TÜRKİYE’DE ALGILANAN SAĞLIK STATÜSÜ VE ETKİLEYEN FAKTÖRLER ÜZERİNE AMPRİK BİR ARAŞTIRMA

Yıl 2025, Sayı: 67, 115 - 125

Doğancan Çavmak

Öz

Bu araştırmanın amacı, algılanan genel sağlık statüsünü ve bu değerlendirmeyi etkileyen faktörleri incelemektir. Bu amaç kapsamında analiz edilen veriler, Türkiye İstatistik Kurumu’ndan alınan, Türkiye Sağlık Araştırması 2022 Mikro Veri Seti’nden elde edilmiştir. Çalışmanın bağımlı değişkeni genel algılanan sağlık statüsü iken bağımsız değişkenler arasında sosyo-demografik ve ekonomik veriler, günlük aktivite düzeyi, kronik hastalık taşıma durumu ve sağlık hizmetlerine erişimle ilgili indikatörler yer almaktadır. Veriler, tanımlayıcı istatistikler ve multinominal lojistik regresyon analizi yöntemleri ile analiz edilmiştir. Analiz sonuçları, düşük sosyo-ekonomik göstergelerin, düşük aktivite düzeyinin ve kronik hastalık taşıyor olmanın algılanan sağlık statüsünde olumsuz değerlendirmeler ile ilişkili olduğunu göstermektedir. Sağlık hizmetlerine erişimle ilgili yaşanan engellerin, bireylerin kötü sağlık statüsü kategorisinde yer alma ihtimallerini anlamlı düzeyde arttırdığı tespit edilmiştir. Sağlık, sosyal hizmet ve ekonomi politikalarının, sosyo-ekonomik olarak zayıf grupta yer alanları hedeflemesi önerilmektedir.

Anahtar Kelimeler

Sağlık statüsü, Sağlığa erişim, Sağlık yönetimi

AN EMPIRICAL EXAMINATION ON THE SELF-PERCEIVED HEALTH STATUS AND AFFECTING FACTORS IN TÜRKİYE

Öz

This study examines the self-perceived general health status and the related factors that can affect the status. The data were obtained from the Türkiye Health Survey 2022 Micro Data Set provided by the Turkish Statistical Institute. The dependent variable of the study is the self-perceived health status, while the independent variables are socio-demographic and economic variable, daily activity level, chronic disease condition, and indicators related to access to healthcare. The data were analyzed using descriptive statistics and multinomial logistic regression analysis. The results showed that low socio-economic indicators, low activity level, and having a chronic disease were associated with poor/bad perceived health status. It has been determined that experienced barriers in access to healthcare significantly increase the odds of individuals being reported in the bad health status category. It is recommended that healthcare policies, social services, and economic policies should prioritize those in the socio-economically weak group.

Anahtar Kelimeler

Health status, Access to healthcare, Healthcare management

Kaynakça

• Antczak, E. and Miszczyńska, K. M. (2020). The self-perceived high level of health quality of Europeans–spatial analysis of determinants. Journal of Applied Economics, 23(1), 746-764.
• Assari, S. and Lankarani, M. M. (2017). Demographic and socioeconomic determinants of physical and mental self-rated health across 10 ethnic groups in the United States. International Journal of Epidemiologic Research, 3(12), 185.
• Benyamini, Y. (2011). Why does self-rated health predict mortality? An update on current knowledge and a research agenda for psychologists. Psychology & Health, 26(11), 1407-1413.
• Cai, J., Coyte, P. C. and Zhao, H. (2017). Determinants of and socio-economic disparities in self-rated health in China. International Journal for Equity in Health, 16, 1-27.
• Caramenti, M. and Castiglioni, I. (2022). Determinants of self-perceived health: The importance of physical well-being but also of mental health and cognitive functioning. Behavioral Sciences, 12(12), 498.
• Chan, Y. Y., Teh, C. H., Lim, K. K., Lim, K. H., Yeo, P. S., Kee, C. C., Omar, M.A. and Ahmad, N. A. (2015). Lifestyle, chronic diseases and self-rated health among Malaysian adults: results from the 2011 National Health and Morbidity Survey (NHMS). BMC Public Health, 15, 1-12.
• Chávez Sosa, J. V., Guerra Pariona, H. N. and Huancahuire-Vega, S. (2022). Association between perceived access to healthcare and the perception of illness among peruvian adults with chronic diseases during COVID-19 pandemic. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 59, 00469580221112832.
• Cialani, C. and Mortazavi, R. (2020). The effect of objective income and perceived economic resources on self-rated health. International Journal for Equity in Health, 19, 1-12.
• Dahlgren, G. and Whitehead, M. (1991). Policies and Strategies to Promote Social Equity in Health. Stockholm, Sweden: Institute for Futures Studies. Background document to WHO – Strategy paper for Europe.
• DeSalvo, K. B., Bloser, N., Reynolds, K., He, J. and Muntner, P. (2006). Mortality prediction with a single general self-rated health question: a meta-analysis. Journal of General Internal Medicine, 21, 267-275.
• Dramé, M., Cantegrit, E. and Godaert, L. (2023). Self-rated health as a predictor of mortality in older adults: a systematic review. International Journal of Environmental Research and Public Health, 20(5), 3813.
• Exworthy, M. (2008). Policy to tackle the social determinants of health: using conceptual models to understand the policy process. Health Policy Planning, 23, 318-327.
• Fayers, P. M. and Sprangers, M. A. (2002). Understanding self-rated health. The Lancet, 359(9302), 187-188.
• Foraker, R. E., Rose, K. M., Chang, P. P., McNeill, A. M., Suchindran, C. M., Selvin, E. and Rosamond, W. D. (2011). Socioeconomic status and the trajectory of self-rated health. Age and Ageing, 40(6), 706-711.
• Furuya, Y., Kondo, N., Yamagata, Z. and Hashimoto, H. (2013). Health literacy, socioeconomic status and self-rated health in Japan. Health Promotion International, 30(3), 505-513.
• Góngora-Salazar, P., Casabianca, M. S. and Rodríguez-Lesmes, P. (2022). Income inequality and self-rated health status in Colombia. International Journal for Equity in Health, 21(1), 69.
• Jylhä, M. (2009). What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Social Science & Medicine, 69(3), 307-316.
• Kim, M. K., Chung, W. J., Lim, S. J., Yoon, S. J., Lee, J. K., Kim, E. K. and Ko, L. J. (2010). Socioeconomic inequity in self-rated health status and contribution of health behavioral factors in Korea. Journal of Preventive Medicine and Public Health, 43(1), 50-61.
• Kwak, C. and Clayton-Matthews, A. (2002). Multinomial logistic regression. Nursing Research, 51(6), 404-410.
• Lamidi, E. O. (2020). Trends in self-rated health by union status and education, 2000–2018. SSM-Population Health, 11, 100616.
• Moorin, R. E. and Holman, C. D. J. (2006). The effects of socioeconomic status, accessibility to services and patient type on hospital use in Western Australia: a retrospective cohort study of patients with homogenous health status. BMC Health Services Research, 6, 1-10.
• Mutz, J. and Lewis, C. M. (2022). Cross-classification between self-rated health and health status: longitudinal analyses of all-cause mortality and leading causes of death in the UK. Scientific Reports, 12(1), 459.
• OECD (2017), Perceived health status, in Health at a Glance 2017: OECD Indicators, OECD Publishing, Paris. http://dx.doi.org/10.1787/health_glance-2017-en
• Olivares-Tirado, P. and Zanga, R. (2024). Associations of Physical Activity and Sedentary Behavior with Self-Rated Health Status in Brazilian Older Adults. Journal of Aging and Physical Activity, 1, 1-12.
• Paul, P., Hakobyan, M. and Valtonen, H. (2016). The association between self-perceived health status and satisfaction with healthcare services: Evidence from Armenia. BMC Health Services Research, 16, 1-13.
• Răileanu Szeles, M. (2018). Comparative examination of self-perceived health and other measures of the quality of life across the EU-27. Social Indicators Research, 137, 391-411.
• Salkever, D. S. (1976). Accessibility and the demand for preventive care. Social Science & Medicine, 10(9- 10), 469-475.
• Schnittker, J. and Bacak, V. (2014). The increasing predictive validity of self-rated health. PloS one, 9(1), e84933.
• Shaaban, A. N., Martins, M. R. O. and Peleteiro, B. (2022). Factors associated with self-perceived health status in Portugal: Results from the National Health Survey 2014. Frontiers in Public Health, 10, 879432.
• Shimonovich, M., Campbell, M., Thomson, R. M., Broadbent, P., Wells, V., Kopasker, D.,McCartney, G., Thomson, H., Pearce, A. and Katikireddi, S. V. (2024). Causal Assessment of Income Inequality on Self‐Rated Health and All‐Cause Mortality: A Systematic Review and Meta‐Analysis. The Milbank Quarterly, 102(1), 141-182.
• Sipahi, B. B. (2022). Türkiye’de Genel Sağlık Durumunun Belirleyicileri: Sosyo Ekonomik Faktörler ve Kapalı Ortam Hava Kirliliği. Journal of Tourism Intelligence and Smartness, 5(1), 89-100.
• Beyaz Sipahi, B. (2022). Türkiye’de Genel Sağlık Durumunun Belirleyicileri: Sosyo Ekonomik Faktörler ve Kapalı Ortam Hava Kirliliği. Journal of Tourism Intelligence and Smartness, 5(1), 89-100.
• Tadiri, C. P., Gisinger, T., Kautzky-Willer, A., Kublickiene, K., Herrero, M. T., Norris, C. M. and GOING-FWD Consortium. (2021). Determinants of perceived health and unmet healthcare needs in universal healthcare systems with high gender equality. BMC Public Health, 21, 1-9.
• Tanner, E. C., Vann, R. J. and Kizilova, E. (2020). Consumer-level perceived access to health services and its effects on vulnerability and health outcomes. Journal of Public Policy & Marketing, 39(2), 240-255
• Tran, B. X., Nguyen, L. H., Nong, V. M. and Nguyen, C. T. (2016). Health status and health service utilization in remote and mountainous areas in Vietnam. Health and Quality of Life Outcomes, 14, 1-9.
• Ürek, D., Karaman, S., Bilgin, İ., Uğurluoğlu, Ö. and Işık, O. (2023). Determinants of Self-Rated Health for Adults in Türkiye. Clinical and Experimental Health Sciences, 13(2), 279-285.
• Wu, S., Wang, R., Zhao, Y., Ma, X., Wu, M., Yan, X. and He, J. (2013). The relationship between self-rated health and objective health status: a population-based study. BMC Public Health, 13, 1-9.
• Xu, D., Arling, G. and Wang, K. (2019). A cross-sectional study of self-rated health among older adults: a comparison of China and the United States. BMJ Open, 9(7), e027895.
• Zadworna, M. (2022). Pathways to healthy aging–exploring the determinants of self-rated health in older adults. Acta Psychologica, 228, 103651.
• Zhao, G., Okoro, C. A., Hsia, J. and Town, M. (2018). Peer Reviewed: Self-Perceived Poor/Fair Health, Frequent Mental Distress, and Health Insurance Status Among Working-Aged US Adults. Preventing Chronic Disease, 15.