Age differences in the association between physical activity and self-rated health: implications for home health care

Self-rated health (SRH) is an important indicator of overall well-being and is associated with morbidity, functional decline, and mortality. This study examined temporal trends, sociodemographic and behavioral determinants, and age-related differences in fair or poor SRH among adults in Missouri. A repeated cross-sectional analysis was conducted among 56,970 adults aged ≥ 18 years. Survey-weighted logistic regression models were used to assess associations between physical activity and SRH, adjusting for sociodemographic and health-related factors. The prevalence of fair or poor SRH declined from 20.5% in 2018 to 16.2% in 2020 before increasing to 20.1% in 2024. Lower income and unemployment were strongly associated with poor SRH. Physical activity was associated with lower odds of poor SRH, with a stronger protective association observed among adults aged ≥ 65 years. These findings highlight the importance of promoting physical activity to support healthy aging and improve health outcomes among community-dwelling adults.