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Indicators of self-rated health in the Canadian population with diabetes


Norbert Schmitz PhD, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Boulevard, Montreal, Quebec, Canada H4H 1R3. E-mail:


Diabet. Med. 29, 1021–1028 (2012)


Aims  Self-rated health is a widely used measure of general health assessing risk factors and poor health outcomes in health surveys and clinical settings. The characteristics of self-rated health may be different in populations with specific chronic conditions, such as populations with diabetes. This study investigates the characteristics of self-rated health in a Canadian community sample of people with diabetes.

Methods  Self-rated health was obtained from 1837 adults with Type 2 diabetes participating in the Montreal Diabetes Health and Well-Being Study. Global disability and depression were assessed using the World Health Organization Disability Assessment Schedule II and the Patient Health Questionnaire, respectively. Logistic regressions studied the association between self-rated health and depression, disability, diabetes-related characteristics, socio-demographic factors, social support and lifestyle-related behaviours in both men and women.

Results  Participants’ answers were dichotomized into excellent/very good/ good (78%) and fair/poor (22%) self-rated health. Both depression (men: odds ratio 1.9, 95% CI 1.4–2.6; women: odds ratio 1.5, 95% CI 1.2–1.9) and disability (men: odds ratio 1.7, 95% CI 1.4–1.9; women: odds ratio 1.7, 95% CI 1.5–1.9) were associated with fair/poor self-rated health. The associations remained unchanged even after controlling for diabetes characteristics. After controlling for confounding variables, chronic conditions were associated with fair/poor self-rated health in both men and women. Obesity was associated with fair/poor self-rated health in women only, while lifestyle behaviours such as being physically active and alcohol consumption were associated with good/very good/excellent self-rated health in men.

Conclusions  In men and women, depression and disability are important factors that are associated with self-rated health in a large sample of individuals with Type 2 diabetes.