Self-rated health in Europe and its determinants: Does generation matter?

Int J Public Health. 2018 Mar;63(2):223-232. doi: 10.1007/s00038-018-1079-5. Epub 2018 Jan 30.


Objectives: To analyse the influence of micro- and macro-factors on self-rated health, and the role of generation on this relationship.

Methods: Cross-sectional study using data from European Health Interview Surveys from 14 European countries. Individuals were divided into four generations ("silent generation", "baby boomers", and "generation X" and "Y"). We conducted multilevel analyses for each generation to study the influence of individual and national explanatory variables on self-rated health.

Results: Age showed an exponential effect in older generations. Education and employment presented the strongest association with low self-rated health, especially in "baby boomers" and women (low education: OR 3.5; 95% CI 3.2-3.9). Tobacco showed a negative effect in younger generations. Overweight and low physical activity were negatively associated with self-rated health regardless of generation. Countries from the Eastern welfare system showed the highest risk of low self-rated health and this association was higher in men for "silent generation" (OR 4.7; 95% CI 3.0-7.6).

Conclusions: The influence of individual and national factors on self-rated health varies regarding generation. The target generation and the demographic structure of a country should be taken into account to develop more accurate health policies.

Keywords: Generation; Health policy; Health survey; Self-rated health; Welfare system.

MeSH terms

  • Adult
  • Age Factors*
  • Cross-Sectional Studies
  • Diagnostic Self Evaluation*
  • Europe
  • Female
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Multilevel Analysis
  • Sex Factors
  • Social Determinants of Health*
  • Social Welfare / statistics & numerical data
  • Socioeconomic Factors