Skip Navigation


American Journal of Epidemiology Advance Access originally published online on June 29, 2009
American Journal of Epidemiology 2009 170(3):343-351; doi:10.1093/aje/kwp144
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Web Figures
Right arrowOA All Versions of this Article:
170/3/343    most recent
kwp144v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (2)
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Salomon, J. A.
Right arrow Articles by Murray, C. J. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Salomon, J. A.
Right arrow Articles by Murray, C. J. L.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

American Journal of Epidemiology © 2009 The Authors
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ORIGINAL CONTRIBUTIONS

Are Americans Feeling Less Healthy? The Puzzle of Trends in Self-rated Health

Joshua A. Salomon, Stella Nordhagen, Shefali Oza and Christopher J. L. Murray

Correspondence to Dr. Joshua A. Salomon, Harvard University Initiative for Global Health, 104 Mount Auburn Street, Third Floor, Cambridge, MA 02138 (e-mail: jsalomon{at}hsph.harvard.edu).

Received for publication January 9, 2009. Accepted for publication May 6, 2009.

Although self-rated health is proposed for use in public health monitoring, previous reports on US levels and trends in self-rated health have shown ambiguous results. This study presents a comprehensive comparative analysis of responses to a common self-rated health question in 4 national surveys from 1971 to 2007: the National Health and Nutrition Examination Survey, Behavioral Risk Factor Surveillance System, National Health Interview Survey, and Current Population Survey. In addition to variation in the levels of self-rated health across surveys, striking discrepancies in time trends were observed. Whereas data from the Behavioral Risk Factor Surveillance System demonstrate that Americans were increasingly likely to report "fair" or "poor" health over the last decade, those from the Current Population Survey indicate the opposite trend. Subgroup analyses revealed that the greatest inconsistencies were among young respondents, Hispanics, and those without a high school education. Trends in "fair" or "poor" ratings were more inconsistent than trends in "excellent" ratings. The observed discrepancies elude simple explanations but suggest that self-rated health may be unsuitable for monitoring changes in population health over time. Analyses of socioeconomic disparities that use self-rated health may be particularly vulnerable to comparability problems, as inconsistencies are most pronounced among the lowest education group. More work is urgently needed on robust and comparable approaches to tracking population health.

health status; health surveys; public health; questionnaires

Abbreviations: BRFSS, Behavioral Risk Factor Surveillance System; CI, confidence interval; CPS, Current Population Survey; NHANES, National Health and Nutrition Examination Survey; NHIS, National Health Interview Survey


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Am J EpidemiolHome page
J. A. Salomon
THE FIRST AUTHOR REPLIES
Am. J. Epidemiol., December 15, 2009; 170(12): 1582 - 1583.
[Full Text] [PDF]

Home page
 Am J EpidemiolHome page
M. Avendano, T. Huijts, and S. V. Subramanian
RE: "ARE AMERICANS FEELING LESS HEALTHY? THE PUZZLE OF TRENDS IN SELF-RATED HEALTH"
Am. J. Epidemiol., December 15, 2009; 170(12): 1581 - 1582.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.