The multidimensionality of health: associations between allostatic load and self-report health measures in a community epidemiologic study

ABSTRACT

With social survey data from a random sample of 1252 black and white adults who participated in the Nashville Stress and Health Study, we cross-classified biological markers of dysregulation with self-report health measures. Our aim was to quantify the degree of concordance between them. The study collected blood and urine samples to derive a 10 component estimate of allostatic load. In addition, the computer-assisted interview included an array of self-report measures such as self-perceived health, doctor-diagnosed diseases, bed days, and activity limitations. Allostatic load and the self-report measures were dichotomised. Modest concordance was observed between allostatic load and self-perceived health (OR = 1.742), doctor-diagnosed diseases (OR = 2.309), bed days (OR = 1.103), activity limitations (OR = 1.778), and ill on any self-report health measure (OR = 1.700). The self-report measures were significantly predictive of allostatic load, with the exception of bed days. Further, there was little evidence to suggest that race, sex, education, or past year depression moderated the level of concordance. Our findings support the hypothesis that biological markers and self-report measures could be used in tandem when specifying an individual’s health status, and the distribution of population health.

KEYWORDS:

• Allostatic load
• biomarkers
• concordance
• dysregulation
• illness
• self-perceived health

Acknowledgements

The authors thank the screeners, interviewers, and clinicians for their efforts during the data collection phase of the study. They also thank Anne Wall for her administrative support.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Institute of Aging [R01AG034067].