The Latent Dimensions of Poor Self-Rated Health: How Chronic Diseases, Functional and Emotional Dimensions Interact Influencing Self-Rated Health in Italian Elderly

Abstract Self-Rated Health (SRH) is becoming one of the most popular indicator of population health. Nevertheless, a limited understanding still remains about the elements to which individuals refer when evaluating their health and how those elements act and interact in the evaluation process. In this study we use a structural equation model with latent variables to identify direct and indirect influences of various health dimensions (chronic morbidity, functional abilities and emotional health) and socio-demographic covariates (age, gender and education) on poor SRH. The sample consists of 25,183 Italian elderly aged 65 years and over, interviewed in the 2005 National Health Interview Survey. The results have pointed out the higher direct effect of psychological and emotional health on SRH, while the higher total effect is caused by chronic morbidity, which influences SRH both directly and altering functional and emotional health. Growing older, being a woman and having a low education negatively impacts on SRH. However, this is almost completely the result of the indirect effect exerted by the covariates, while their direct effect is not significant (gender), negative (age) or very modest (education).