What do people include when they self-rate their health? Differential associations according to health status in community-dwelling older adults
Schuez, BEC and Wurm, S and Schollgen, I and Tesch-Romer, C, What do people include when they self-rate their health? Differential associations according to health status in community-dwelling older adults, Quality of Life Research, 20 pp. 1573-1580. ISSN 0962-9343 (2011) [Refereed Article]
Aims Self-rated health (SRH) is widely regarded a valid
and reliable indicator of health status. The validity of selfrated
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
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.
Self-rated health; Health status; Older people; Latent moderated structural equations