Self-rated health among U.S. adolescents

Abstract

Purpose-This article investigates the meaning of subjective health assessments for younger respondents by examining the temporal stability of self-rated health (SRH) among adolescents. Two competing understandings of SRH are tested: SRH as a spontaneous health assessment or as an enduring self-concept.Methods-Using data from two waves of the National Longitudinal Study of Adolescent Health (n = 13,511), an intra-class correlation coefficient and a weighted Kappa estimate are calculated to assess the test-retest reliability for SRH. Self-rated health (T2) is then modeled as a function of SRH (T1), physical health (T1), and mental health (T1), and changes in physical and mental health (T2-T1).Results-SRH is found to be moderately stable over repeated observations (K = .40; ρ = .55) among adolescents. Findings from multivariate analyses suggest that SRH (T2) is largely determined by SRH (T1) and less so by changes in physical or psychological health status (T2-T1).Conclusions-SRH among adolescents is in part a spontaneous health assessment but it is best understood as an enduring self-concept. KeywordsSelf-rated health; Adolescents; National Longitudinal Study of Adolescent HealthResearchers concerned with social processes related to health outcomes often rely on data obtained from large nationally representative social surveys. These surveys are important mechanisms through which prevalence rates for specific illnesses are established and they enable researchers to test a number of important hypotheses regarding the social determinants of physical and mental health. Compared with clinical studies in which health is assessed by trained medical examiners, social surveys rely heavily on self-reported data [1]. Moreover, because health status is just one of many aspects of respondents' lives that are assessed in national surveys, investigators are often limited with respect to the number of health-related questions that they are able to pose to respondents. As a result, researchers frequently use single items such as self-rated health (SRH) to assess respondents' overall health status. To illustrate, the General Social Survey (GSS) has collected yearly crosssectional data on a nationally representative sample of adults in the United States since 1972. The GSS is the most widely cited national data set available to social scientists; however, the only consistent measure of health status asked of respondents across 24 waves of data collection is SRH.In large part, the reliance on this single item to assess the health of adults is not considered to be a problem, because SRH is consistently evidenced as a valid measure of current physical health status. For example, in two comprehensive reviews that covered 46 studies, the researchers found that adults who reported "poor" health were more likely to die in 40 of the 46 studies [2,3]. Even after controlling for morbidity, health-related behaviors, and access to health services, SRH predicted mortality over short (i.e., 2 years) and long (i.e., 10 years) periods of t...

Trends in Life Satisfaction and Self-rated Health in Czech School-aged Children: HBSC Study.

“…It mostly depends on the conscious and unconscious comparison of oneself with peers of the same age (7). SRH is found to be a relatively stable over repeated observations during adolescence (21,22). It deteriorates with disability, health-compromising behaviour and a lack of general well-being (22).…”

Influence of individual and socio-environmental factors on self-rated health in adolescents

“…It is considered an easily assessed and understood, robust, valid and reliable measure of physical health status in adults 2,3 . Although most widely used as a proxy of health status among adults, SRH deserves more research attention as a health indicator among adolescents.…”

“…Although most widely used as a proxy of health status among adults, SRH deserves more research attention as a health indicator among adolescents. Studies comparing SRH between adults and adolescents have shown that, while SRH in adults may reflect chronic and acute conditions, in adolescents, it may extend beyond the physical health status, reflecting personal, environmental and socio-behavioral factors 2,4,5 . Studies on the determinants of adolescent SRH are limited.…”

Subjective and objective indicators of socioeconomic status and self-rated health in Korean adolescents

“…To adjust for the effects of other associated factors, health-related behavioral (smoking, alcohol consumption, physical activity, consumption of breakfast) and psychological factors (depression, perceived stress, body weight perception) were included (Boardman, 2006;Breidablik, Meland, & Lydersen, 2008;Heshmat et al, 2015;Moor et al, 2014;Page & Suwanteerangkul, 2009;Piko, 2007;Vingilis et al, 2002) <Table 1> Overview of instruments…”