RESEARCH ARTICLE


A Single- vs. Multi-Item Self-Rated Health Status Measure: A 21-Country Study



Jeroen K. Van Ginneken*, George Groenewold
Netherlands Interdisciplinary Demographic Institute, P.O. Box 11650, 2502 AR The Hague, The Netherlands.


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Creative Commons License
K. Van Ginneken et al.; Licensee Bentham Open

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.

* Address correspondence to this author at the Netherlands Interdisciplinary Demographic Institute, P.O. Box 11650, 2502 AR The Hague, The Netherlands; Tel: +31 (0)70 3565200; Fax: +31 (0)70 3647187; E-mails: Ginneken@nidi.nl


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.

Keywords: Self-rated health, multi-item health status indices, validity, World Health Survey.