A single- vs. multi-item self-rated health status measure: a 21-country study

J.K.S. van Ginneken, W.G.F. Groenewold

Research output: Contribution to journal/periodicalArticleScientificpeer-review

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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.
Original languageEnglish
Pages (from-to)1-9
JournalThe Open Public Health Journal
Publication statusPublished - 2012


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