Medical care usage and self-rated mental health

Background Population studies frequently employ a single item dependent variable for overall health. Self-rated mental health has been the focus of attention less often. The purpose of this project was to investigate the relationship between use of medical care and poor mental health in an elderly p...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Rohrer, James E [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2004

Schlagwörter:	Self-Rated Health self-rated mental health and Community Health

Anmerkung:	© Rohrer; licensee BioMed Central Ltd. 2004. This article is published under license to BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

Übergeordnetes Werk:	Enthalten in: BMC public health - London : BioMed Central, 2001, 4(2004), 1 vom: 23. Feb.
Übergeordnetes Werk:	volume:4 ; year:2004 ; number:1 ; day:23 ; month:02

Links:	Volltext

DOI / URN:	10.1186/1471-2458-4-3

Katalog-ID:	SPR027823237

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520			\|a Background Population studies frequently employ a single item dependent variable for overall health. Self-rated mental health has been the focus of attention less often. The purpose of this project was to investigate the relationship between use of medical care and poor mental health in an elderly population. Methods This study involved a cross-sectional telephone survey of persons over 65 years of age in West Texas, a sparsely-populated 108-county region. Independent variables included number of medical visits, race/ethnicity, age, gender and ability to pay for care. Mental health was measured by asking subjects how often they felt downhearted or blue. Results Multiple logistic regression analysis revealed that more medical visits were made by persons who were downhearted or blue. Females, persons who had difficulty paying for care, Hispanic respondents, and older persons were more likely to report poor mental health. Conclusions Elderly persons in this region who use more medical care are at greater risk of being in poor mental health. Public health agencies that are planning population-based approaches to improving mental health should consider targeting persons who are high users of medical care as well as those of limited means, women, persons of Hispanic ethnicity, and people who are of greater age.
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allfields	10.1186/1471-2458-4-3 doi (DE-627)SPR027823237 (SPR)1471-2458-4-3-e DE-627 ger DE-627 rakwb eng Rohrer, James E verfasserin aut Medical care usage and self-rated mental health 2004 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Rohrer; licensee BioMed Central Ltd. 2004. This article is published under license to BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL. Background Population studies frequently employ a single item dependent variable for overall health. Self-rated mental health has been the focus of attention less often. The purpose of this project was to investigate the relationship between use of medical care and poor mental health in an elderly population. Methods This study involved a cross-sectional telephone survey of persons over 65 years of age in West Texas, a sparsely-populated 108-county region. Independent variables included number of medical visits, race/ethnicity, age, gender and ability to pay for care. Mental health was measured by asking subjects how often they felt downhearted or blue. Results Multiple logistic regression analysis revealed that more medical visits were made by persons who were downhearted or blue. Females, persons who had difficulty paying for care, Hispanic respondents, and older persons were more likely to report poor mental health. Conclusions Elderly persons in this region who use more medical care are at greater risk of being in poor mental health. Public health agencies that are planning population-based approaches to improving mental health should consider targeting persons who are high users of medical care as well as those of limited means, women, persons of Hispanic ethnicity, and people who are of greater age. Self-Rated Health (dpeaa)DE-He213 self-rated mental health (dpeaa)DE-He213 and Community Health (dpeaa)DE-He213 Enthalten in BMC public health London : BioMed Central, 2001 4(2004), 1 vom: 23. Feb. (DE-627)326643583 (DE-600)2041338-5 1471-2458 nnns volume:4 year:2004 number:1 day:23 month:02 https://dx.doi.org/10.1186/1471-2458-4-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2004 1 23 02
spelling	10.1186/1471-2458-4-3 doi (DE-627)SPR027823237 (SPR)1471-2458-4-3-e DE-627 ger DE-627 rakwb eng Rohrer, James E verfasserin aut Medical care usage and self-rated mental health 2004 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Rohrer; licensee BioMed Central Ltd. 2004. This article is published under license to BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL. Background Population studies frequently employ a single item dependent variable for overall health. Self-rated mental health has been the focus of attention less often. The purpose of this project was to investigate the relationship between use of medical care and poor mental health in an elderly population. Methods This study involved a cross-sectional telephone survey of persons over 65 years of age in West Texas, a sparsely-populated 108-county region. Independent variables included number of medical visits, race/ethnicity, age, gender and ability to pay for care. Mental health was measured by asking subjects how often they felt downhearted or blue. Results Multiple logistic regression analysis revealed that more medical visits were made by persons who were downhearted or blue. Females, persons who had difficulty paying for care, Hispanic respondents, and older persons were more likely to report poor mental health. Conclusions Elderly persons in this region who use more medical care are at greater risk of being in poor mental health. Public health agencies that are planning population-based approaches to improving mental health should consider targeting persons who are high users of medical care as well as those of limited means, women, persons of Hispanic ethnicity, and people who are of greater age. Self-Rated Health (dpeaa)DE-He213 self-rated mental health (dpeaa)DE-He213 and Community Health (dpeaa)DE-He213 Enthalten in BMC public health London : BioMed Central, 2001 4(2004), 1 vom: 23. Feb. (DE-627)326643583 (DE-600)2041338-5 1471-2458 nnns volume:4 year:2004 number:1 day:23 month:02 https://dx.doi.org/10.1186/1471-2458-4-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2004 1 23 02
allfields_unstemmed	10.1186/1471-2458-4-3 doi (DE-627)SPR027823237 (SPR)1471-2458-4-3-e DE-627 ger DE-627 rakwb eng Rohrer, James E verfasserin aut Medical care usage and self-rated mental health 2004 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Rohrer; licensee BioMed Central Ltd. 2004. This article is published under license to BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL. Background Population studies frequently employ a single item dependent variable for overall health. Self-rated mental health has been the focus of attention less often. The purpose of this project was to investigate the relationship between use of medical care and poor mental health in an elderly population. Methods This study involved a cross-sectional telephone survey of persons over 65 years of age in West Texas, a sparsely-populated 108-county region. Independent variables included number of medical visits, race/ethnicity, age, gender and ability to pay for care. Mental health was measured by asking subjects how often they felt downhearted or blue. Results Multiple logistic regression analysis revealed that more medical visits were made by persons who were downhearted or blue. Females, persons who had difficulty paying for care, Hispanic respondents, and older persons were more likely to report poor mental health. Conclusions Elderly persons in this region who use more medical care are at greater risk of being in poor mental health. Public health agencies that are planning population-based approaches to improving mental health should consider targeting persons who are high users of medical care as well as those of limited means, women, persons of Hispanic ethnicity, and people who are of greater age. Self-Rated Health (dpeaa)DE-He213 self-rated mental health (dpeaa)DE-He213 and Community Health (dpeaa)DE-He213 Enthalten in BMC public health London : BioMed Central, 2001 4(2004), 1 vom: 23. Feb. (DE-627)326643583 (DE-600)2041338-5 1471-2458 nnns volume:4 year:2004 number:1 day:23 month:02 https://dx.doi.org/10.1186/1471-2458-4-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2004 1 23 02
allfieldsGer	10.1186/1471-2458-4-3 doi (DE-627)SPR027823237 (SPR)1471-2458-4-3-e DE-627 ger DE-627 rakwb eng Rohrer, James E verfasserin aut Medical care usage and self-rated mental health 2004 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Rohrer; licensee BioMed Central Ltd. 2004. This article is published under license to BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL. Background Population studies frequently employ a single item dependent variable for overall health. Self-rated mental health has been the focus of attention less often. The purpose of this project was to investigate the relationship between use of medical care and poor mental health in an elderly population. Methods This study involved a cross-sectional telephone survey of persons over 65 years of age in West Texas, a sparsely-populated 108-county region. Independent variables included number of medical visits, race/ethnicity, age, gender and ability to pay for care. Mental health was measured by asking subjects how often they felt downhearted or blue. Results Multiple logistic regression analysis revealed that more medical visits were made by persons who were downhearted or blue. Females, persons who had difficulty paying for care, Hispanic respondents, and older persons were more likely to report poor mental health. Conclusions Elderly persons in this region who use more medical care are at greater risk of being in poor mental health. Public health agencies that are planning population-based approaches to improving mental health should consider targeting persons who are high users of medical care as well as those of limited means, women, persons of Hispanic ethnicity, and people who are of greater age. Self-Rated Health (dpeaa)DE-He213 self-rated mental health (dpeaa)DE-He213 and Community Health (dpeaa)DE-He213 Enthalten in BMC public health London : BioMed Central, 2001 4(2004), 1 vom: 23. Feb. (DE-627)326643583 (DE-600)2041338-5 1471-2458 nnns volume:4 year:2004 number:1 day:23 month:02 https://dx.doi.org/10.1186/1471-2458-4-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2004 1 23 02
allfieldsSound	10.1186/1471-2458-4-3 doi (DE-627)SPR027823237 (SPR)1471-2458-4-3-e DE-627 ger DE-627 rakwb eng Rohrer, James E verfasserin aut Medical care usage and self-rated mental health 2004 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Rohrer; licensee BioMed Central Ltd. 2004. This article is published under license to BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL. Background Population studies frequently employ a single item dependent variable for overall health. Self-rated mental health has been the focus of attention less often. The purpose of this project was to investigate the relationship between use of medical care and poor mental health in an elderly population. Methods This study involved a cross-sectional telephone survey of persons over 65 years of age in West Texas, a sparsely-populated 108-county region. Independent variables included number of medical visits, race/ethnicity, age, gender and ability to pay for care. Mental health was measured by asking subjects how often they felt downhearted or blue. Results Multiple logistic regression analysis revealed that more medical visits were made by persons who were downhearted or blue. Females, persons who had difficulty paying for care, Hispanic respondents, and older persons were more likely to report poor mental health. Conclusions Elderly persons in this region who use more medical care are at greater risk of being in poor mental health. Public health agencies that are planning population-based approaches to improving mental health should consider targeting persons who are high users of medical care as well as those of limited means, women, persons of Hispanic ethnicity, and people who are of greater age. Self-Rated Health (dpeaa)DE-He213 self-rated mental health (dpeaa)DE-He213 and Community Health (dpeaa)DE-He213 Enthalten in BMC public health London : BioMed Central, 2001 4(2004), 1 vom: 23. Feb. (DE-627)326643583 (DE-600)2041338-5 1471-2458 nnns volume:4 year:2004 number:1 day:23 month:02 https://dx.doi.org/10.1186/1471-2458-4-3 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 4 2004 1 23 02
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title_auth	Medical care usage and self-rated mental health
abstract	Background Population studies frequently employ a single item dependent variable for overall health. Self-rated mental health has been the focus of attention less often. The purpose of this project was to investigate the relationship between use of medical care and poor mental health in an elderly population. Methods This study involved a cross-sectional telephone survey of persons over 65 years of age in West Texas, a sparsely-populated 108-county region. Independent variables included number of medical visits, race/ethnicity, age, gender and ability to pay for care. Mental health was measured by asking subjects how often they felt downhearted or blue. Results Multiple logistic regression analysis revealed that more medical visits were made by persons who were downhearted or blue. Females, persons who had difficulty paying for care, Hispanic respondents, and older persons were more likely to report poor mental health. Conclusions Elderly persons in this region who use more medical care are at greater risk of being in poor mental health. Public health agencies that are planning population-based approaches to improving mental health should consider targeting persons who are high users of medical care as well as those of limited means, women, persons of Hispanic ethnicity, and people who are of greater age. © Rohrer; licensee BioMed Central Ltd. 2004. This article is published under license to BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
abstractGer	Background Population studies frequently employ a single item dependent variable for overall health. Self-rated mental health has been the focus of attention less often. The purpose of this project was to investigate the relationship between use of medical care and poor mental health in an elderly population. Methods This study involved a cross-sectional telephone survey of persons over 65 years of age in West Texas, a sparsely-populated 108-county region. Independent variables included number of medical visits, race/ethnicity, age, gender and ability to pay for care. Mental health was measured by asking subjects how often they felt downhearted or blue. Results Multiple logistic regression analysis revealed that more medical visits were made by persons who were downhearted or blue. Females, persons who had difficulty paying for care, Hispanic respondents, and older persons were more likely to report poor mental health. Conclusions Elderly persons in this region who use more medical care are at greater risk of being in poor mental health. Public health agencies that are planning population-based approaches to improving mental health should consider targeting persons who are high users of medical care as well as those of limited means, women, persons of Hispanic ethnicity, and people who are of greater age. © Rohrer; licensee BioMed Central Ltd. 2004. This article is published under license to BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
abstract_unstemmed	Background Population studies frequently employ a single item dependent variable for overall health. Self-rated mental health has been the focus of attention less often. The purpose of this project was to investigate the relationship between use of medical care and poor mental health in an elderly population. Methods This study involved a cross-sectional telephone survey of persons over 65 years of age in West Texas, a sparsely-populated 108-county region. Independent variables included number of medical visits, race/ethnicity, age, gender and ability to pay for care. Mental health was measured by asking subjects how often they felt downhearted or blue. Results Multiple logistic regression analysis revealed that more medical visits were made by persons who were downhearted or blue. Females, persons who had difficulty paying for care, Hispanic respondents, and older persons were more likely to report poor mental health. Conclusions Elderly persons in this region who use more medical care are at greater risk of being in poor mental health. Public health agencies that are planning population-based approaches to improving mental health should consider targeting persons who are high users of medical care as well as those of limited means, women, persons of Hispanic ethnicity, and people who are of greater age. © Rohrer; licensee BioMed Central Ltd. 2004. This article is published under license to BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
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Medical care usage and self-rated mental health

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