Inflated Responses in Measures of Self-Assessed Health

This paper focuses on the self-reported responses given to survey questions of the form "Overall, how would you rate your health?" with typical response items being on a scale ranging from poor to excellent. Usually, the overwhelming majority of responses fall in either the middle category or the one immediately to the "right" of this (for example, good and very good). However, based on a wide range of other medical indicators, such favorable responses appear to paint an overly rosy picture of true health. The hypothesis here is that these "middle" responses have been, in some sense, inflated. That is, for whatever reason, a significant number of responders inaccurately report into these categories. Our results do indeed suggest that such inflation is present in these categories. Adjusted responses to these questions could lead to significant changes in policy, and should be reflected upon when analyzing and interpreting these scales.