Life satisfaction, multimorbidity, and self-rated health among respondents with a disability group

BACKGROUND: In Russia, disability group assignment reflects the medical determination of disease severity and functional impairment, whereas self-rated health reflects personal perception of physical condition, functional capacity, and limitations.

AIM: This study aimed to assess the association between disability and such components of life perception as life satisfaction, self-rated health, and the presence of diseases, based on a representative population survey.

METHODS: Data from the Russian Longitudinal Monitoring Survey—Higher School of Economics (RLMS-HSE) for 2023 were analyzed. The study included 996 respondents who answered “yes” to the presence of disability, reported diseases from the specified list, and evaluated their health status and life satisfaction. Statistical analysis was performed using SPSS 26.0 (IBM Company).

RESULTS: Disability group I was reported in 8.3%, group II in 49.6%, and group III in 42.1%. The mean age of respondents was 65.4 ± 16.1 years; the proportion of persons aged ≥ 65 years was 62.7% in group I, 64.0% in group II, and 54.9% in group III (p = 0.02). The proportion of those rating their health as “poor” or “very poor” was 73.5% in group I, 50.8% in group II, and 42.7% in group III. The mean number of diseases was 4.4 ± 2.6 (without statistically significant differences between disability groups). The proportion of respondents who were “completely satisfied with life” or “rather satisfied” was almost 10-fold higher (39.6%) than those who rated their health as “very good” or “good” (3.4%; p = 0.007). When multivariable logistic regression was performed, being “completely satisfied with life” or “rather satisfied” was associated with age ≥ 65 years (p = 0.004; OR 1.55; 95% CI 1.15–2.07), self-rated health as “very good” or “good” (p = 0.02; OR 2.42; 95% CI 1.15–5.09), and financial well-being, i.e., absence of perceived poverty (p < 0.001; OR 1.97; 95% CI 1.49–2.59), whereas no associations were found with sex, number of diseases, or disability group severity (groups I and II compared with group III).

CONCLUSION: Not all persons with disability rate their health as “poor” or “very poor”, even in the presence of multimorbidity and disability group I. The proportion of respondents with disability who are satisfied with life exceeds the proportion of those not satisfied. Financial well-being is one of the key determinants of life satisfaction in persons with disability. These findings indicate the need to coordinate the capacities of state medical and social services and to improve living standards and material well-being.