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Whiners and deniers – What does self-rated health measure?

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  • Layes, Audrey
  • Asada, Yukiko
  • Kephart, George

Abstract

Self-rated health is a widely used measure of health typically obtained from a question, “How do you rate your health?” Despite the measure’s popularity, debates continue as to what exactly self-rated health captures. This study augments the rich literature on the construct of self-rated health using a unique measurement approach. We conceptualize self-rated health as consisting of two components: latent health and reporting behaviour. We operationalize a preference-standardized health-related quality of life as a measure of latent health, and its systematic deviation from self-rated health as a measure of reporting behaviour. Using the 2005 Canadian Community Health Survey, we assess comparatively how the deviations between self-rated health and latent health, measured by the Health Utilities Index Mark 3, vary systematically by demographic, socioeconomic, and cultural factors. We present reporting behaviour by these factors in terms of pessimism and optimism relative to the assessment of the average Canadian. Our analysis shows reporting behaviour statistically and clinically significantly varies by age and socioeconomic status: those aged 80+ years and those with less income and education exhibit optimism about their health. In addition, our analysis indicates a tendency for persons with healthier lifestyles to be slightly pessimistic about their health. Our results imply that it may be misleading to take self-rated health at face value as a measure of health status for applications where preferences should be standardized. For this popular measure to continue to play an important role in population health research and policy development, its users must acknowledge and understand the determinants of self-rated health, including reporting behaviour.

Suggested Citation

  • Layes, Audrey & Asada, Yukiko & Kephart, George, 2012. "Whiners and deniers – What does self-rated health measure?," Social Science & Medicine, Elsevier, vol. 75(1), pages 1-9.
  • Handle: RePEc:eee:socmed:v:75:y:2012:i:1:p:1-9
    DOI: 10.1016/j.socscimed.2011.10.030
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    5. Vonneilich, Nico & Lüdecke, Daniel & von dem Knesebeck, Olaf, 2020. "Educational inequalities in self-rated health and social relationships – analyses based on the European Social Survey 2002-2016," Social Science & Medicine, Elsevier, vol. 267(C).
    6. Oksuzyan, Anna & Dańko, Maciej J. & Caputo, Jennifer & Jasilionis, Domantas & Shkolnikov, Vladimir M., 2019. "Is the story about sensitive women and stoical men true? Gender differences in health after adjustment for reporting behavior," Social Science & Medicine, Elsevier, vol. 228(C), pages 41-50.
    7. Alice Sanwald & Engelbert Theurl, 2014. "Atypical Employment and Health: A Meta-Analysis," Working Papers 2014-15, Faculty of Economics and Statistics, Universität Innsbruck.
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    9. S M Asik Ullah & Kazuo Asahiro & Masao Moriyama & Masakazu Tani, 2021. "Socioeconomic Status Changes of the Host Communities after the Rohingya Refugee Influx in the Southern Coastal Area of Bangladesh," Sustainability, MDPI, vol. 13(8), pages 1-21, April.
    10. Moustapha Dramé & Eléonore Cantegrit & Lidvine Godaert, 2023. "Self-Rated Health as a Predictor of Mortality in Older Adults: A Systematic Review," IJERPH, MDPI, vol. 20(5), pages 1-12, February.
    11. Hughes, Amanda & Kumari, Meena, 2019. "Testosterone, risk, and socioeconomic position in British men: Exploring causal directionality," Social Science & Medicine, Elsevier, vol. 220(C), pages 129-140.
    12. Lång, Elisabeth & Nystedt, Paul, 2018. "Blowing up money? The earnings penalty of smoking in the 1970s and the 21st century," Journal of Health Economics, Elsevier, vol. 60(C), pages 39-52.
    13. Black, Nicole & Johnston, David W. & Shields, Michael A. & Suziedelyte, Agne, 2017. "Who provides inconsistent reports of their health status? The importance of age, cognitive ability and socioeconomic status," Social Science & Medicine, Elsevier, vol. 191(C), pages 9-18.
    14. Maria Gheorghe & Werner Brouwer & Pieter Baal, 2015. "Did the health of the Dutch population improve between 2001 and 2008? Investigating age- and gender-specific trends in quality of life," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(8), pages 801-811, November.
    15. Ates, Merih, 2017. "Does grandchild care influence grandparents’ self-rated health? Evidence from a fixed effects approach," Social Science & Medicine, Elsevier, vol. 190(C), pages 67-74.
    16. Anna Zajacova & Katrina Walsemann & Jennifer Dowd, 2015. "The Long Arm of Adolescent Health Among Men and Women: Does Attained Status Explain Its Association with Mid-Adulthood Health?," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 34(1), pages 19-48, February.
    17. Nesson, Erik T. & Robinson, Joshua J., 2019. "On the measurement of health and its effect on the measurement of health inequality," Economics & Human Biology, Elsevier, vol. 35(C), pages 207-221.
    18. Hajizadeh, Mohammad & Hu, Min & Bombay, Amy & Asada, Yukiko, 2018. "Socioeconomic inequalities in health among Indigenous peoples living off-reserve in Canada: Trends and determinants," Health Policy, Elsevier, vol. 122(8), pages 854-865.
    19. Au, Nicole & Johnston, David W., 2014. "Self-assessed health: What does it mean and what does it hide?," Social Science & Medicine, Elsevier, vol. 121(C), pages 21-28.

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