Association between self-rated health and physical activity among physician assistants in Ghana: a cross-sectional study

Patrick K. Akwaboah; Richmond Larweh; Akosua A. Somuah; George Baah; Kofi Adjei Ntiri

doi:10.18203/2394-6040.ijcmph20252081

Authors

Patrick K. Akwaboah Department of Health Sciences, University of Lethbridge, Canada https://orcid.org/0000-0001-7799-7089
Richmond Larweh BIMA, Ghana, West Africa https://orcid.org/0009-0000-2442-4543
Akosua A. Somuah Ghana Health Service, Ghana, West Africa https://orcid.org/0000-0001-5936-8270
George Baah Ghana Institute of Management and Public Administration, Accra, Ghana, West Africa https://orcid.org/0009-0000-2069-4634
Kofi Adjei Ntiri Ghana Health Service, Ghana, West Africa https://orcid.org/0000-0001-8066-9182

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20252081

Keywords:

Self-rated health, Ghana, Active transportation, Healthcare, Physician assistants, Physical activity, Workers

Abstract

Background: Self-rated health (SRH) has been a subjective measure of health, yet its association with physical activity (PA) among healthcare workers in sub-Saharan Africa remains underexplored. This study examined the association between SRH and PA [leisure-time physical activity (LTPA) and active transportation (AT)] among Physician Assistants in Ghana.

Methods: A cross-sectional study involving 439 licensed Physician Assistants was conducted between October and December 2024 using an online survey. Multivariate logistic regressions modelled the association between SRH and PA, using adjusted odds ratios (aOR) and 95% confidence intervals (CIs) and controlling for sociodemographic, work-related, environmental and psychological factors.

Results: Overall, 18.7% of PAs reported poor SRH. Participants in the third quartile of LTPA had the highest odds of good SRH (aOR=3.36, 95% CI: 1.58–7.16), though a plateau effect was observed at higher activity levels. AT to and from work was significantly associated with good SRH (aOR=2.32 and 2.16, respectively). Anxiety, older age, lower income, lower rank and poor environmental conditions were associated with reduced odds of good SRH. The availability of sidewalks showed a strong positive association with good SRH. Gender differences in PA domains were also observed, with males being significantly more active than females.

Conclusions: Engagement in moderate LTPA and active commuting is associated with good SRH among Ghanaian Physician Assistants. Interventions to increase physical activity may enhance health outcomes in this vital health workforce. Longitudinal studies are needed to establish causal relationships and inform policy.

Metrics

Metrics Loading ...

References

DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P. Mortality prediction with a single general self-rated health question. A meta-analysis. J Gen Int Med. 2006;21(3):267-75. DOI: https://doi.org/10.1111/j.1525-1497.2005.00291.x

Wu S, Wang R, Zhao Y, Ma X, Wu M, Yan X, et al. The relationship between self-rated health and objective health status: a population-based study. BMC Public Health. 2013;13(1):320. DOI: https://doi.org/10.1186/1471-2458-13-320

Ocampo JM. Self-rated health: Importance of use in elderly adults. Colombia Medica. 2010;41(3):275-89. DOI: https://doi.org/10.25100/cm.v41i3.715

Darboe A, Lin IF, Kuo HW. Effort-reward imbalance and self-rated health among Gambian healthcare professionals. BMC Health Services Res. 2016;16:125. DOI: https://doi.org/10.1186/s12913-016-1347-0

Weyers S, Peter R, Boggild H, Jeppesen HJ, Siegrist J. Psychosocial work stress is associated with poor self-rated health in Danish nurses: a test of the effort-reward imbalance model. Scandinavian J Car Sci. 2006;20(1):26-34. DOI: https://doi.org/10.1111/j.1471-6712.2006.00376.x

Brand SL, Thompson Coon J, Fleming LE, Carroll L, Bethel A, Wyatt K. Whole-system approaches to improving the health and wellbeing of healthcare workers: A systematic review. PLoS One. 2017;12(12):188418. DOI: https://doi.org/10.1371/journal.pone.0188418

World Health Organization. Physical activity. 2020. Available at: https://www.who.int/news-room/fact-sheets/detail/physical-activity. Accessed on 21 January 2025.

Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Global Health. 2018;6(10):1077-86. DOI: https://doi.org/10.1016/S2214-109X(18)30357-7

Stanojevic Jerkovic O, Sauliune S, Šumskas L, Birt CA, Kersnik J. Determinants of self-rated health in elderly populations in urban areas in Slovenia, Lithuania and UK: findings of the EURO-URHIS 2 survey. European J Publ Health. 2017;27(2):74-9.

Berglund E, Lytsy P, Westerling R. Active Traveling and Its Associations with Self-Rated Health, BMI and Physical Activity: A Comparative Study in the Adult Swedish Population. International J Environmental Res Public Health. 2016;13(5):455. DOI: https://doi.org/10.3390/ijerph13050455

Avila-Palencia I, Int Panis L, Dons E, Gaupp-Berghausen M, Raser E, Götschi T, et al. The effects of transport mode use on self-perceived health, mental health and social contact measures: A cross-sectional and longitudinal study. Environment International. 2018;120:199-206. DOI: https://doi.org/10.1016/j.envint.2018.08.002

Scheepers CE, Wendel-Vos GCW, van Wesemael PJV, den Hertog FRJ, Stipdonk HL, Int Panis LLR, et al. Perceived health status associated with transport choice for short distance trips. Prev Med Rep. 2015;2:839-44. DOI: https://doi.org/10.1016/j.pmedr.2015.09.013

Appelqvist-Schmidlechner K, Vaara JP, Vasankari T, Häkkinen A, Mäntysaari M, Kyröläinen H. Relationship between different domains of physical activity and positive mental health among young adult men. BMC Public Health. 2020;20(1):1116. DOI: https://doi.org/10.1186/s12889-020-09175-6

Sargent-Cox K, Cherbuin N, Morris L, Butterworth P, Anstey KJ. The effect of health behavior change on self-rated health across the adult life course: A longitudinal cohort study. Preventive Med. 2014;58:75-80. DOI: https://doi.org/10.1016/j.ypmed.2013.10.017

Haveman-Nies A, De Groot LC, Van Staveren WA. Relation of dietary quality, physical activity and smoking habits to 10-year changes in health status in older Europeans in the SENECA study. American J Public Health. 2003;93(2):318-23. DOI: https://doi.org/10.2105/AJPH.93.2.318

Muthuri R, Senkubuge F, Hongoro C. Predictors of Health-Related Quality of Life among Healthcare Workers in the Context of Health System Strengthening in Kenya. Healthcare (Basel). 2020;9(1):45. DOI: https://doi.org/10.3390/healthcare9010018

Amoah PA. The Relationship among Functional Health Literacy, Self-Rated Health and Social Support among Younger and Older Adults in Ghana. International J Env Res Public Health. 2019;16(17):87. DOI: https://doi.org/10.3390/ijerph16173188

Tetteh J, Kogi R, Yawson AO, Mensah G, Biritwum R, Yawson AE. Effect of self-rated health status on functioning difficulties among older adults in Ghana: Coarsened exact matching method of analysis of the World Health Organization's study on global AGEing and adult health, Wave 2. PLoS One. 2019;14(11):224327. DOI: https://doi.org/10.1371/journal.pone.0224327

Musau EG, Pisa NM, Masoumi HE. Association between transport-related physical activity and wellness in sub-Saharan Africa: A systematic literature review. Transportation Research Interdisciplinary Perspectives. 2023;22:100928. DOI: https://doi.org/10.1016/j.trip.2023.100928

Adjase ET. Physician assistants in Ghana. JAAPA. 2015;28(4):15. DOI: https://doi.org/10.1097/01.JAA.0000462393.36053.13

Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. PLoS Medicine. 2007;4(10):297. DOI: https://doi.org/10.1371/journal.pmed.0040297

Medical and Dental Council. Gazette 2024 [Available from: https://www.mdcghana.org/gazette/.

Cleland CL, Hunter RF, Kee F, Cupples ME, Sallis JF, Tully MA. Validity of the global physical activity questionnaire (GPAQ) in assessing levels and change in moderate-vigorous physical activity and sedentary behaviour. BMC Public Health. 2014;14:1255. DOI: https://doi.org/10.1186/1471-2458-14-1255

Cai J, Coyte PC, Zhao H. Determinants of and socio-economic disparities in self-rated health in China. International Journal for Equity in Health. 2017;16(1):7. DOI: https://doi.org/10.1186/s12939-016-0496-4

Jia Y, Gao J, Dai J, Zheng P, Wu X, Li G, et al. Difference of the associations between self-rated health and demographic characteristics, lifestyle and psychosocial work environment between two types of Chinese worksite. BMC Public Health. 2014;14:851. DOI: https://doi.org/10.1186/1471-2458-14-851

Pappas NA, Alamanos Y, Dimoliatis ID. Self-rated health, work characteristics and health related behaviours among nurses in Greece: a cross sectional study. BMC Nursing. 2005;4:8. DOI: https://doi.org/10.1186/1472-6955-4-8

Peng K, Jiang J, Jiang N, An R, Zheng J, Yan S. Self-rated health and its related influencing factors among emergency department physicians: a national cross-sectional study. Frontiers in Public Health. 2023;11:1147403. DOI: https://doi.org/10.3389/fpubh.2023.1147403

Mc Dowell CP, Carlin A, Capranica L, Dillon C, Harrington JM, Lakerveld J, et al. Associations of self-reported physical activity and depression in 10,000 Irish adults across harmonised datasets: a DEDIPAC-study. BMC Public Health. 2018;18(1):779. DOI: https://doi.org/10.1186/s12889-018-5702-4

Browner WS, Newman TB, Hulley SB. Designing Clinical Research. 4th Ed. Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB, editors. Philadelphia, PA: Wolters Kluwer Health; 2013.

Azevedo MR, Araújo CL, Reichert FF, Siqueira FV, da Silva MC, Hallal PC. Gender differences in leisure-time physical activity. International Journal of Public Health. 2007;52(1):8-15. DOI: https://doi.org/10.1007/s00038-006-5062-1

Kleszczewska D, Mazur J, Bucksch J, Dzielska A, Brindley C, Michalska A. Active transport to school may reduce psychosomatic symptoms in school-aged children: data from nine countries. International J Environ Res Pub Heal. 2020;17(23):437. DOI: https://doi.org/10.3390/ijerph17238709

Arem H, Moore SC, Patel A, Hartge P, Berrington de Gonzalez A, Visvanathan K, et al. Leisure Time Physical Activity and Mortality: A Detailed Pooled Analysis of the Dose-Response Relationship. JAMA Internal Med. 2015;175(6):959-67. DOI: https://doi.org/10.1001/jamainternmed.2015.0533

Mahindru A, Patil P, Agrawal V. Role of Physical Activity on Mental Health and Well-Being: A Review. Cureus. 2023;15(1):33475. DOI: https://doi.org/10.7759/cureus.33475

Ou JY, Peters JL, Levy JI, Bongiovanni R, Rossini A, Scammell MK. Self-rated health and its association with perceived environmental hazards, the social environment and cultural stressors in an environmental justice population. BMC Public Health. 2018;18(1):970. DOI: https://doi.org/10.1186/s12889-018-5797-7

Wang Y, Steenbergen B, van der Krabben E, Kooij HJ, Raaphorst K, Hoekman R. The Impact of the Built Environment and Social Environment on Physical Activity: A Scoping Review. International J Env Res Publ Health. 2023;20(12):34. DOI: https://doi.org/10.3390/ijerph20126189

Stewart TL, Chipperfield JG, Perry RP, Weiner B. Attributing illness to 'old age:' consequences of a self-directed stereotype for health and mortality. Psychol Health. 2012;27(8):881-97. DOI: https://doi.org/10.1080/08870446.2011.630735

Milner A, Witt K, Spittal MJ, Bismark M, Graham M, LaMontagne AD. The relationship between working conditions and self-rated health among medical doctors: evidence from seven waves of the Medicine In Australia Balancing Employment and Life (Mabel) survey. BMC Health Serv Res. 2017;17(1):609. DOI: https://doi.org/10.1186/s12913-017-2554-z

Kim HH, Katelyn Kim HJ. Income inequality, emotional anxiety and self-rated health in times of the coronavirus pandemic: Evidence from a cross-national survey. Res Social Stratif Mobil. 2021;75:100640. DOI: https://doi.org/10.1016/j.rssm.2021.100640