Lifestyles and self-rated health, in Portuguese elderly from rural and urban areas.

Joana Araújo, Elisabete Ramos, Carla Lopes


The perception of health status is essential for better planning in health, not only due to its role as a determinant of health, but also because it is related with the adoption of health-promoting behaviours. The aim of the present study was to explore the relationship between lifestyles and self-rated health, in Portuguese elderly, according to their residence in rural or urban areas. We evaluated 80 individuals from Rebordelo, Trás-os-Montes (rural area) and 383 from Porto (urban area), with 60 or more years and with four or less years of education. Data were collected by trained interviewers, through a structured questionnaire, to evaluate social, demographic, health and behavioural characteristics. Anthropometric measures were also obtained. Leisure-time physical activity, tobacco, alcohol and fruit and vegetable consumption were the lifestyles evaluated. To evaluate self-rated health, each person rated their health status, according to five options (excellent, very good, good, reasonable or poor), later grouped into two: poor versus the others. Odds ratio (OR) and 95% confidence intervals (95%CI) were calculated by unconditional logistic regression, after adjustment for sex and education. About 41% of the elderly from the rural area and 32% from the urban area rated their health status as poor. In multivariate analysis, in the rural area, poor self-rated health was inversely associated with the practice of leisure-time physical activity (OR = 0.22, 95%CI 0.06-0.80). In urban area, alcohol consumption was associated with a lower probability of self-rating health as poor (considering not drinking as reference, >0-15 g alcohol/day: OR = 0.42, 95%CI 0.24-0.72; >15 g alcohol/day: OR = 0.60, 95%CI 0.32-1.11). In the rural area, a positive association between fruit and vegetable consumption and poor self-rated health was found (≥ 5 vs. <5 portions/day: OR = 5.21, 95%CI 1.14-23.83), while in the urban area there was an inverse association (OR = 0.75, 95%CI 0.45-1.25). Poor Self-rated health was inversely associated with leisure-time physical activity in the rural area, and with the consumption of alcoholic beverages in the urban area. The consumption of fruit and vegetables was associated with self-rated health in both populations, but while in the rural area the consumption of 5 or more servings per day was associated with a poor perception of health, in the urban area this association was in the inverse direction.

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