Abstract
Objectives: Data have been collected on self-rated health using a single question on how individuals rate their health in cross-sectional surveys carried out in a large number of countries. Doubts have been expressed about the validity of this measure and this was the main reason to undertake the current study. Study Design: Data of 21 cross-sectional surveys were analyzed derived from the World Health Survey (WHS) carried out among adults in 2002-2003. Methods: We compared the single-item self-rated health measure with a multi-item health status index. Information on both types of measures was available from WHS. The multi-item index was constructed using data on functional limitations in daily activities. Results: The relationship of age with the multi-item health status index was linear while the relationship of age with self-rated health deviated from linearity in the younger and the oldest age groups. Both measures were compared with two criterion variables: life expectancy at age 20 and self-reported chronic conditions. The multi-item index was more strongly related to life expectancy and to chronic conditions than was the single-item self-rated health measure. Conclusions: The multi-item health status index could be a stronger predictor of mortality than the single-item self-rated health measure. It is recommended to rely in health surveys as much as possible on multi-item health status measures. Single-item self-rated health measures should continue to be used in situations where there are no other alternatives available, but researchers and policy makers should be aware of their limitations.
Highlights
Self-rated health (SRH), called self-rated health status, self-rated general health or self-reported health is a frequently used measure of self-perceived or subjective morbidity
Age-Adjusted Percentages in Less Good Health According to WHS Health Status Index (WHSHSI) and SRH
The most important difference occurred in the age group 80 years and older; the percentage in less good health according to WHSHSI continued to increase in this age group while the percentage in less good health according to SRH decreased in this age group
Summary
Self-rated health (SRH), called self-rated health status, self-rated general health or self-reported health is a frequently used measure of self-perceived or subjective morbidity. SRH is a single-item indicator consisting of one question: “How do you rate your health? SRH belongs to the group of self-perceived morbidity measures [14]. The term self-rated health is according to us not the most suitable to use since it is nearly synonymous with selfperceived morbidity; the term self-reported general health is more appropriate as is the term single-item SRH. Doubts have been expressed if SRH and other types of questions or instruments in the group of self-perceived morbidity are valid and reliable measures of morbidity.
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