Assessment of consistency between self reported health status and performance based health status (functionality) as measures of health status of adults in the Kassena-Nankana District, Ghana at the beginning of 21st century

Lele, Pallavi Sachin
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Introduction: Despite the steady growth of the elderly population in developing countries, this group, remains neglected in health related policies in developing countries, largely due to lack of empirical data on the health problems of elderly. There is need for research and development of convenient and cost effective ways of generating information on the health status of the elderly. Self reports of health are becoming common in health surveys of elderly throughout the world. Despite the considerable use of self reports in developed countries, in developing countries such research is only beginning. Therefore there is need for systematic documentation of factors affecting self reported health status in developing country settings for effective usage of self reports in surveys. Material and methods: The Adult Health and Aging Survey undertaken by Navrongo Health Research Centre, Ghana, as part of WHO SAGE (Study on Global Aging) aimed at generating longitudinal data on health and wellbeing of the elderly in Kassena-Nankana district of Ghana. This survey provides an opportunity to assess consistency between various dimensions of self reported health by comparing measures in an effort to establish the validity of information obtained by self reports. Analysis: Statistical analysis of self reported overall health (SRH), experiences of difficulty encountered in work and day to day activities (Overall Difficulty) and component experiences of health over various domains was carried out using ordered logistic regression and kappa analysis in order to understand what type of relationship exists between different types of measures of health. Overall self reported status of health (SRH) was the main outcome variable and three sets of variables were used as explanatory variables. The first set of variables captured functionality, the second captured psychosocial aspects of health, while the third involved demographic characteristics as possible confounders. Results: An analysis involving 4483 elderly individuals showed that functionality was associated with overall self reported health status in both summary and component forms. Addition of psychosocial domains to the model improved the model when summary functionality was used. However, addition of possible confounders did not improve the model. Conclusion and recommendations: The findings indicate that sex, marital status and ethnic background are important factors to be taken into account while interpreting the responses of self reported health in the Kassena-Nankana district of Ghana. For the current analysis both outcome and explanatory variables were self reported. The findings of the study would get validated with further research into associations between self reported measures and performance based measures and qualitative inquiries on meanings of overall and component health experiences in the same population.
M.Sc.(Med.), Faculty of Health Sciences, University of the Witwatersrand, 2009
health status, Kassena-Nankana, District, Ghana, adults