Behavioral Risk Factor Surveillance System 2009: Determinants of self-rated health for adults with chronic diseases

Chronic diseases are the leading causes of death and disability in the United States accounting for 70% of all deaths. As the U.S. population continues to age, the burden of chronic diseases will become even more apparent and significant. Self-rated health is an important indicator of health and is a significant predictor of mortality and morbidity. The purpose of this study is to examine the key predictors of poor self-rated health status among those with and without chronic diseases. Using the 2009 Behavioral Risk Factor Surveillance System (BRFSS) survey, we performed multiple logistic regression analysis to estimate the effects of 3 main categories of predictors: 1) health care access 2) health behaviors 3) emotional support. We also assessed effect modification by self-reported chronic disease through stratification. Our findings show that individual demographic factors make a greater contribution to self-rated poor health than health behaviors. Age, income (OR=5.597, p<0.001) and education (OR=2.204, p<0.001) were major contributors to self-rated health compared with health behaviors like alcohol consumption (OR=0.999, p<0.001), physical activity and smoking. An important finding is that emotional support was a significant predictor of self-rated health for persons with and without chronic illness but more so for healthy persons. Moreover, insufficient emotional support (“sometimes” or “rarely”) increases the odds of reporting poor health compared to having no emotional support at all. The results of this study have potential implications for research and practice when considering the use of self-rated health status as a marker for evaluating overall health in the context of chronic diseases.