Sex and Gender-based Analysis of this topic
Definition
Self-rated health (or self-perceived health) is a measure of how people describe their own health. It is measured in Canada on a five-point scale: excellent, very good, good, fair and poor [1]. Self-rated heath (also called “global health” [2]) reflects aspects of people’s health not covered in other indicators such as incipient disease, disease severity, pain and discomfort, social, mental and physical function, and physiological and psychological resources. Self-rated health is one of the core comparable health indicators agreed upon for annual reporting in Canada [3], and internationally considered a core indicator of health and health status, use of health services, changes in functional status and recovery from episodes of illness [4,5].
Sex Issues
Most women in Canada report that their health is excellent or very good. However, in every age category, women are more likely to report their health as being “fair” or “poor” than their male counterparts [3, 4]. The largest gap between the sexes among those reporting excellent/very good health is observable in the age group of 15 – 19 years, but the gap declines sharply among young adults, aged 20-34 years [4]. Differences between the sexes increase with age after 64 years [4].
Gender Issues
Canadian women were more likely to report poor health than excellent health from 1994 to 2003 [3, 4, 5]. In those 10 years, women’s tobacco smoking has decreased and self-reported physical activity has increased, however obesity and overweight has increased and income inequalities have widened for women [6]. Therefore, it is clear that self-rated health is affected by more than just personal lifestyle habits.
Time stress and unpaid work data demonstrate that women continue to balance more of the domestic responsibilities and chores than their male counterparts [4]. Unpaid caregiving, in particular, a role many more women take on, has been demonstrably linked to declining health and health status [7].
Diversity
Teenage and young women show substantially poorer self-rated health compared to their male peers [4]. Senior women are more likely to report being in “fair” or “poor” than men of the same age [4]. Although women live longer than men, their self-rated health and the Health Adjusted Life Expectancy illustrate that greater likelihood of chronic diseases, co-morbidities and loss of mobility seriously affects the quality of their elder years [3,4].
Income is directly linked to health and income disparities within a population and have been found to be directly linked to the overall health of the population. Women (and men) with lowest incomes in Canada report having fair or poor health nearly four times more than those in the highest income group [2]. Women with lower education levels (who have not completed high school) are more than twice as likely to report having fair or poor health as those who have completed secondary school and those who have post-secondary education. In addition to income, women’s self-rated health is directly linked to the presence of chronic disease. Women with lower incomes who are living with diabetes, arthritis, or heart disease report poor or fair health [2].
Critique
Self-rated health is internationally considered an important indicator of women’s health. It provides a reliable measure of the health of the general population and is useful for measuring changes over time, and inequities between and among sub-populations [2, 3, 5]. The Canadian Community Health Survey (CCHS) measure of self-rated health is reliable for the population surveyed, but limited by the nature of the populations excluded. The target population of the CCHS was people aged 12 years or older who were living in private dwellings in the 10 provinces and three territories. People living on Indian Reserves or Crown lands, clientele of institutions, full-time members of the Canadian Armed Forces and residents of certain remote regions were excluded. While the same measure was used in the Statistics Canada Aboriginal Peoples Survey of 2001, the same restrictions and limitations apply in who was included in the survey and who was not.