Reaction to political and socioeconomic transition and self-perceived health status in the adult population of Gjilan region, Kosovo

Aim: The objective of our study was to assess the association of reaction to political and socioeconomic transition with self-perceived general health status in adult men and women in a region of Kosovo, a post-war country in the Western Balkans which has proclaimed independence in 2008. Methods: This was a cross-sectional study carried out in Gjilan region of Kosovo in 2014, including a representative sample of 867 primary health care users aged ≥35 years (419 men aged 54.3±10.9 years and 448 women aged 54.0±10.1 years; overall response rate: 87%). Reaction to political and socioeconomic aspects of transition was assessed by a three-item scale (trichotomized in the analysis into positive attitude, intermediate attitude, and negative attitude towards transition), which was previously used in the neighbouring Albania. Self-reported health status was measured on a 5-point scale which was dichotomized in the analysis into “good” vs. “poor” health. Demographic and socioeconomic data were also collected. Binary logistic regression was used to assess the association of reaction to transition with self-rated health status. Results: In crude/unadjusted models, negative attitude to transition was a “strong” predictor of poor self-perceived health (OR=2.5, 95%CI=1.7-3.8). Upon multivariable adjustment for all the demographic factors and socioeconomic characteristics, the association was attenuated and was only borderline statistically significant (OR=1.6, 95%CI=1.0-2.6, P=0.07). Conclusion: Our findings indicate an important association between reaction to transition and self-perceived health status in the adult population of the newly independent Kosovo. Policymakers and decision-makers in post-war countries such as Kosovo should be aware of the health effects of attitudes towards political and socioeconomic aspects of transition, which is seemingly an important psychosocial factor

Reaction to political and socioeconomic transition and self-perceived health status in the adult population of Gjilan region, Kosovo

Aim: The objective of our study was to assess the association of reaction to political and socioeconomic transition with self-perceived general health status in adult men and women in a region of Kosovo, a post-war country in the Western Balkans which has proclaimed independence in 2008.Methods: This was a cross-sectional study carried out in Gjilan region of Kosovo in 2014, including a representative sample of 867 primary health care users aged ≥35 years (419 men aged 54.3±10.9 years and 448 women aged 54.0±10.1 years; overall response rate: 87%). Reaction to political and socioeconomic aspects of transition was assessed by a three-item scale (trichotomized in the analysis into positive attitude, intermediate attitude, and negative attitude towards transition), which was previously used in the neighbouring Albania. Self-reported health status was measured on a 5-point scale which was dichotomized in the analysis into “good” vs. “poor” health. Demographic and socioeconomic data were also collected. Binary logistic regression was used to assess the association of reaction to transition with self-rated health status.Results: In crude/unadjusted models, negative attitude to transition was a “strong” predictor of poor self-perceived health (OR=2.5, 95%CI=1.7-3.8). Upon multivariable adjustment for all the demographic factors and socioeconomic characteristics, the association was attenuated and was only borderline statistically significant (OR=1.6, 95%CI=1.0-2.6, P=0.07).Conclusion: Our findings indicate an important association between reaction to transition and self-perceived health status in the adult population of the newly independent Kosovo. Policymakers and decision-makers in post-war countries such as Kosovo should be aware of the health effects of attitudes towards political and socioeconomic aspects of transition, which is seemingly an important psychosocial factor

OSTILITATEA ȘI STAREA DE SĂNĂTATE A POPULAȚIEI ADULTE DIN REGIUNEA GJILAN, KOSOVO

BACKGROUND: The aim of this study was to assess the association of hostility with self-reported health status in the adult population of Gjilan region in Kosovo, a transitional country in the Western Balkans which is striving for international recognition. METHODS: A cross-sectional study was conducted in Gjilan region, Kosovo, in 2014 including a representative sample of 867 primary health care users (419 males and 448 females; overall mean age: 54.2±10.5 years; overall response rate: 87%). Hostility was assessed with the 8-item Cynical Distrust Scale. Self-reported health status was measured on a 5-point scale which was subsequently dichotomized into “good” vs. “poor” health. Demographic and socioeconomic data were also collected. Binary logistic regression was used to assess the association of hostility with self-reported health status.   RESULTS: In this representative sample of primary health care users in Kosovo, overall, 80.5% of participants perceived their health status as “good” compared with 19.5% of individuals who perceived their health status as “poor”. Upon multivariable adjustment for demographic factors and socioeconomic characteristics, there was evidence of a strong and significant association between the upper tertile of hostility score and poor self-perceived health: OR=1.7, 95%CI=1.0-2.7. CONCLUSION: Our findings point to a strong positive association between hostility and poor self-perceived health status in the adult population of transitional Kosovo. Health professionals and policymakers in developing settings and transitional societies should be aware of the negative health effects of psychosocial factors. Keywords: cynical distrust, Gjilan, hostility, Kosovo, psychosocial factors, self-perceived health status.CONTEXT: Scopul acestui studiu a fost evaluarea asocierii ostilităţii cu starea de sănătate auto-percepută a populației adulte a regiunii Gjilan din Kosovo, o țară în tranziție din Balcanii de Vest, care se luptă pentru recunoaștere internațională. METODE: A fost realizat un studiu transversal în regiunea Gjilan, Kosovo, în 2014 pe un eșantion reprezentativ de 867 de utilizatori ai serviciilor de asistență medicală primară (419 bărbați și 448 femei, cu o medie de vârstă: 54,2 ± 10,5 ani; rata generală de răspuns: 87%). Ostilitatea a fost evaluată cu ajutorul celor 8 itemi ai Scalei  Cynical Distrust. Starea de sănătate auto-raportată a fost măsurată pe o scală de 5 puncte, care a fost ulterior împărţită în sănătate "bună" versus sănătate "proastă". De asemenea au fost colectate date demografice și socio-economice. S-a utilizat pentru a evalua asocierea ostilitate - stare de sănătate auto-raportată regresia logistică binară. REZULTATE: În acest eșantion reprezentativ de utilizatori ai asistenței medicale primare în Kosovo, 80,5% dintre participanți şi-au perceput starea de sănătate ca fiind "bună", comparativ cu 19,5% care şi-au perceput starea de sănătate ca fiind "proastă". Pe baza ajustării multivariabile pentru factorii demografici și caracteristicile socio-economice a rezultat evidenţa unei asocieri puternice și semnificative între cea de a treia cuartilă superioară a scorului ostilitate și starea proastă de sănătate auto-percepută: OR = 1,7, 95% CI = 1,0-2,7. CONCLUZII: Rezultatele noastre indică o asociere pozitivă puternică între ostilitate și starea proastă de sănătate auto-percepută, în populația adultă a regiunii în tranziţie Kosovo. În cursul dezvoltării societăților de tranziție profesioniștii din domeniul sănătății și factorii de decizie politică ar trebui să fie conștienți de efectele negative ale factorilor psihosociali asupra stării de sănătate.   Cuvinte cheie: neîncredere cinică, Gjilan, ostilitate, Kosovo, factorii psihosociali, stare de sănătate auto-percepută