Determinants of Self-Rated Health in Tehran, from Individual Characteristics towards Community-Level Attributes.

Introduction: It is generally believed that the attributes of shared environment affect health of residents beyond the individual risk factors. This study investigates some individual and neighborhood characteristics that may affect self-rated health (SRH) in Iran.

Methods: Questions were asked about the social capital, economic status and SRH of 1,982 citizens from 200 randomly selected locations in Tehran. The neighborhood characteristics were assessed by an observational checklist. A multilevel model was designed.

Results: SRH was significantly different between neighborhoods (P-value < 0.001) and between economic groups (P-value < 0.001). At the individual level, social capital (SC) and being married had a positive association with SRH, while age, being female and bad economic statuses were negatively associated with SRH. At the neighborhood level, neighborhoods with higher average education were positively association with SRH, and living in neighborhoods under construction had a negative association with SRH.

Conclusions: These findings highlight the importance of shared social and physical environment, as well as individual characteristics on health, although the mechanisms may still be controversial.