Multilevel Analysis of Factors Associated with Perceived Good Health and Multimorbidity among Older Adults: Using the 2017 Community Health Survey

Purpose: This study aimed to identify individual- and regional-level factors associated with perceived good health and multimorbidity among older adults. Methods: Secondary analysis of the 2017 Korea Community Health Survey was conducted on a sample of 67,532 older adults. The individual level data set was combined with regional-level factors from the administrative data released on the Korea National Statistical Office website. Distribution of perceived good health and multimorbidity in 254 public health centers were calculated using sampling weights and presented as percentages. Multilevel logistic regression analyses were used to identify individual- and regional-level factors associated with perceived good health and multimorbidity. Results: Overall, 21.1% of subjects perceived their health to be good, ranging from 9.3% to 39.4% by region. The prevalence of multimorbidity was 15.9%, and varied between 6.6% and 22.6% by region. At the individual level, perceived good health was associated with men, younger age, higher educational levels, higher income levels, and those married and living with a partner and maintaining a healthy lifestyle. At the regional level, higher rates of health center personnel among public officials and higher levels of financial independence were associated with perceived good health. Multimorbidity was associated with marital status and healthy lifestyle, and higher rates of health center personnel among public officials. Conclusion: Regional factors such as health care personnel and local economy could affect population health. Our findings suggest the need to consider individual- and regional-level factors to promote good health among older adults and reduce the health gap by region.