Profiles of Self-Rated Health in Midlife Adults with Chronic Illnesses

Five waves of data from the Health and Retirement Study were analyzed to: (1) uncover segments of chronically ill midlife adults who share unique profiles of characteristics that predict self-rated health (SRH), and (2) capture predictor-outcome relationships for each segment. Selected components of the Interaction Model of Client Health Behavior (IMCHB) guided the inclusion of patient characteristics derived from the literature that would likely predict SRH. Self-rated health served as a measure of cognitive appraisal, a key dynamic variable within the IMCHB. In this sample of over 6000 midlife adults with chronic illnesses, three distinct segments were identified through latent class regression. Each segment differed on their cognitive appraisals of health. The Positive Health (PH) segment was characterized by respondents who appraised their health as excellent or very good. In contrast, the Negative health (NH) segment had poor or fair health appraisals. The Average Health (AH) group straddled both sides of this health appraisal and rated their health as fair, good, or very good. Several factors influenced SRH regardless of class membership. In all three segments, respondents who had more than one chronic health condition (relative to those with only one chronic condition), those who engaged in vigorous activity less than three times per week (relative to those who engaged in vigorous activity at least three times per week), those who were current smokers (relative to non-smokers), and/or respondents in the middle net worth quintiles (relative to the highest net worth quintile) were more likely to report poorer levels of SRH. In contrast to the class-independent predictors, several predictors of SRH differed in strength across the three segments. These included: having a health problem that limited paid work, depressed mood, being overweight, not living with a partner, and time since baseline interview. In addition to confirming what is already known about the correlates of SRH and how SRH is manifested in midlife adults with selected chronic illnesses, this study captured unique predictor-outcome relationships for three distinct sample segments. Implications for further research include testing interventions that are designed to match the unique profiles of each of these segments.

Self Assessment (Psychology)

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