The aim of this methodological study is to examine what self-rated health is understood to mean by survey respondents. The data are derived from semi-structured (re-)interviews with 42 middle-aged participants of the 1994 Finnish Survey on Living Conditions. When the respondents are asked to describe their present health, the results show concrete, contextual, and partly contradictory conceptions of "health". Health is presented primarily as absence of ill-health, but also connected to personal experience and life situation, and as a result of action. Second, when assessing self-rated health all respondents base their assessments on ill-health, modified by the severity, duration and restrictions posed by ill-health. Further analysis shows that some respondents base their assessments also on fitness and health behaviour. The results suggest that in addition to the medical model of health, adopting health promotion messages and "healthy" lifestyles are important factors contributing to health assessments.