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

  • Layes, Audrey
  • Asada, Yukiko
  • Kephart, George
Registered author(s):

    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.

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    File URL: http://www.sciencedirect.com/science/article/pii/S0277953611006745
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    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 75 (2012)
    Issue (Month): 1 ()
    Pages: 1-9

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    Handle: RePEc:eee:socmed:v:75:y:2012:i:1:p:1-9
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    1. Singh-Manoux, Archana & Marmot, Michael, 2005. "Role of socialization in explaining social inequalities in health," Social Science & Medicine, Elsevier, vol. 60(9), pages 2129-2133, May.
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    3. Leinonen, Raija & Heikkinen, Eino & Jylhä, Marja, 2001. "Predictors of decline in self-assessments of health among older people -- a 5-year longitudinal study," Social Science & Medicine, Elsevier, vol. 52(9), pages 1329-1341, May.
    4. Humphries, Karin H. & van Doorslaer, Eddy, 2000. "Income-related health inequality in Canada," Social Science & Medicine, Elsevier, vol. 50(5), pages 663-671, March.
    5. Wilkinson, Richard G & Pickett, Kate E., 2006. "Income inequality and population health: A review and explanation of the evidence," Social Science & Medicine, Elsevier, vol. 62(7), pages 1768-1784, April.
    6. Jennifer Beam Dowd & Megan Todd, 2011. "Does Self-reported Health Bias the Measurement of Health Inequalities in U.S. Adults? Evidence Using Anchoring Vignettes From the Health and Retirement Study," Journals of Gerontology: Series B, Gerontological Society of America, vol. 66(4), pages 478-489.
    7. Groot, Wim, 2000. "Adaptation and scale of reference bias in self-assessments of quality of life," Journal of Health Economics, Elsevier, vol. 19(3), pages 403-420, May.
    8. Jylhä, Marja, 2009. "What is self-rated health and why does it predict mortality? Towards a unified conceptual model," Social Science & Medicine, Elsevier, vol. 69(3), pages 307-316, August.
    9. Shmueli, Amir, 2003. "Socio-economic and demographic variation in health and in its measures: the issue of reporting heterogeneity," Social Science & Medicine, Elsevier, vol. 57(1), pages 125-134, July.
    10. Baron-Epel, Orna & Kaplan, Giora & Haviv-Messika, Amalia & Tarabeia, Jalal & Green, Manfred S. & Nitzan Kaluski, Dorit, 2005. "Self-reported health as a cultural health determinant in Arab and Jewish Israelis: MABAT--National Health and Nutrition Survey 1999-2001," Social Science & Medicine, Elsevier, vol. 61(6), pages 1256-1266, September.
    11. Doorslaer, Eddy van & Jones, Andrew M., 2003. "Inequalities in self-reported health: validation of a new approach to measurement," Journal of Health Economics, Elsevier, vol. 22(1), pages 61-87, January.
    12. van Doorslaer, Eddy & Gerdtham, Ulf-G., 2003. "Does inequality in self-assessed health predict inequality in survival by income? Evidence from Swedish data," Social Science & Medicine, Elsevier, vol. 57(9), pages 1621-1629, November.
    13. Greg Samsa & David Edelman & Margaret L. Rothman & G. Rhys Williams & Joseph Lipscomb & David Matchar, 1999. "Determining Clinically Important Differences in Health Status Measures: A General Approach with Illustration to the Health Utilities Index Mark II," PharmacoEconomics, Springer Healthcare | Adis, vol. 15(2), pages 141-155.
    14. Bobak, Martin & Pikhart, Hynek & Hertzman, Clyde & Rose, Richard & Marmot, Michael, 1998. "Socioeconomic factors, perceived control and self-reported health in Russia. A cross-sectional survey," Social Science & Medicine, Elsevier, vol. 47(2), pages 269-279, July.
    15. Mansyur, Carol & Amick, Benjamin C. & Harrist, Ronald B. & Franzini, Luisa, 2008. "Social capital, income inequality, and self-rated health in 45 countries," Social Science & Medicine, Elsevier, vol. 66(1), pages 43-56, January.
    16. Bailis, Daniel S. & Segall, Alexander & Chipperfield, Judith G., 2003. "Two views of self-rated general health status," Social Science & Medicine, Elsevier, vol. 56(2), pages 203-217, January.
    17. Jylhä, Marja, 2010. "Self-rated health between psychology and biology. A response to Huisman and Deeg," Social Science & Medicine, Elsevier, vol. 70(5), pages 655-657, March.
    18. P Grootendorst & D Feeny & W Furlong, 1999. "Health Utilities Index Mark 3: Evidence of Construct Validity for Stroke and Arthritis in a Population Health Survey," Centre for Health Economics and Policy Analysis Working Paper Series 1999-06, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
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