Associations between self-rated health and health behaviour among older adults in Estonia: a cross-sectional analysis

OBJECTIVES: The population of Estonia has one of the lowest life expectancies and health statuses in Europe. This is reflected in a lower perception of health among older adults. This study focuses on the role of health behaviour (smoking, alcohol consumption, physical activity and nutrition) in self-rated health, accounting for sociodemographic characteristics, activity limitations and long-term illnesses as well as satisfaction with life of older Estonian men and women. DESIGN: We use representative cross-sectional data from Wave 4 of the Estonian Survey of Health, Ageing and Retirement in Europe, conducted mainly in 2011. PARTICIPANTS: Frequencies, χ(2) tests and logistic regression models include respondents aged 50 years and older, with no upper age limit (n=6660). RESULTS: Men have 20% higher odds (CI 1.02 to 1.43) of poor self-rated health. Being of foreign origin (OR 1.48; CI 1.24 to 1.77), having a basic (2.50; CI 2.06 to 3.00) or secondary (1.71; CI 1.43 to 2.04) education, being retired (2.00; CI 1.65 to 2.44) or staying at home (1.49; CI 1.16 to 1.93) and having activity limitations (3.25; CI 2.77 to 3.80) or long-term illnesses (4.78; CI 4.08 to 5.60) are related to poor self-rated health. Never being involved in vigorous (2.30; CI 1.90 to 2.79) or moderate physical activity (1.41; CI 1.02 to 1.94), and consuming legumes and eggs less frequently (1.25; CI 1.08 to 1.45) is associated with poorer self-rated health. Lower satisfaction with life accounts for some of the variation (2.28; CI 1.92 to 2.71). CONCLUSIONS: There is a strong cumulative effect of one’s previous life course on the self-rated health of older adults in Estonia, suggesting that public health policies have long-term consequences rather than immediate consequences. Health services supporting health behaviours and targeting vulnerable population groups with specific sociodemographic characteristics and health problems may influence self-rated health for some. Public health services emphasising social activities or psychological aspects may be most successful in improving self-rated health of older Estonians through satisfaction with life.