Sociodemographic Determinants of Health and Well-Being Among Adults Residing in the Combined Kaiser Permanente Regions

Perm J. 2019:23:18-091. doi: 10.7812/TPP/18-091.

Abstract

Context: Kaiser Permanente commissioned a health and well-being (HWB) survey of adult members and nonmembers in its 8 Regions.

Objective: To estimate the prevalence of HWB indicators and evaluate differences in prevalence of excellent/very good (E/VG) health and thriving overall in life (thriving) by race/ethnicity, age group, sex, education, and financial situation.

Design: Cross-sectional survey conducted by email and phone during Winter 2016-2017 with a racial/ethnic group-stratified quota sample. Participants (N = 26,304) provided sociodemographic characteristics and ratings for 6 HWB indicators. Using population-weighted data, we estimated the prevalence of HWB indicators and used logistic regression models to test for differences in E/VG health and thriving by sociodemographic factors.

Main outcome measures: Overall health and overall life evaluation.

Results: Of adults, 52% were in E/VG health and 63% were thriving. Blacks were less likely to be in E/VG health than whites, Hispanics, and Asian/Pacific Islanders, but there was little racial/ethnic variation in those who were thriving. E/VG health and thriving varied significantly by level of education and financial situation. Across all racial/ethnic groups, large differences in percentages were observed in E/VG health and thriving between the lowest and highest levels of education and financial situation but little racial/ethnic variation within education and financial situation strata.

Conclusion: Differences in health status and life evaluation are associated very strongly with financial situation and educational attainment, and these social determinants partially explain racial/ethnic disparities in HWB. The lack of strong correlation of health status and life evaluation suggests these are different domains of well-being.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Cross-Sectional Studies
  • Female
  • Health Status*
  • Health Surveys
  • Humans
  • Male
  • Mental Health / statistics & numerical data
  • Middle Aged
  • Racial Groups / statistics & numerical data
  • Sex Factors
  • Social Determinants of Health / statistics & numerical data*
  • Socioeconomic Factors
  • United States / epidemiology
  • Young Adult