Title

The Association Between Hardship and Self-Rated Health: Does the Choice of Indicator Matter?

Publication Date

3-29-2018

Document Type

Article

Abstract

Purpose The purpose of this study was to investigate the association between four specific forms of hardship (difficulty paying bills, ongoing financial stress, medication reduction due to cost, and food insecurity) and self-rated health among older men and women. Methods Cross-sectional logistic regression analysis was conducted using the 2010 wave of the Health and Retirement Study Leave-Behind Questionnaire (N = 7619) to determine the association between four hardship indicators and self-rated health. Hardship indicators (difficulty paying bills, ongoing financial stress, medication reduction due to cost, and food insecurity) were dichotomized (0 = no hardship, 1 = yes hardship) for this analysis. Results After adjusting for sociodemographic factors, participants reporting difficulty paying bills had an 1.8 higher odds of reporting poor self-rated health (95% confidence intervals [CI]: 1.57, 2.15) and those reporting taking less medication due to cost had a 2.5 times higher odds of poor self-rated health (95% CI: 1.97, 3.09) compared to those not reporting these hardships. When stratified by gender, and adjusting for sociodemographic factors, men who took less medication due to cost had a 1.93 higher odds of low self-rated health (95% CI: 1.39, 2.67) and women who took less medications due to cost had a 2.9 higher odds of reporting poor self-rated health (95% CI: 2.23, 2.70) compared to women not reporting these hardships. Conclusions Research in this area can provide greater conceptual and measurement clarity on the hardship experience and further elucidate the pathway between specific hardships and poor health outcomes to inform intervention development.

Publication Title

Annals of Epidemiology

DOI

10.1016/j.annepidem.2018.03.013

Version

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