Factors affecting change over time in self-reported health.

BACKGROUND Self-reported health status has become a conventional measure of health status at the population level. Further, the literature supports its use as a valid indicator of morbidity and mortality. However, relatively little attention has been paid to how self-reported health status changes over time or the factors affecting change. This paper explores the factors affecting health status change over time using data from a neighbourhood health survey. METHODS Two rounds (2001; 2003) of health survey data (n=671) were collected across 4 distinct neighbourhoods in Hamilton, Ontario. Logistic regression analysis is used to predict change in self-reported health status between the two time periods as well as determinants of change using a range of compositional, contextual and collective characteristics of individuals as potential explanatory variables. RESULTS Results reveal that approximately one third of participants experienced a change in health status between the two survey years. Interestingly, the key factors affecting change in health status are compositional characteristics of individuals (e.g., smoking, health care use) as opposed to contextual (e.g., neighbourhood of residence) or collective (e.g., marital status). Contrary to published literature, the current study does not reveal any significant links between a change in health status and either gender or age. CONCLUSION These results inform our understanding of both the stability of health ratings over time and the determinants of health status change. Further research should be undertaken to enhance this understanding; in particular, studies with larger sample sizes, longer time frames and more sensitive indicators of composition, context and collective are needed.