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Vojnosanitetski pregled
2018, vol. 75, iss. 7, pp. 664-674
article language: English
document type: Original Scientific Paper
published on: 09/08/2018
doi: 10.2298/VSP160914381P
Creative Commons License 4.0
Self-rated health among older adults in two fast ageing European countries: Evidence from Italy and Serbia
aUniversity of Oxford, Department of Psychiatry, Oxford, United Kingdom
bUniversity of Belgrade, Faculty of Medicine, Institute of Social Medicine
cUniversity of Belgrade, Faculty of Medicine, Institute of Medical Statistics and Informatics



Background/Aim. Self-rated health (SRH) is a widely adopted tool to compare health across countries. Relationships of socio-demographics with SRH in later life have been extensively cross-nationally observed. However, cross-comparisons of the effects of health behaviors (i.e., eating habits, smoking, and alcohol consumption) and health status (i.e., chronic diseases) on SRH are less frequent. Our aim was to examine SRH differences between older adults in Italy and Serbia and to observe the role of predictors of SRH particularly referring to health behaviors in both countries. Methods. Two samples of 4,406 Italians and 3,539 Serbs aged 65 and older were extracted from national health surveys conducted in 2013. For this secondary analysis, SRH, sociodemographics, health status variables, and health behavior factors were selected. In the multivariate logistic regression models, SRH was the dependent variable while the selected independent predictors were socio-demographics, characteristics related to health status and to health behavior. Results. Both Italians (30.3%) and Serbs (22.3%) reported lower values of good- or very good-SRH than the European average (36.9%). The logistic regressions showed that Serbs reported poor-SRH significantly more often than Italians. Moreover, gender, education level, chronic diseases, and daily life limitations resulted as significant predictors of SRH in both national samples. In addition, vegetables intake was positively associate to SRH among Italians, while among Serbs an adequate fruits intake was positively associated to SRH. Conclusion. Health behavior and health status factors are associated with better SRH in the population aged 65 and older. The effects differ between countries. It is essential that decision-makers of the implementation of international preventive strategies take into account the specific characteristics of countries in the organization of interventions for the aged population.



Bobak, M., Pikhart, H., Rose, R., Hertzman, C., Marmot, M. (2000) Socioeconomic factors, material inequalities, and perceived control in self-rated health: cross-sectional data from seven post-communist countries. Social Science & Medicine, 51(9): 1343-1350
Bustacchini, S., Abbatecola, A.M., Bonfigli, A.R., Chiatti, C., Corsonello, A., di Stefano, G., Galeazzi, R., Fabbietti, P., Lisa, R., Guffanti, E.E., Provinciali, M., Lattanzio, F. (2015) The Report-AGE project: a permanent epidemiological observatory to identify clinical and biological markers of health outcomes in elderly hospitalized patients in Italy. Aging Clinical and Experimental Research, 27(6): 893-901
Charlson, M., Szatrowski, T.P., Peterson, J., Gold, J. (1994) Validation of a combined comorbidity index. Journal of Clinical Epidemiology, 47(11): 1245-1251
Chen, C., Chang, W., Lan, T. (2014) Identifying factors associated with changes in physical functioning in an older population. Geriatrics & Gerontology International, 15(2): 156-164
Ergin, I., Kunst, A.E. (2015) Regional inequalities in self-rated health and disability in younger and older generations in Turkey: the contribution of wealth and education. BMC Public Health, 15(1): 987
EUROSTAT (2013) European health interview survey (EHIS wave 2): Methodological manual. Luxembourg,, 2016 May 5
EUROSTAT (2015) Self-perceived health by sex, age and labour status. Luxembourg,, 2016 May 5
EUROSTAT (2015) Population on 1 January by broad age group and sex. Luxembourg,, 2016 May 5
Harris, L. J., Graetz, I., Podila, P.S.B., Wan, J., Waters, T.M., Bailey, J.E. (2016) Characteristics of Hospital and Emergency Care Super-utilizers with Multiple Chronic Conditions. Journal of Emergency Medicine, 50(4): e203-e214
ISTAT (2011) Ilfuturodemografico del Paese: Previsioni regionali del la popolazione residente al 2065. Rome,, 2016 May 5
ISTAT (2013) Multiscoposullefamiglie: Aspettidella vita quotidiana - parte generale. Rome,, 2016 May 5
Jakovljevic, M.B. (2013) Resource allocation strategies in Southeastern European health policy. European Journal of Health Economics, 14(2): 153-159
Jakovljević, B., Stojanov, V.J., Paunović, K., Belojević, G., Radosavljević, V. (2004) Alcohol consumption, arterial blood pressure and general mortality rate: Twenty-years follow-up study. Vojnosanitetski pregled, vol. 61, br. 6, str. 629-635
Jürges, H., Avendano, M., Mackenbach, J.P. (2008) Are different measures of self-rated health comparable? An assessment in five European countries. European Journal of Epidemiology, 23(12): 773-781
Lantz, P.M., Lynch, J.W., House, J.S., Lepkowski, J.M., Mero, R.P., Musick, M.A., Williams, D.R. (2001) Socioeconomic disparities in health change in a longitudinal study of US adults: the role of health-risk behaviors. Social science & medicine, 53(1): 29-40
Liu, Y., Liu, L., Li, Y., Chen, Y. (2015) Relationship between Health Literacy, Health-Related Behaviors and Health Status: A Survey of Elderly Chinese. International Journal of Environmental Research and Public Health, 12(8): 9714-9725
Lloyd-Sherlock, P. (2000) Population ageing in developed and developing regions: implications for health policy. Social Science & Medicine, 51(6): 887-895
Ministry of Health of the Republic of Serbia (2013) Results of the national health survey of the Republic of Serbia. Belgrade,, 2016 May 5
OECD (2015) ISCED 2011 operational manual: Guidelines for classifying national education programmes and related qualifications. Paris,, 2016 May 5
Pavlov, T. (2009) Migracioni potencijal Srbije u 2009.godini. Belgrade: Group 484
Penev, G. (2014) Population ageing trends in Serbia from the beginning of the 21st century and prospects until 2061: Regional aspect. Zbornik Matice srpske za društvene nauke, br. 148, str. 687-700
Reddy, K.K., Reddy, B.K., Rao, A.P. (2004) Interaction among body composition, self-rated health and functional status of the elderly in an Indian population. Asia Pac J Clin Nutr, 13(1), 78‒85
Satarić, N., Rašević, M., Miloradović, S. (2009) They cannot wait: A study on poor elderly in Serbia. Belgrade: Amity
Södergren, M., McNaughton, S.A., Salmon, J., Ball, K., Crawford, D.A. (2012) Associations between fruit and vegetable intake, leisure-time physical activity, sitting time and self-rated health among older adults: cross-sectional data from the WELL study. BMC Public Health, 12(1): 551
Unger, J.B., Johnson, C. A., Marks, G. (1997) Functional decline in the elderly: Evidence for direct and stress-buffering protective effects of social interactions and physical activity. Annals of Behavioral Medicine, 19(2): 152-160
Vadla, R., Božikov, J., Åkerström, B., Cheung, W., Kovačić, L., Masanovic, M., Merilainen, S., Mihel, S., Nummelin-Niemi, H., Stefanaki, I., Stencrantz, B. (2011) Differences in healthcare service utilisation in elderly, registered in eight districts of five European countries. Scandinavian Journal of Public Health, 39(3): 272-279
van Minh, H., Byass, P., Wall, S. (2010) Multilevel analysis of effects of individual characteristics and household factors on self-rated health among older adults in rural Vietnam. Geriatrics & Gerontology International, 10(2): 209‒15
Vasto, S., Barera, A., Rizzo, C., Carlo, M., Caruso, C., Panotopoulos, G. (2013) Mediterranean Diet And Longevity: An Example Of Nutraceuticals?. Current Vascular Pharmacology, 12(5): 735-738
Westermeyer, J. (2000) Health of Albanians and Serbians Following the War in Kosovo. JAMA, 284(5): 615
World Bank (2015) Population ages 65 and above (% of total). Washington,, 2016 May 5
World Health Organization (2002) Active ageing: A policy framework. Geneva: World Health Organization,, 2016 May 5
World Health Organization (2006) BMI classification. Geneva,, 2016 May 5
World Health Organization (2003) Diet, nutrition and the prevention of chronic diseases: Report of a joint WHO/FAO expert consultation. Geneva: World Health Organization,, 2016 May 5