A theoretical framework of the good health status of Jamaicans: using econometric analysis to model good health status over the life course

BACKGROUND: In recent times, the World Health Organization has increasing drawn attention to the pivotal role of social conditions in determining health status. The non-biological factors produced inequalities in health and need to be considered in health development. In spite of this, extensive review of health Caribbean revealed that no study has examined health status over the life course of Jamaicans. With the value of research in public health, this study is timely and will add value to understand the elderly, middle age and young adults in Jamaica. OBJECTIVE: The aim of this study is to develop models that can be used to examine (or evaluate) health of Jamaicans, elderly, middle age and young adults. METHOD: The current study used data from a cross-sectional survey which was conducted between July and October 2002. Stratified random probability sampling technique was used to collect the data from 25,018 respondents across the island. The non-response rate for the survey was 29.7% with 20.5% who did not respond to particular questions, 9.0% did not participated in the survey and another 0.2% was rejected due to data cleaning. Logistic regression analyses were used to model health status of Jamaicans, young adults, middle age adults and elderly. The predictive power of the model was tested using Omnibus Test of Model and Hosmer and Lemeshow (24) was used to examine goodness of fit of the model. The correlation matrix was examined in order to ascertain whether autocorrelation (or multi-collinearity) existed between variables. RESULTS: Using logistic regression analysis, eleven variables emerged as statistically significant predictors of current good health Status of Jamaicans (p<0.05). The factors are retirement income (95%CI=0.487-0.958), logged medical expenditure (95% Confidence Interval, CI =0.907-0.993), marital status (Separated or widowed or divorced: 95%CI=0.309-0.464; married: 95%CI=0.495-0.667; Never married), health insurance (95%CI=0.029-0.046), area of residence (other towns:, 95%CI=1.052-1.455; rural area:), education (secondary: 95%CI=1.167-1.576; tertiary: 95%CI=1.466-2.820; primary or below: OR=1.00), social support (95%CI=0.745-0.964), gender (95%CI=1.281-1.706), psychological affective conditions (negative affective: 95%CI=0.939-0.980; positive affective: 95%CI:1.047-1.107), number of males in household (95%CI:1.066-1.235), number of children in household (95%CI=1.117-1.266) and previous health status. CONCLUSION: The study concludes that good health status across the three age cohorts can be modelled using data for Jamaicans. Health status is determined by a number of non-biological factors, and that poor health status is difficult to model as a low proportion of the data was correctly classified. Public health requires research with which to make more informed decisions, which means that this study offers an understanding of Jamaicans as well as young adults; middle aged adults and elderly.