The Structure of Health in Europe: the Relationships between Morbidity, Functional Limitation, and Subjective Health

Aija Duntava, Uppsala University
Liubov V. Borisova, Uppsala University
Ilkka Henrik Mäkinen , Uppsala University

The main objective of this study is to explore the relationships between the three commonly used proxies of health, morbidity, functional limitation, and subjective health, using the most recent data from 18 European countries. The existing studies on the topic are outdated, limited to the United States and to elderly population. Data on 32,679 respondents of the European Social Survey (2014) were analyzed using structural equation modeling. The results suggest that (a) morbidity and functional limitation lead to poorer self-rated health, and (b) morbidity increases the probability of reporting functional limitation(s). Moreover, functional limitation mediates the relationship between morbidity and self-rated health. The model holds across both genders and all age groups. The differences in the health structure between all seven pairs of groups divided by gender, age and gender-age were investigated using the multi-group analysis in SEM and independent-samples t-tests. Significant differences in morbidity indicators were observed between six of these. Similarly, differences in the magnitude of the relationships between the studied aspects of health were found among five pairs of groups. When both gender and age are taken into account the differences in the structure of health seem to diminish, apart from the elderly. This suggests that the health structure of the elderly is different from that of younger adults. It is recommended for policy planners to acknowledge the group differences by shaping the policies and health services accordingly.

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 Presented in Session 30. Health, Wellbeing and Morbidity