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Self-rated health status

Introduction

Self-rated health is among the most frequently assessed health perceptions in epidemiological research. A large number of empirical studies have demonstrated how a person's appraisal of his or her general health is a powerful predictor of future morbidity and mortality, even after controlling for a variety of physical and psychosocial and socioeconomic factors.[1] Self-rated health is believed to principally reflect physical health problems (acute and chronic conditions and physical functioning) and, to a lesser extent, health behaviours and mental health problems.[2,3] Longitudinal studies show self-rated health is a strong and independent predictor of subsequent illness and premature death.[3,4]

In 2006, the New South Wales Population Health Survey asked respondents aged 16 years and over: Overall, how would you rate your health during the last 4 weeks: Was it Excellent, Very good, Good, Fair, Poor or Very poor?

Results

Self-rated health status

Overall, in 2006, 22.1 per cent of adults rated their health in the last 4 weeks excellent, 30.0 per cent very good, 28.1 per cent good, 13.7 per cent fair, 4.8 per cent poor, and 1.1 per cent very poor. When ratings of excellent and very good and good were combined to give an overall positive rating, 80.3 per cent of adults rated their health positively. A significantly lower proportion of females (78.1 per cent) than males (82.5 per cent) rated their health positively. Among males, a significantly higher proportion of adults aged 16-24 years (87.4 per cent) and 25-34 years (88.9 per cent), and a significantly lower proportion of adults aged 65-74 years (77.4 per cent) and 75 years and over (64.9 per cent), rated their health positively, compared with the overall adult male population. Among females, a significantly higher proportion of adults aged 35-44 years (82.4 per cent), and a significantly lower proportion of adults aged 65-74 years (74.1 per cent) and 75 years and over (64.5 per cent), rated their health positively, compared with the overall adult female population.

The proportion of adults rating their health positively did not differ significantly between urban areas and rural areas; however, a lower proportion of adults in the Sydney South West Health Area (77.0 per cent) rated their health positively, compared with the overall adult population.

A positive rating for self-rated health decreased with socioeconomic disadvantage. A higher proportion of adults in the least disadvantaged quintile (86.2 per cent), and a lower proportion of adults in the most disadvantaged quintile (74.9 per cent), rated their health positively, compared with the overall adult population.

The proportion of adults who rated their health positively decreased significantly from 1997 (85.0 per cent) to 2006 (80.3 per cent). The significant decrease was observed in both males (85.0 per cent to 82.5 per cent) and females (85.1 per cent to 78.1 per cent).

Chronic disease risk factors

An index of chronic disease risk factors was calculated using the following indicators: any alcohol risk drinking, recommended daily fruit or vegetable intake, inadequate physical activity, current smoking, and obesity. Using the index 17.0 per cent of adults had no risk factors, 33.9 per cent had one risk factor, 29.1 per cent had 2 risk factors, 15.5 per cent had 3 risk factors, 3.8 per cent had 4 risk factors, and 0.8 per cent had 5 risk factors.

Overall, in 2006, 20.1 per cent of adults had 3 or more chronic disease risk factors. A significantly lower proportion of females (16.8 per cent) than males (23.3 per cent) had 3 or more chronic disease risk factors. Among males, a significantly lower proportion of adults aged 65-74 years (18.5 per cent) and 75 years and over (12.5 per cent) had 3 or more chronic disease risk factors, compared with the overall adult male population. Among females, a significantly higher proportion of adults aged 25-34 years (21.8 per cent), and a significantly lower proportion of adults aged 65-74 years (10.1 per cent) and 75 years and over (9.7 per cent), had 3 or more chronic disease risk factors, compared with the overall adult female population.

A significantly higher proportion of adults in rural areas (22.1 per cent) than urban areas (19.2 per cent) had 3 or more chronic disease risk factors. A higher proportion of adults in the Greater Southern (25.0 per cent) and Greater Western (25.1 per cent) Health Areas had 3 or more chronic disease risk factors, compared with the overall adult population.

The proportion of adults with 3 or more chronic disease risk factors increased with socioeconomic disadvantage. A lower proportion of adults in the least disadvantaged quintile (15.8 per cent), and a higher proportion of adults in the most disadvantaged quintile (23.8 per cent), had 3 or more chronic disease risk factors, compared with the overall adult population.

The proportion of adults who had 3 or more chronic disease risk factors has decreased significantly between 2002 (34.9 per cent) to 2006 (20.1 per cent). The significant decrease was observed in both males (39.6 per cent to 23.3 per cent) and females (30.2 per cent to 16.8 per cent).

References

  1. Eriksson I, Unden A-L, and Elofsson S. Self-rated health. Comparisons between three different measures. Results from a population study. Int J Epidemiol 2001; 30: 326-333. Abstract available online at http://ije.oxfordjournals.org/cgi/content/abstract/30/2/326 (accessed 10 May 2007).
  2. Krause NM and Jay GM. What do global self-rated health items measure? J Med Care 1994; 32: 930-942. Abstract available online at www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=8090045 (accessed 10 May 2007.
  3. Cott CA, Gignac MA, Badley EM. Determinants of self rated health for Canadians with chronic disease and disability. J Epidemiol Community Health 1999; 53: 731-736. Abstract available online at http://jech.bmj.com/cgi/content/abstract/53/11/731 (accessed 10 May 2007).
  4. McCallum J, Shadbolt B, Wang D. Self-rated health and survival: A 7-year follow up study of Australian elderly. Am J Public Health 1994; 84: 1100-1105. Available online at www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1614762 (accessed 10 May 2007).

Graphs

Source: New South Wales Population Health Survey 2006 (HOIST). Centre for Epidemiology and Research, NSW Department of Health.
Print version: Although this page can be printed directly from your web browser, a higher quality version is available as a PDF file that can be printed or viewed on screen.
Produced by: Centre for Epidemiology and Research, Population Health Division, NSW Department of Health.
Last updated on: 1 July 2007

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