Social Determinants of Self-reported Health Among Population in Republic of Macedonia – Results from a Case-control Study

INTRODUCTION: Studying self-reported health is considered an indicator for morbidity and mortality that may be used in primary health care to detect poor health in certain population groups that predicts health care utilization. GOAL: The goal of the survey is to assess the socioeconomic self-rated health gradient and to describe contribution of behavioral risk factors to this gradient among population in Republic of Macedonia. MATERIAL AND METHODS: Data is collected through a “nested case-control study”, conducted in the period March – December, 2013. “Cases” are households with TB patient(s) registered in the period July, 2012 – June, 2013 and “controls” are households randomly chosen in cases’ immediate vicinity. RESULTS: The total study population is 562 households with total of 2720 respondents. Self-rated health was reported as excellent or good by only half of the respondents, with slightly less positive answers among cases compared to controls and evident differences in responses for poor or extreme difficulties in everyday life. Positive association was found between poor rated health and long-standing diseases and education was associated with poor self-rated health. Adding questions on mobility, self-care, pain, cognition, interpersonal activities and affect has only reaffirmed the findings, with statistically significant differences among study groups along all six dimensions. CONCLUSION: The ease of use of simple questions to ask for self-rated health makes it an extremely beneficial tool in health care planning.