Self-assessment of health. How socioeconomic, functional, and emotional dimensions influence self-rated health among Italian nonagenarians

Self-Rated Health (SRH) is currently one of the most popular indicators of population health. Studies show that SRH has a strong association with physical functioning, well-being, and mortality across a variety of populations and ages. Despite its wide use, the different elements that act and interact when an individual assesses their own health are still not clear. To date, only one study has focused on the process of self-assessment of health among the oldest-old individuals. The aim of this paper is to explore direct and indirect effects of socioeconomic status, presence of disease, functional health, and emotional health on the good self-assessment of health among Italian nonagenarians. By applying Structural Equation Modelling (SEM) on Mugello Study data, we find a strong direct effect of both emotional and functional health on SRH, confirming their key roles in the process of self-assessment of health among the oldest-old individuals. Furthermore, we find indirect effects of socioeconomic status, presence of disease, and functional health on SRH. This is in line with existing literature on younger adults and elderly people.