Ball, W. P. (2023) Doctoral thesis. Edinburgh Napier University, [ONS LS]

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Background: Unfair and avoidable inequalities in health remain pervasive & persistent in the United Kingdom. Excess Mortality has been observed in Scotland compared to the rest of the UK. Area deprivation measures have become less able to explain excess mortality over time. Studying nurses’ health serves to identify differences with the general population. Stratified cross-national comparison of nurses’ health may improve insights as they are demographically and socioeconomically homogenous.
Methods: Individual-level records (n = 478,802) from nationally representative studies derived from Census data have been linked to a UK-comparable composite measure of small-area deprivation. Self-rated health and inequalities in samples of economically active nurses and non-nurses have been compared. A logistic regression model was used to estimate the effect of nurse status on self-rated health, adjusting for deprivation and other confounders. A cross-national comparison in a subsample of nurses has been conducted. Secure national data have been analysed using the eDatashield process which simulates combined analysis.
Results: nurses reported better self-rated health and have preferential socioeconomic characteristics. A social gradient by deprivation exists for nurses and non-nurses reporting less than good health, although inequalities are smaller for nurses. The odds of reporting good or better health for nurses were 1.33 (SLS - 95% CI 1.19 – 1.49) and 1.41 (ONS LS - 95% CI 1.32 – 1.52) times that of non-nurses. Cross-national self-rated health in nurses was similar but marginally poorer in Scotland. The odds of nurses living in England & Wales reporting good or better health were 1.16 (95% CI 1.01 – 1.34) times that of nurses living in Scotland.
Conclusion: A self-rated health benefit for nurses remains after adjustment for socioeconomic and demographic differences. Inequalities for nurses are smaller but still present. An excess in poor self-rated health was found for Scottish nurses.

Available online: Doctoral thesis.
Output from project: 1005034


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