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Associations between self-rated health and health behaviour among older adults in Estonia: a cross-sectional analysis
  1. Liili Abuladze1,
  2. Nele Kunder2,
  3. Katrin Lang2,
  4. Sirje Vaask3
  1. 1 Estonian Institute for Population Studies, School of Governance, Law and Society, Tallinn University, Tallinn, Estonia
  2. 2 Department of Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia
  3. 3 School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
  1. Correspondence to Liili Abuladze; liili{at}


Objectives The population of Estonia has one of the lowest life expectancies and health statuses in Europe. This is reflected in a lower perception of health among older adults. This study focuses on the role of health behaviour (smoking, alcohol consumption, physical activity and nutrition) in self-rated health, accounting for sociodemographic characteristics, activity limitations and long-term illnesses as well as satisfaction with life of older Estonian men and women.

Design We use representative cross-sectional data from Wave 4 of the Estonian Survey of Health, Ageing and Retirement in Europe, conducted mainly in 2011.

Participants Frequencies, χ2 tests and logistic regression models include respondents aged 50 years and older, with no upper age limit (n=6660).

Results Men have 20% higher odds (CI 1.02 to 1.43) of poor self-rated health. Being of foreign origin (OR 1.48; CI 1.24 to 1.77), having a basic (2.50; CI 2.06 to 3.00) or secondary (1.71; CI 1.43 to 2.04) education, being retired (2.00; CI 1.65 to 2.44) or staying at home (1.49; CI 1.16 to 1.93) and having activity limitations (3.25; CI 2.77 to 3.80) or long-term illnesses (4.78; CI 4.08 to 5.60) are related to poor self-rated health. Never being involved in vigorous (2.30; CI 1.90 to 2.79) or moderate physical activity (1.41; CI 1.02 to 1.94), and consuming legumes and eggs less frequently (1.25; CI 1.08 to 1.45) is associated with poorer self-rated health. Lower satisfaction with life accounts for some of the variation (2.28; CI 1.92 to 2.71).

Conclusions There is a strong cumulative effect of one’s previous life course on the self-rated health of older adults in Estonia, suggesting that public health policies have long-term consequences rather than immediate consequences. Health services supporting health behaviours and targeting vulnerable population groups with specific sociodemographic characteristics and health problems may influence self-rated health for some. Public health services emphasising social activities or psychological aspects may be most successful in improving self-rated health of older Estonians through satisfaction with life.

  • self-rated health
  • health behaviour
  • ageing
  • vulnerable groups
  • smoking and alcohol use
  • nutrition
  • physical activity

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors LA and NK conducted statistical analyses of the data. LA authored the paper. NK, KL and SV critically reviewed and contributed to the manuscript.

  • Competing interests None declared.

  • Ethics approval Until July 2011, Survey of Health, Ageing and Retirement in Europe (SHARE) was reviewed and approved by the Ethics Committee of the University of Mannheim. Since then, the Ethics Council of the Max Planck Society for the Advancement of Science (MPG) is responsible for ethical reviews and the approval of the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement To access SHARE data, data access approval is needed from the SHARE team, see more information on the project website: . For the dataset and syntax used for this analysis, contact Liili Abuladze.

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