Demographic variation in self-rated physical health across 22 countries: findings from the Global Flourishing Study.

Background: Relatively few studies have examined how self-rated physical health (SRH) varies across: (a) countries around the world and (b) demographic characteristics in diverse nations and cultures.

Methods: The current study addresses these issues by providing a cross-national random effects meta-analysis of SRH using data from the Global Flourishing Study (GFS), an international survey of 202,898 individuals from 22 geographically, economically, and culturally diverse countries collected in 2022-2023.

Results: On a scale of 0-10 (0 = poor and 10 = excellent), the mean SRH ranged from 5.97 in Japan to 8.29 in Indonesia. Three of the four largest SRH means were found in developing, non-Western countries (Indonesia, Nigeria, and Kenya), while the five lowest were in economically developed nations (Germany, Australia, Sweden, the UK, and Japan). Countries also differed in the degree of variation around the mean. SRH was more evenly dispersed in nations like Israel, Poland, and the USA and more unequally distributed in places like Egypt, Tanzania, and India. SRH also varied across demographic characteristics. Results from a random effects meta-analysis of all 22 countries showed that SRH varied across age, gender, marital status, employment, education, religious service attendance, and immigration status in at least some countries. In general, SRH tended to be higher among: (a) younger individuals; (b) males; (c) those who were single/never married, married, or had domestic partnerships (compared with other groups such as widowed, divorced, or separated); (d) employed individuals and students; (e) people with more years of education; and (f) those who attended religious services. There was considerable heterogeneity across countries in the associations between demographic characteristics and SRH, however, suggesting that country-level contexts are important. Results were similar when weighted based on the population size in each country.

Conclusions: While being mindful of challenges due to varying cultural contexts and possible interpretations and translations of key survey questions, findings suggest substantial variation in SRH across countries and meaningful demographic characteristics. This study lays the foundation for future longitudinal GFS studies on the causes and correlates of SRH in a global context.