Determinants of self rated health for Canadians with chronic disease and disability.

OBJECTIVE To identify the factors associated with self rated health of people with and without chronic health conditions or long term disability. SETTING Canadian household population. DESIGN Analysis of 1994/95 National Population Health Survey interview data with 13,995 respondents aged 20 years and older. Determinants of poor and good compared with excellent health were examined using multivariate nominal logistic regression. Factors included in the analyses were illness related (chronic disease, long and short-term disability, and pain) demographic, lifestyle (smoking, physical activity, drinking), and social psychological resources (mastery, chronic stress, distress, self esteem, and social support). RESULTS Illness related variables were associated with poor health, with smaller but significant contributions from demographic and lifestyle factors. Psychological resources, especially high mastery and self esteem, are associated with better health in those with chronic conditions or disability. CONCLUSION The determinants of self rated health for people with chronic illness and disability make the greatest contribution to the findings for the overall population.