stroke accounts for the largest impact on SRH among chronic conditions. However, the SRH profile of the stroke population is under-investigated and unclear. Studies document that stroke prevalence and impact on disability status vary by race and that SRH varies among different populations. This cross-sectional study used the North Carolina Established Populations for the Epidemiological Study of the Elderly dataset (NC-EPESE) to examine the relationship between SRH and Activities of Daily Living (ADL) among stroke victims, by race. SRH was assessed at two levels: favorable (excellent/good) and unfavorable (fair/poor) health. ADL status was assessed with the Katz-ADL scale and captured data on 6 activities of daily living: walking, bathing, dressing, eating, transfer and toileting. ADL was further assessed by six questions which captured upper and lower extremity limitations. Findings showed that SRH differed significantly by gender (p=.035) but not by race (p=.180). SRH and ADL was not significantly associated among blacks but was for whites. Modeling the relationship and adjusting for covariates, SRH significantly predicted ADL status among whites OR=.24; p=.02, but not among blacks. Findings may be indicative of information bias or differences in SRH construct by race. Further studies are needed to understand the components and relationship between SRH and ADL by race.