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What determines Self-Rated Health (SRH)? A cross-sectional study of SF-36 health domains in the EPIC-Norfolk cohort
  1. Nahal Mavaddat1,
  2. Ann Louise Kinmonth1,
  3. Simon Sanderson1,
  4. Paul Surtees2,
  5. Sheila Bingham3,
  6. Kay Tee Khaw4
  1. 1General Practice and Primary Care Research Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
  2. 2Strangeways Research Laboratory, Institute of Public Health, University of Cambridge, Cambridge, UK
  3. 3MRC Centre for Nutritional Epidemiology Cancer Prevention and Survival, Department of Public Health and Primary Care, Institute of Public Health University of Cambridge, Cambridge, UK
  4. 4Clinical Gerontology Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge
  1. Correspondence to Dr Nahal Mavaddat, General Practice and Primary Care Research Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0SR, UK; nm212{at}medschl.cam.ac.uk

Abstract

Background Self-Rated Health (SRH) as assessed by a single-item measure is an independent predictor of health outcomes. However, it remains uncertain which elements of the subjective health experience it most strongly captures. In view of its ability to predict outcomes, elucidation of what determines SRH is potentially important in the provision of services. This study aimed to determine the extent to which dimensions of physical, mental and social functioning are associated with SRH.

Methods We studied 20 853 men and women aged 39–79 years from a population-based cohort study (European Prospective Investigation of Cancer study) who had completed an SRH (Short Form (SF)-1) measure and SF-36 questionnaire. SF-36 subscales were used to quantify dimensions of health best predicting poor or fair SRH within a logistic regression model.

Results In multivariate models adjusting for age, gender, social class, medical conditions and depression, all subscales of the SF-36 were independently associated with SRH, with the Physical Functioning subscale more strongly associated with poor or fair compared with excellent, very good or good health (OR 3.7 (95% CI 3.3 to 4.1)) than Mental Health (OR 1.4 (95% CI 1.2 to 1.5)) or Social Functioning subscales (OR 1.8 (95% CI 1.6 to 2.0)) for those below and above the median.

Conclusion This study confirms that physical functioning is more strongly associated with SRH than mental health and social functioning, even where the relative associations between each dimension and SRH may be expected to differ, such as in those with depression. It suggests that the way people take account of physical, mental and social dimensions of function when rating their health may be relatively stable across groups.

  • self-rated health
  • health status
  • subjective health
  • SF-36
  • functional status

https://doi.org/10.1136/jech.2009.090845

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    Footnotes

    • Funding This work was undertaken by the General Practice and Primary Care Research Unit, University of Cambridge, which receives core funding from the National Institute for Health Research (NIHR) and is part of the National School for Primary Care Research. EPIC-Norfolk is supported by programme grants from Medical Research Council UK (G9502233,G0300128) and Cancer Research UK (C865/A2883) with additional support from the European Union, Stroke Association, Research into Ageing, British Heart Foundation, Department of Health and the Wellcome Trust.

    • Competing interests None.

    • Patient consent Obtained.

    • Ethics approval Ethics approval was provided by the Norfolk Local Research Ethics Committee, UK.

    • Provenance and peer review Not commissioned; externally peer reviewed.