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What do people include when they self-rate their health? Differential associations according to health status in community-dwelling older adults

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Abstract

Aims

Self-rated health (SRH) is widely regarded a valid and reliable indicator of health status. The validity of self-rated health has been demonstrated in many studies, for example by predicting mortality over and above medical and epidemiological data. However, the meaning of SRH can differ between individuals, especially in elderly individuals with considerable individual differences in their physical health states. It is thus important to determine whether predictors of self-rated health vary according to physical health status in order to interpret self-rated health data.

Methods

In a representative survey study, 1174 individuals over 65 years of age rated their health and filled in questionnaires on subjective well-being, control beliefs, depressive symptoms, and functional health. Structural equation modeling with latent moderated structural equations was used to determine whether health status (number of illnesses) moderated the association of self-rated health with these predictors.

Results

Self-rated health was predicted by positive affect, depressive symptoms, control beliefs, and physical functioning. Moderated effects were found for positive affect and physical functioning, suggesting that there are stronger associations with positive affect in healthier individuals and stronger associations with physical functioning in less healthy individuals.

Conclusions

This implies that SRH has differential associations depending on health status, which should be taken into account in interpreting any research with SRH as predictor or criterion.

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Notes

  1. Instruments (German and English versions), information on sampling and information on data access: www.german-ageing-survey.org

  2. Age, sex, and region of residence were included as control variables because the study sample was disproportionally stratified according to these criteria.

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Acknowledgments

This study was supported by the German Federal Ministry for Family Affairs, Senior Citizens, Women and Youth [Grant 301-1720-2/2] and the German Ministry of Education and Research [Grant 01ET0702]. I.S. was supported by the International Max Planck Research School “The Life Course: Evolutionary and Ontogenetic Dynamics” (LIFE). We would like to thank Christopher Marx for assistance during the preparation of the manuscript.

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Authors and Affiliations

  1. German Centre of Gerontology, Manfred-von-Richthofen-Str. 2, 12101, Berlin, Germany

    Benjamin Schüz, Susanne Wurm & Clemens Tesch-Römer

  2. Mannheim Institute of Public Health, Social and Preventive Medicine, Ludolf-Krehl-Strasse 7-11, 68167, Mannheim, Germany

    Ina Schöllgen

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  1. Benjamin Schüz
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  2. Susanne Wurm
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  4. Clemens Tesch-Römer
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Correspondence to Benjamin Schüz.

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Schüz, B., Wurm, S., Schöllgen, I. et al. What do people include when they self-rate their health? Differential associations according to health status in community-dwelling older adults. Qual Life Res 20, 1573–1580 (2011). https://doi.org/10.1007/s11136-011-9909-4

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