Area- and Individual-Level Correlates of Self-Rated Health: Implications for Geographic Health Disparities

Background: Self-rated health (SRH) is a common measure of overall health. However, little is known about multilevel correlates of physical and mental SRH. Methods: Patients attending primary care clinics completed a survey before their appointment, which we linked to community data from American Community Survey and other sources (n = 455). We conducted multilevel logistic regression to assess correlates of excellent/very good versus good/fair/poor physical and mental SRH. Results: 43.9% of participants had excellent/very good physical SRH, and 55.2% had excellent/very good mental SRH. Physical SRH was associated with age (odds ratio[OR] = 0.82 per 10 years; 95% confidence interval[CI] = 0.72-0.93) and community correlates, including retail establishment density (OR = 0.94, 95% CI = 0.90-0.99) and percent of students eligible for free/reduced lunch (OR = 1.60, 95% CI = 1.08-2.38) (all P <.05). Mental SRH was not associated with any characteristics. Conclusions: Practitioners in public health, social work, and medicine could use zip codes to intervene in patients and communities to improve physical SRH.