Investigating the Proximal Determinants of Self-Rated Health in Three African Peri-urban Communities

Self-rated health (SRH) has consistently been associated with mortality, disability and morbidity. We investigated proximal determinants of SRH. Data come from baseline surveys of women (15-44y) and men (20-59y) in three (Ethiopia, Ghana and Uganda) of six sites of the Family Health and Wealth Study, an ongoing longitudinal study. We considered three proximal determinants of self-rated health: systolic blood pressure; non-communicable disease; and health problems. The effective analytic sample was as follows: Ethiopia (943 women; 959 men); Ghana (791 women; 747 men); and Uganda (463 women; 442 men); representing 91-99% of the total sample. Data were explored to observe patterns in the variables and relationships of interest and generate frequencies. Following estimation of ordinal logistic regressions, the presence of one or more health problems was the only proximal determinant that remained significantly associated with SRH in both men and women across the three sites. As these study cohorts are being followed over time, we expect that future findings will more fully inform the influence of proximal determinants on self-rated health.