RESEARCH ARTICLE
A Single- vs. Multi-Item Self-Rated Health Status Measure: A 21-Country Study
Jeroen K. Van Ginneken*, George Groenewold
Article Information
Identifiers and Pagination:
Year: 2012Volume: 5
First Page: 1
Last Page: 9
Publisher ID: TOPHJ-5-1
DOI: 10.2174/1874944501205010001
Article History:
Received Date: 26/11/2011Revision Received Date: 07/12/2011
Acceptance Date: 14/12/2011
Electronic publication date: 12/4/2012
Collection year: 2012
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
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.