Skip to main content

Advertisement

SpringerLink
Log in

Gender, educational and age differences in meanings that underlie global self-rated health

  • Original Article
  • Published:
International Journal of Public Health

Abstract

Objectives

The single-item question on self-rated health has been widely used in surveys. This study aims to explore which frames of reference are used by respondents when answering this question, to describe differences in the used frame of reference according to gender, educational background and age, and to determine whether subgroup differences can be explained by differences in prior health experiences.

Methods

Face-to-face interviews were conducted in a sample of 310 adults who were asked to rate their health using a single-item question with closed-ended answering categories and to explain the reasons for the rating they gave with open-ended probes. Different indicators of prior health experiences were taken into account.

Results

Physical health problems were the most utilized referents. However, participants also mentioned reasons that go beyond the physical dimension of health. Subgroup differences were found. Prior health experiences partly explained subgroup differences for some referents, but not for others.

Conclusions

Investigators using the single question on self-rated health for comparing health across different population groups should be aware that the meaning of the question varies across different socio-demographic groups.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Abdulrahim S, Ajrouch K (2010) Social and cultural meanings of self-rated health: Arab immigrants in the United States. Qual Health Res 20(9):1229–1240. doi:10.1177/1049732310371104

    Article  PubMed  Google Scholar 

  • Bailis DS, Segall A, Chipperfield JG (2003) Two views of self-rated general health status. Soc Sci Med 56(2):203–217 (pii:S0277-9536(02)00020-5)

    Article  PubMed  Google Scholar 

  • Benyamini Y, Blumstein T, Lusky A, Modan B (2003) Gender differences in the self-rated health-mortality association: is it poor self-rated health that predicts mortality or excellent self-rated health that predicts survival? Gerontologist 43(3):396–405

    Article  PubMed  Google Scholar 

  • Borawski EA, Kinney JM, Kahana E (1996) The meaning of older adults’ health appraisals: congruence with health status and determinant of mortality. J Gerontol B Psychol 51(3):S157–S170

    Article  CAS  Google Scholar 

  • Burstrom B, Fredlund P (2001) Self rated health: is it as good a predictor of subsequent mortality among adults in lower as well as in higher social classes? J Epidemiol Community Health 55(11):836–840

    Article  PubMed  CAS  Google Scholar 

  • Cox B et al (2009) The reliability of the Minimum European Health Module. Int J Public Health 54(2):55–60. doi:10.1007/s00038-009-7104-y

    Article  PubMed  Google Scholar 

  • D’Uva TB, O’Donnell O, van Doorslaer E (2008) Differential health reporting by education level and its impact on the measurement of health inequalities among older Europeans. Int J Epidemiol 37(6):1375–1383. doi:10.1093/ije/dyn146

    Article  PubMed  Google Scholar 

  • Deeg DJH, Kriegsman DMW (2003) Concepts of self-rated health: specifying the gender difference in mortality risk. Gerontologist 43(3):376–386

    Article  PubMed  Google Scholar 

  • Dowd JB, Zajacova A (2007) Does the predictive power of self-rated health for subsequent mortality risk vary by socioeconomic status in the US? Int J Epidemiol 36(6):1214–1221. doi:10.1093/Ije/Dym214

    Article  PubMed  Google Scholar 

  • Dowd JB, Zajacova A (2010) Does self-rated health mean the same thing across socioeconomic groups? Evidence from biomarker data. Ann Epidemiol 20(10):743–749. doi:10.1016/j.annepidem.2010.06.007

    Article  PubMed  Google Scholar 

  • Franks P, Gold MR, Fiscella K (2003) Sociodemographics, self-rated health, and mortality in the US. Soc Sci Med 56(12):2505–2514 (pii:S0277-9536(02)00281-2)

    Article  PubMed  Google Scholar 

  • Fylkesnes K (1993) Determinants of health-care utilization—visits and referrals. Scand J Soc Med 21(1):40–50

    PubMed  CAS  Google Scholar 

  • Gavagan T (2008) A systematic review of COPC: evidence for effectiveness. J Health Care Poor U 19(3):963–980

    Article  Google Scholar 

  • Huisman M, van Lenthe F, Mackenbach J (2007) The predictive ability of self-assessed health for mortality in different educational groups. Int J Epidemiol 36(6):1207–1213. doi:10.1093/ije/dym095

    Article  PubMed  Google Scholar 

  • Idler EL, Benyamini Y (1997) Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 38(1):21–37

    Article  PubMed  CAS  Google Scholar 

  • Idler EL, Kasl SV (1995) Self-ratings of health: do they also predict change in functional ability? J Gerontol B Psychol Sci Soc Sci 50(6):S344–S353

    Article  PubMed  CAS  Google Scholar 

  • Idler EL, Hudson SV, Leventhal H (1999) The meanings of self-ratings of health—a qualitative and quantitative approach. Res Aging 21(3):458–476

    Article  Google Scholar 

  • Jagger C, Spiers NA, Clarke M (1993) Factors associated with decline in function, institutionalization and mortality of elderly people. Age Ageing 22(3):190–197

    Article  PubMed  CAS  Google Scholar 

  • Jylha M (2009) What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med 69(3):307–316. doi:10.1016/j.socscimed.2009.05.013

    Article  PubMed  Google Scholar 

  • Kaplan G, Baron-Epel O (2003) What lies behind the subjective evaluation of health status? Soc Sci Med 56(8):1669–1676 (pii:S0277-9536(02)00179-X)

    Article  PubMed  Google Scholar 

  • Krause NM, Jay GM (1994) What do global self-rated health items measure. Med Care 32(9):930–942

    Article  PubMed  CAS  Google Scholar 

  • Lang T, Delpierre C (2009) ‘How are you?’ what do you mean? Eur J Public Health 19(4):353. doi:10.1093/eurpub/ckp083

    Article  PubMed  Google Scholar 

  • Locker D, Maggirias J, Wexler E (2009) What frames of reference underlie self-ratings of oral health? J Public Health Dent 69(2):78–89. doi:10.1111/j.1752-7325.2008.00103.x

    Article  PubMed  Google Scholar 

  • Lundberg O, Manderbacka K (1996) Assessing reliability of a measure of self-rated health. Scand J Soc Med 24(3):218–224

    PubMed  CAS  Google Scholar 

  • Mallinson S (2002) Listening to respondents: a qualitative assessment of the Short-Form 36 health status questionnaire. Soc Sci Med 54(1):11–21

    Article  PubMed  Google Scholar 

  • Manderbacka K (1998) Examining what self-rated health question is understood to mean by respondents. Scand J Soc Med 26(2):145–153

    PubMed  CAS  Google Scholar 

  • Mantzavinis GD, Pappas N, Dimoliatis LDK, Ioannidis JPA (2005) Multivariate models of self-reported health often neglected essential candidate determinants and methodological issues. J Clin Epidemiol 58(5):436–443. doi:10.1016/j.jclinepi.2004.08.016

    Article  PubMed  Google Scholar 

  • Martikainen P et al (1999) Reliability of perceived health by sex and age. Soc Sci Med 48(8):1117–1122

    Article  PubMed  CAS  Google Scholar 

  • McFadden E, Luben R, Bingham S, Wareham N, Kinmonth AL, Khaw KT (2009) Does the association between self-rated health and mortality vary by social class? Soc Sci Med 68(2):275–280. doi:10.1016/j.socscimed.2008.10.012

    Article  PubMed  CAS  Google Scholar 

  • McHorney CA, Ware JE Jr, Raczek AE (1993) The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 31(3):247–263

    Article  PubMed  CAS  Google Scholar 

  • Moller L, Kristensen TS, Hollnagel H (1996) Self rated health as a predictor of coronary heart disease in Copenhagen, Denmark. J Epidemiol Community Health 50(4):423–428

    Article  PubMed  CAS  Google Scholar 

  • Nielsen ABS, Siersma V, Hiort LC, Drivsholm T, Kreiner S, Hollnagel H (2008) Self-rated general health among 40-year-old Danes and its association with all-cause mortality at 10-, 20-, and 29 years’ follow-up. Scand J Public Healt 36(1):3–11. doi:10.1177/1403494807085242

    Article  Google Scholar 

  • Quesnel-Vallee A (2007) Self-rated health: caught in the crossfire of the quest for ‘true’ health? Int J Epidemiol 36(6):1161–1164. doi:10.1093/ije/dym236

    Article  PubMed  Google Scholar 

  • Simon JG, De Boer JB, Joung IMA, Bosma H, Mackenbach JP (2005) How is your health in general? A qualitative study on self-assessed health. Eur J Public Health 15(2):200–208. doi:10.1093/eurpub/cki102

    Article  PubMed  CAS  Google Scholar 

  • Singh-Manoux A, Martikainen P, Ferrie J, Zins M, Marmot M, Goldberg M (2006) What does self rated health measure? Results from the British Whitehall II and French Gazel cohort studies. J Epidemiol Community Health 60(4):364–372. doi:10.1136/jech.2005.039883

    Article  PubMed  Google Scholar 

  • Singh-Manoux A et al (2007) The association between self-rated health and mortality in different socioeconomic groups in the GAZEL cohort study. Int J Epidemiol 36(6):1222–1228. doi:10.1093/ije/dym170

    Article  PubMed  Google Scholar 

  • Ware JE, Sherbourne CD (1992) The Mos 36-item short-form health survey (sf-36).1. Conceptual-framework and item selection. Med Care 30(6):473–483

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

Authors do not have any conflict of interest.

Author information

Authors and Affiliations

  1. Department of General Practice and Primary Health Care, Ghent University, Campus Heymans, 1K3, De Pintelaan 185, 9000, Ghent, Belgium

    Wim Peersman, Jan De Maeseneer & Sara Willems

  2. Department of Rehabilitation Sciences and Physiotherapy Ghent, Artevelde University College, Ghent University, Campus Heymans, 1B3, De Pintelaan 185, 9000, Ghent, Belgium

    Wim Peersman & Dirk Cambier

Authors
  1. Wim Peersman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dirk Cambier
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jan De Maeseneer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sara Willems
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wim Peersman.

Appendix

Appendix

See Table 6.

Table 6 Categories of the categorization scheme illustrated with examples (Ghent, Belgium, 2000)
Full size table

Rights and permissions

Reprints and permissions

About this article

Cite this article

Peersman, W., Cambier, D., De Maeseneer, J. et al. Gender, educational and age differences in meanings that underlie global self-rated health. Int J Public Health 57, 513–523 (2012). https://doi.org/10.1007/s00038-011-0320-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00038-011-0320-2

Keywords

Search

Navigation