Ekologiya cheloveka (Human Ecology)Ekologiya cheloveka (Human Ecology)Экология человека1728-08692949-1444Eco-Vector6442410.33396/1728-0869-2021-3-48-53ArticlesСтатьиResearch ArticleSelf-Perceived Health and Its Associations with Social Factors and Perceived Environmental Quality in Southern Kazakhstan: a Cross-Sectional StudyСУБЪЕКТИВНАЯ ОЦЕНКА ЗДОРОВЬЯ, СВЯЗЬ С СОЦИАЛЬНЫМИ ФАКТОРАМИ И ЭКОЛОГИЧЕСКИМ БЛАГОПОЛУЧИЕМ В ЮЖНОМ КАЗАХСТАНЕ: ПОПЕРЕЧНОЕ ИССЛЕДОВАНИЕAlipbekovaSandugash N.АлипбековаС. Н.

PhD student

sandu-92@mail.ruBuleshovMyrzatai A.БулешовМ. А.Khoja Akhmet Yassawi International Kazakh-Turkish UniversityМеждународный казахско-турецкий университет им. Х. А. Ясави15032021283NO3 (2021)№3 (2021)485331032021Copyright ©; 2021, Alipbekova S.N., Buleshov M.A.Copyright ©; 2021, Алипбекова С.Н., Булешов М.А.2021Alipbekova S.N., Buleshov M.A.Алипбекова С.Н., Булешов М.А.https://creativecommons.org/licenses/by-nc-nd/4.0https://hum-ecol.ru/1728-0869/article/view/64424

Introduction: Self-perceived health (SPH) has been shown to be a valid proxy indicator of health status in epidemiological studies. Substantial social variations in SPH have been previously reported from Kazakhstan. Southern Kazakhstan is among the poorest regions of the country with limited health information in international peer-reviewed literature. Aim: The aim of this study was to assess SPH in Southern Kazakhstan and its associations with selected social factors and perceived environmental quality. Methods: Altogether, 1 148 permanent residents of the Turkistan region aged 16-63 years participated in a cross-sectional study. Data on SPH, age, gender, ethnicity, marital status, education, perceived environmental quality, smoking and alcohol consumption were collected by a questionnaire. Associations between SPH and selected socio-demographic and geographical variables were assessed using multivariable logistic regression. Crude and adjusted odds ratios (OR) were calculated. Results: Poor, satisfactory, good and very good SPH was reported by 4.4 %, 27.1 %, 55.3 % and 13.2 % of the participants, respectively. Men (OR = 2.11; 95 % CI: 1.53-2.89), cohabiting responders (OR = 2.37; 95 % CI: 1.30-4.35), those who perceived environmental quality as unhealthy (OR = 2.12; 95 % CI: 1.31-3.43) or satisfactory (OR = 1.75; 95 % CI: 1.16-2.66), smokers (OR = 1.64; 95 % CI: 1.02-2.64), alcohol drinkers (OR = 1.44; 95 % CI: 1.00-2.06) and residents of Ordabasinski district (OR = 1.98; 95 % CI: 1.22-3.23) were more likely to report poorer health (poor+satisfactory combined) than their counterparts in the reference categories in the final multivariable model. Conclusions: The observed variations in SPH in Southern Kazakhstan contribute to the knowledge on inequalities in health in Kazakhstan and warrant monitoring of health inequalities on the national level. Further research in Southern Kazakhstan should address the factors behind the associations documented in this study.

Введение. Субъективная оценка здоровья (СОЗ) является валидным прокси-индикатором фактического здоровья и может использоваться в эпидемиологических исследованиях. Предыдущие исследования показали существенные социальные различия в СОЗ. Южный Казахстан является экономически и экологически неблагополучным регионом с ограниченной информацией о здоровье населения в международной рецензируемой литературе. Цель. Изучить СОЗ населения на юге Казахстана в зависимости от социальных факторов и субъективной оценки экологического благополучия (СОЭБ). Методы. 1 148 человек из четырех сельских районов и? двух городов Туркестанской области участвовали в поперечном исследовании. Данные о различных аспектах здоровья и факторах риска собирали посредством анкетирования с помощью подготовленных сотрудников учреждений здравоохранения. Для данного исследования использовали только данные о СОЗ, возрасте, поле, этнической принадлежности, семейном положении, образовании, курении, употреблении алкоголя и СОЭБ в месте проживания. Связь между признаками анализировали с помощью многомерного логистического регрессионного анализа с расчетом нескоррективанных и скорректированых отношений шансов (ОШ) с 95 % доверительными интервалами (ДИ). Результаты. Распространенность плохой, удовлетворительной, хорошей и очень хорошей СОЗ составила 4,4 %, 27,1 % 55,3 % и 13,2 % соответственно. Мужской пол (OШ = 2,11; 95 % ДИ: 1,53-2,89), сожительство (OШ = 2,37; 95 % ДИ: 1,30-4,35), низкая (ОШ = 2,12; 95 % ДИ: 1,31-3,43) или удовлетворительная (ОШ = 1,75; 95 % ДИ: 1,16-2,66) оценка экологического благополучия, курение (ОШ = 1,64; 95 % ДИ: 1,02-2,64), употребление алкоголя (ОШ = 1,44; 95 % ДИ: 1,00-2,06) и проживание в Ордабасинском районе (ОШ = 1,98; 95 % ДИ: 1,22-3,23) были связаны с более низкой СОЗ. Выводы: Результаты исследования дополняют предыдущие казахстанские данные о социальных различиях в показателях здоровья населения и подтверждают необходимость проведения мониторинга социального неравенства, в т. ч. и по показателям здоровья. Дальнейшие исследования в Казахстане должны быть нацелены на изучение факторов, объясняющих выявленные статистические связи.

Self-rated healthsocial inequalitiesperception of environmentKazakhstanсамооценка здоровьясоциальное неравенствосубъективная оценка экологического благополучияКазахстанAbikulova A. K., Tulebaev K. A., Akanov A. A., Turdalieva B. S., Kalmahanov S. B., Kumar A.B., Izekenova A. K., Mussaeva B. A., Grjibovski A. M. Inequalities in self-rated health among 45+ year-olds in Almaty, Kazakhstan: a cross-sectional study. BMC Public Health. 2013, 13, 654.Aubin H. J., Ali Oicheih L., Gabriel S., Berlin I. Association of smoking reduction and mortality: protocol for a systematic review and meta-analysis of longitudinal observational studies. BMJ Open. 2021 Jan 20, 11 (1), e039483.Bircher J., Kuruvilla S. Defining health by addressing individual, social, and environmental determinants: new opportunities for health care and public health. J Public Health Policy. 2014, 35, pp. 363-386.Bobak M., Pikhart H., Hertzman C., Rose R., Marmot M. Socioeconomic factors, perceived control and self-reported health in Russia: a cross-sectional survey. Soc Sci Med. 1998, 47, pp. 269-279.Bobak M., Pikhart H., Rose R., Hertzman C., Marmot M. Socioeconomic factors, material inequalities, and perceived control in self-rated health: cross-sectional data from seven post-communist countries. Soc Sci Med. 2000, 51, pp. 1343-1350.Buka S. L., Rosenthal S. R., Lacy M. E. Epidemiological Study Designs: Traditional and Novel Approaches to Advance Life Course Health Development Research. In: Halfon N., Forrest C., Lerner R., Faustman E. (eds). Handbook of Life Course Health Development. Springer, Cham, 2018.Burström B., Fredlund P. Self rated health: Is it as good a predictor of subsequent mortality among adults in lower as well as in higher social classes? J Epidemiol Community Health. 2001, 55, pp. 836-840.DeSalvo K. B., Bloser N., Reynolds K., He J., Muntner P: Mortality prediction with a single general self-rated health question. A meta-analysis. J Gen Intern Med. 2006, 21, pp. 267-275.Dunn J. R., Walker J. D., Graham J., Weiss C. B. Gender Differences in the Relationship between Housing, Socioeconomic Status, and Self-Reported Health Status. Rev Environ Health. 2021, 19, pp. 177-196.Gilmore A. B., McKee M., Rose R. Determinants of and inequalities in self-perceived health in Ukraine. Soc Sci Med. 2002, 55, pp. 2177-2188.Idler E. L., Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997, 38, pp. 21-37.Jasilionis D., Stankuniene V., Ambrozaitiene D., Jdanov D. A., Shkolnikov V. M. Ethnic mortality differentials in Lithuania: contradictory evidence from census-linked and unlinked mortality estimates. J Epidemiol Community Health. 2012, 66, e7.Loretta G. Platts, Christopher J. Gerry. Social inequalities in self-rated health in Ukraine in 2007: the role of psychosocial, material and behavioural factors. Eur J Public Health. 2017, 27, pp. 211-217.Martikainen M. G., Aromaa A., Heliovaara M., Dlaukka T., Knekt P., Maatele J., Lahelma E. Reliability of perceived health by sex and age. Soc Sci Med. 1999, 48, pp. 1117-1122.McCormack G. R., Cabaj J., Orpana H., Lukic R., Blackstaffe A., Goopy S., Hagel B., Keough N., Martinson R., Chapman J., Lee C., Tang J., Fabreau G. A scoping review on the relations between urban form and health: a focus on Canadian quantitative evidence. Health Promot Chronic Dis Prev Can. 2019, 39, pp. 187-200.Ou J. Y., Peters J. L., Levy J. I. et al. Self-rated health and its association with perceived environmental hazards, the social environment, and cultural stressors in an environmental justice population. BMC Public Health. 2018, 18, 970.Salgado M., Madureira J., Mendes A. S. et al. Environmental determinants of population health in urban settings. A systematic review. BMC Public Health. 2020, 20, p. 853.Stanojevic Jerkovic O., Sauliune S., Sumskas L., Birt C. A., Kersnik J. Determinants of self-rated health in elderly populations in urban areas in Slovenia, Lithuania and UK: findings of the EURO-URHIS 2 survey. Eur J Public Health. 2017, 27 (suppl 2), pp. 74-79.Stelemekas M., Manthey J., Badaras R., Casswell S., Ferreira-Borges C., Kalediene R., Lange S., Neufeld M., Petkeviciene J., Radisauskas R., Room R., Telksnys T., Zurlyte I., Rehm J. Alcohol control policy measures and allcause mortality in Lithuania: an interrupted time-series analysis. Addiction. 2021 Mar 10. doi: 10.1111/add.15470. (In press)Supiyev A., Nurgozhin T., Zhumadilov Z., Sharman A., Marmot M., Bobak M. Levels and distribution of self-rated health in the Kazakh population: results from the Kazakhstan household health survey 2012. BMC Public Health. 2014, 14, 768.