Research article

Factors associated with self-rated health status in university students: a cross-sectional study in three European countries

Rafael T Mikolajczyk¹ , Patrick Brzoska² , Claudia Maier² , Veronika Ottova³ , Sabine Meier¹ , Urszula Dudziak⁴ , Snezhana Ilieva⁵ and Walid El Ansari⁶

¹  Department of Public Health Medicine, School of Public Health, University of Bielefeld, Bielefeld, Germany

²  Department of Epidemiology & International Public Health, School of Public Health, University of Bielefeld, Bielefeld, Germany

³  Department of Prevention & Health Promotion, School of Public Health, University of Bielefeld, Bielefeld, Germany

⁴  Institute of Family Sciences, Catholic University of Lublin, Lublin, Poland

⁵  Department of Social, Work and Educational Psychology, Faculty of Philosophy, Sofia University "St. Kl. Ohridski", Sofia, Bulgaria

⁶  Faculty of Sport, Health & Social Care, University of Gloucestershire, Gloucester, UK

author email corresponding author email

BMC Public Health 2008, 8:215doi:10.1186/1471-2458-8-215

Published:	18 June 2008

Abstract

Background

Self-rated health status (SRHS) is a reliable and valid measure for assessing the subjective and objective health of individuals. Previous studies have either focused predominantly on the elderly or investigated only a narrow range of factors potentially associated with SRHS. In examining student populations, these past studies were limited to single countries. The objectives of this study were to assess which candidate variables were independently associated with SRHS in university students, to compare these variables by country and by gender, and to investigate which of the variables was most important as a rating frame for SRHS.

Methods

The data is from the Cross-National Student Health Survey, conducted in 2005 in universities in Germany, Bulgaria, and Poland (n = 2103; mean age = 20.7 years). SRHS was assessed with a single question using a five-point scale ranging from "excellent" to "poor". The study also measured a wide range of variables including: physical and psychological health, studying, social contacts/social support, and socio-demographic status.

Results

Psychosomatic complaints (considered an aspect of physical health and, adjusted for psychological health) were the most important indicators in forming a rating frame for students' SRHS. There were few differences in the effects of variables associated with SRHS by gender (well-being: a measure of psychological health) and the variables associated with SRHS by country (well-being and self-efficacy). The remaining variables showed homogenous effects for both genders and for all three countries.

Conclusion

The results suggest that SRHS can be reasonably used to compare students' health across countries. SRHS is affected by different physical, psychological and psychosomatic aspects of health; however, its strongest association is with psychosomatic complaints.