Social Indicators Research

, Volume 137, Issue 1, pp 391–411 | Cite as

Comparative Examination of Self-Perceived Health and Other Measures of the Quality of Life Across the EU-27

  • Monica Răileanu Szeles


In various fields of research self-perceived health has been defined and analysed as a significant measure of the health-related quality of life, and also as a predictor of health status. This paper examines the determinants of self-perceived health in the EU-27 area in order to find whether a common set of governmental policies could improve the self-perceived health and whether this positive effect would remain positive and significant on other measures of the quality of life as well as across the quintiles of income distribution. A number of panel regression models using the first-difference GMM estimator are applied to comparatively examine self-perceived health together with other measures of health status and quality of life, based on Eurostat data from 2003 to 2012. The empirical results of the paper could provide useful insights for the European health policy and other common actions and policies in the field of the quality of life.


Self-perceived health Quality of life Health policy 

JEL Classification

I15 I31 


  1. Adler, N. E., & Ostrove, J. M. (1999). Socioeconomic status and health: What we know and what we don’t. Annals of the New York Academy of Sciences, 896, 3–15.CrossRefGoogle Scholar
  2. Arellano, M., & Bond, S. (1991). Some tests of specification for panel data: Monte Carlo evidence and an application to employment equations. Review of Economic Studies, 58, 277–297.CrossRefGoogle Scholar
  3. Arellano, M., & Bover, O. (1995). Another look at the instrumental variable estimation of error-components models. Journal of Econometrics, 68, 29–51.CrossRefGoogle Scholar
  4. Arnadottir, S. A., Gunnarsdottir, E., Stenlund, H., & Lundin-Olsson, L. (2011). Determinants of self-perceived health in old age: A population-based, cross-sectional study using the International Classification of Functioning. BMC Public Health, 11, 670.CrossRefGoogle Scholar
  5. Beckett, M. (2000). Converging health inequalities in later life—An artifact of mortality selection? Journal of Health and Social Behavior, 41, 106–119.CrossRefGoogle Scholar
  6. Bergner, M., Bobbitt, R. A., Carter, W. B., & Gilson, B. S. (1981). The Sickness Impact Profile: development and final revision of a health status measure. Medical Care, 19(8), 787–805.CrossRefGoogle Scholar
  7. Blakely, T. A., Lochner, K., & Kawachi, I. (2002). Metropolitan area income inequality and self-perceived health—A multi-level study. Social Science and Medicine, 54(1), 65–77.CrossRefGoogle Scholar
  8. Blank, N., & Diderichsen, F. (1996). The prediction of different experiences of long-term illness: A longitudinal approach in Sweden. Journal of Epidemiology and Community Health, 50, 156–161.CrossRefGoogle Scholar
  9. Blendon, R. J., Schoen, C., DesRoches, C., et al. (2003). Common concerns amid diverse systems: Health care experiences in five countries. Health Affairs, 22, 106–121.CrossRefGoogle Scholar
  10. Blundell, R., & Bond, S. (1998). Initial conditions and moment restrictions in dynamic panel data models. Journal of Econometrics, 87, 115–143.CrossRefGoogle Scholar
  11. Bond, S., Hoeffler, A., & Temple, J. (2001). GMM estimation of empirical growth models. CERP discussion paper, 3048.Google Scholar
  12. Borg, V., & Kristensen, T. S. (2000). Social class and self-perceived health: Can the gradient be explained by differences in life style or work environment? Social Science and Medicine, 51(7), 1019–1030.CrossRefGoogle Scholar
  13. Borzel, T. (1999). Towards convergence in Europe? Institutional adaptation to Europeanization in Germany and Spain. Journal of Common Market Studies, 39(4), 573–596.CrossRefGoogle Scholar
  14. Bourne, P. A. (2009). The validity of using self-reported illness to measure objective health. Nord American Journal of Medical Sciences., 1(5), 232–238.Google Scholar
  15. Campbell, A., Converse, P. E., & Rodgers, W. L. (1976). The quality of American life. New York: Russell Sage Foundation.Google Scholar
  16. Chandola, T. (2000). Social class differences in mortality using the new UK National Statistics Socio-Economic Classification. Social Science and Medicine, 50(5), 641–649.CrossRefGoogle Scholar
  17. Chandola, T., & Jenkinson, C. (2000). The new UK national statistics socio-economic classification: Investigating social class differences in self-reported health status. Journal of Public Health Medicine, 22(2), 182–190.CrossRefGoogle Scholar
  18. Commission on Social Determinants of Health. (2007). A conceptual framework for action on the social determinants of health. Geneva: World Health Organisation.Google Scholar
  19. Cousins, S. O. (1997). Validity and reliability of self-reported health of persons aged 70 and older. Health Care for Women International, 18, 165–174.CrossRefGoogle Scholar
  20. Cutler, D. M., & Lleras-Muney, A. (2006). Education and health: Evaluating theories and evidence. National bureau of economic research working paper, 12352. Cambridge, MA: National Bureau of Economic Research.Google Scholar
  21. Deaton, A. (2007). Income, aging, health and wellbeing around the world: evidence from the Gallup World Poll. NBER working paper. Cambridge, MA: National Bureau of Economic Research.Google Scholar
  22. Diener, E. (1984). Subjective well-being. Psychological Bulletin, 95, 542–575CrossRefGoogle Scholar
  23. Diener, E. (2000). Subjective well being: The science of happiness and a proposal for a national index. American Psychologist, 55(1), 34–43.CrossRefGoogle Scholar
  24. Diener, E., Suh, E. M., Lucas, R. E., & Smith, H. L. (1999). Subjective well-being: Three decades of progress. Psychological Bulletin, 125(2), 276–302.CrossRefGoogle Scholar
  25. Drukker, D. (2008). Econometric analysis of dynamic panel-data models using Stata. Presentation at the summer North American Stata Users Group meeting July 24–25.…/drukker_xtdpd.pdf.
  26. Easterlin, R. (1997). Will raising the incomes of all increase the happiness of all? In N. R. Goodwin, F. Ackerman, & D. Kiron (Eds.), The consumer society. Washington, DC: Island Press.Google Scholar
  27. Eckersley, R. (2001). Culture, health and well-being. In R. Eckersley, J. Dixon, & B. Douglas (Eds.), The social origins of health and well-being (pp. 51–70). Cambridge: Cambridge University Press.Google Scholar
  28. Eid, M. (2008). Measuring the immeasurable: Psychometric modeling of subjective well-being data. In M. Eid & R. J. Larsen (Eds.), The science of subjective well-being (pp. 141–167). New York: Guilford Press.Google Scholar
  29. Eurostat. (2015). Quality of life. Luxembourg: Publications Office of the European Union.Google Scholar
  30. Fiscella, K., Franks, P., Gold, M. R., & Clancy, C. M. (2000). Inequality in quality: Addressing socioeconomic, racial, and ethnic disparities in health care. JAMA, 17, 283(19), 2579–2584.CrossRefGoogle Scholar
  31. Frey, B. S., & Stutzer, A. (2002). Happiness and economics. Princeton, NJ: Princeton University Press.Google Scholar
  32. Fries, J. F., Spitz, P. W., & Young, D. Y. (1982). The dimensions of health outcomes: the health assessment questionnaire, disability and pain scales. The Journal of Rheumatology, 9(5), 789–793.Google Scholar
  33. Froom, P., Melamed, S., Triber, I., Ratson, N., & Hermoni, D. (2004). Predicting self-reported health: The CORDIS study. Preventive Medicine, 39, 419–423.CrossRefGoogle Scholar
  34. Gilmour, H. (2012). Social participation and the health and well-being of Canadian seniors. Health Reports, 23(4), 23–32.Google Scholar
  35. Groot, W, & van den Brink, H. M. (2006). What does education do on our health? Measuring the effects of education on health and civic engagement: Proceedings of the Copenhagen Symposium. OCDE.Google Scholar
  36. Grzywacz, J., Almeida, D., Neupert, S. D., et al. (2004). Socioeconomic status and health: A micro-level analysis of exposure and vulnerability to daily stressors. Journal of Health and Social Behavior, 45, 1–16.CrossRefGoogle Scholar
  37. Gunasekara, F. I., Carter, K., Liu, I., Richardson, K., & Blakely, T. (2011). The relationship between income and health using longitudinal data from New Zealand. Journal of Epidemiology and Community Health, 66(6), e12.CrossRefGoogle Scholar
  38. Guyatt, A. H., Feeny, D. H., & Patrick, D. L. (1993). Measuring health-related quality of life. Annals of Internal Medicine, 118(8), 622–629.CrossRefGoogle Scholar
  39. Hunt, S. M., McKenna, S. P., McEwen, J., Backett, E. M., Williams, J., & Papp, E. (1980). A quantitative approach to perceived health status: A validation study. Journal of Epidemiology and Community Health, 34, 281–286.CrossRefGoogle Scholar
  40. Hutchinson, G., Simeon, D. T., Bain, B. C., Wyatt, G. E., Tucker, M. B., & LeFranc, E. (2004). Social and health determinants of well-being and life satisfaction in Jamaica. International Journal of Social Psychiatry, 50, 43–53.CrossRefGoogle Scholar
  41. Jylhä, M. (2009). What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Social Science and Medicine, 69, 307–316.CrossRefGoogle Scholar
  42. Kaleta, D., Makowiec-Dabrowska, T., & Jegier, A. (2008). Employment status and self-perceived health. International Journal of Occupational Medicine and Environmental Health, 21(3), 227–236.CrossRefGoogle Scholar
  43. Kaplan, M. S., McFarland, B. H., Newsom, J. T., & Huguet, N. (2004). Spending more, feeling worse: Medical care expenditures and self rated health. Journal of Epidemiology and Community Health, 58, 529–530.CrossRefGoogle Scholar
  44. Kawachi, I., & Kennedy, B. P. (2003). The health of nations. New York: The New Press.Google Scholar
  45. Kondo, N., Sembajwe, G., Kawachi, I., van Dam, R. M., Subramanian, S. V., & Yamagata, Z. (2009). Income inequality, mortality, and self perceived health: meta-analysis of multilevel studies. BMJ, 339(7731), 1178–1181.Google Scholar
  46. Kriston, P., Pikó, B., & Kovács, E. (2012). Self perceived health, as an indicator of psychological wellbeing: behavioural epidemiological analysis among the adolescent population. Orvosi Hetilap, 153(47), 1875–1882CrossRefGoogle Scholar
  47. Lane, R. E. (1994). Friendship or commodities? The road not taken: Friendship, consumerism, and happiness. Critical Review, 8, 521–554.CrossRefGoogle Scholar
  48. Leganger, A., & Kraft, P. (2003). Control constructs: Do they mediate the relation between educational attainment and health behaviour? Journal of Health Psychology, 8, 361–372.CrossRefGoogle Scholar
  49. Lim, H., Kimm, H., & Han Song, I. (2015). The relationship between employment status and self-perceived health among wage workers in South Korea: The moderating role of household income. Health and Social Work, 40(1), 26–33.CrossRefGoogle Scholar
  50. Lopez, R. (2004). Income inequality and self-perceived health in US metropolitan areas: A multi-level analysis. Social Science and Medicine, 59(12), 2409–2419.CrossRefGoogle Scholar
  51. López-Casasnovas, G., & Soley-Bori, M. (2014). The socioeconomic determinants of health: Economic growth and health in the OECD countries during the last three decades. International Journal of Environmental Research and Public Health, 11(1), 815–829.CrossRefGoogle Scholar
  52. Lora, E. (2012). Health perceptions in Latin America. Health Policy and Planning, 27(7), 555–569.CrossRefGoogle Scholar
  53. Lundberg, O., & Manderbacka, K. (1996). Assessing reliability of a measure of self-rated health. Scandinavian Journal of Social Medicine, 24, 218–224.CrossRefGoogle Scholar
  54. Lynch, S. M. (2003). Cohort and life-course patterns in the relationship between education and health: A hierarchical approach. Demography, 42(2), 309–331.CrossRefGoogle Scholar
  55. Mellor, J. M., & Milyo, J. (2002). Exploring the relationships between income inequality, socioeconomic status and health: A self-guided tour? International Journal of Epidemiology, 31, 685–687.CrossRefGoogle Scholar
  56. Meyer, O. L., Castro-Schilo, L., & Aguilar-Gaxiola, S. (2014). Determinants of mental health and self-perceived health: A model of socioeconomic status, neighborhood safety and physical activity. American Journal of Public Health, 104(9), 1734–1741.CrossRefGoogle Scholar
  57. Miething, A., & Åberg Yngwe, M. (2014). Stability and variability in income position over time: Exploring their role in self-rated health in Swedish survey data. BMC Public Health, 14, 1300.CrossRefGoogle Scholar
  58. Mohan, R., Beydoun, H. A., Beydoun, M. A., Barnes-Eley, M., Davis, J., et al. (2011). Self-rated health as a tool for estimating health-adjusted life expectancy among patients newly diagnosed with localized prostate cancer: A preliminary study. Quality of Life Research, 20, 713–721.CrossRefGoogle Scholar
  59. Morgan, K. J., & Eastwood, J. G. (2014). Social determinants of maternal self-perceived health in South Western Sydney, Australia. BMC Research Notes, 7, 51.CrossRefGoogle Scholar
  60. Mustard, C. A., Vermeulen, M., & Lavis, J. N. (2003). Is occupational class a determinant of decline in perceived health status? Social Science and Medicine, 57, 2291–2303.CrossRefGoogle Scholar
  61. Norström, F., Virtanen, P., Hammarström, A., Gustafsson, P. E., & Janlert, U. (2014). How does unemployment affect self-assessed health? A systematic review focusing on subgroup effects. BMC Public Health, 14, 1310.CrossRefGoogle Scholar
  62. Orpana, H. M., Lemyre, M., & Kelly, S. (2007). Do stressors explain the association between income and declines in self-rated health? A longitudinal analysis of the national population health survey. International Journal of Behavior Medicine, 14(1), 40–47.CrossRefGoogle Scholar
  63. Răileanu-Szeles, M. (2015). Explaining the dynamics and drivers of financial well-being in the European Union. Social Indicators Research, 120(3), 701–722.CrossRefGoogle Scholar
  64. Rocha, K. B., Muntaner, C., Solar, O., Borrell, C., Bernales, P., González, M. J., et al. (2014). Social class, psychosocial occupational risk factors, and the association with self-perceived health and mental health in Chile. Cadernos de Saúde Pública, 30(10), 2219–2234.CrossRefGoogle Scholar
  65. Roodman, D. (2009). How to do xtabond2: An introduction to difference and system GMM in Stata. The Stata Journal, 9, 86–136.Google Scholar
  66. Rouse, C. E., & Barrow, L. (2006). U.S. elementary and secondary schools: Equalizing opportunity or replicating the status quo? Future of Children, 16(2), 99–123.CrossRefGoogle Scholar
  67. Sposito, G., et al. (2010). Relationship between subjective well-being and the functionality of elderly outpatients. Revista Brasileira de Fisioterapia, 14(1), 81–89.CrossRefGoogle Scholar
  68. Stiglitz, J. E., Sen, A., & Fitoussi, J. P. (2009). Report by the commission on the measurement of economic performance and social progress, p. 24.Google Scholar
  69. Stoll, L., Michaelson, J., & Seaford, C. (2012). Well-being evidence for policy: A review. London: New Economics Foundation.Google Scholar
  70. Subramanian, S. V., Kim, D., & Kawachi, I. (2005). Covariation in the socioeconomic determinants of self perceived health and happiness: A multivariate multilevel analysis of individuals and communities in the USA. Journal of Epidemiology and Community Health, 59, 664–669.CrossRefGoogle Scholar
  71. Šućur, Z., & Zrinščak, S. (2007). Differences that hurt: Self-perceived health inequalities in Croatia and European Union. Croatian Medical Journal, 48(5), 653–666.Google Scholar
  72. Szwarcwald, C. L., Borges de Souza-Júnior, P. R., Pires Esteves, M. A., Nogueira Damacena, G., & Viacava, F. (2005). Socio-demographic determinants of self-perceived health in Brazil. Cadernos de Saúde Pública, 21(1), 119–128.Google Scholar
  73. Tareque, M. I., Saito, Y., & Kawahara, K. (2015). Healthy life expectancy and the correlates of self-rated health in Bangladesh in 1996 and 2002. BMC Public Health, 15, 312–322.CrossRefGoogle Scholar
  74. Wagstaff, A., & van Doorslaer, E. (2000). Income inequality and health: What does the literature tell us? Annual Review of Public Health, 21, 543–567.CrossRefGoogle Scholar
  75. World Health Organization. (1948). The constitution of the World Health Organization. Adopted by the International Health Conference held in New York. 19 June–22 July 1946.Google Scholar
  76. World Health Organization. (2012). Health 2020. Regional Committee for Europe: Policy framework and strategy.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.Transilvania University of BrasovBrasovRomania
  2. 2.Institute for Economic ForecastingRomanian AcademyBucharestRomania

Personalised recommendations