The moderating effect of sociodemographic factors on the  predictive power of self-rated health for mortality in Canada

Falconer, James; Quesnel‐Vallée, Amélie

doi:10.25336/p64c7p

Cited by 1 publication

(2 citation statements)

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“…This result is consistent with the finding that older populations tend to underweight their health when they self-rate. 3,23 In summary, dichotomizing SRH using lower cut points results in differences in SRH being more likely to reflect differences in levels of HUI between populations rather than systematic differences in how respondents tend to interpret the SRH question. Said differently, our findings suggest that diverse groups of people tend to agree on what poor health looks like but are less likely to agree on what good health looks like.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have validated its usefulness as a subjective proxy for objective health measures. [1][2][3][4][5][6][7][8][9] In surveys, self-rated health is most often reported as a Likert scale consisting of three to five values ranging from higher values like "excellent" or "very good" to lower values like "very poor" or "very bad." The Canadian Community Health Survey (CCHS)-a survey that is used widely in health surveillance and research in Canada-asks respondents whether "in general" they would say their health is: "excellent," "very good," "good," "fair," or "poor."…”

Section: Introductionmentioning

confidence: 99%

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The Validity and Reliability of Dichotomized Self-rated Health Under Different Cutpoints

Plante,

Missiuna,

Neudorf

2024

Preprint

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Introduction Self-rated health is a widely used indicator of overall health status. It is most often reported on a Likert scale of three to five values in surveys. To facilitate presentation and interpretation, it is common practice to simplify the variable by dichotomizing it; however, little documented reflection has been done on how this should be done. Methods We use regression analysis to explore the validity and reliability of all four possible dichotomizations of self-reported health in the Canadian Community Health Survey in 2013-2015 by mapping them to a validated health measure: the Health Utility Index Mark 3 (HUI). We posit that more valid cutpoints in self-rated health are associated with larger changes in HUI. We posit further that more reliable cutpoints are associated with similar changes across sociodemographic variables, including age, sex, education, marital status, geography and income. We also provide descriptive statistics to contextualize our analysis. Results The greatest proportion of respondents reported having "very good" health, although the proportion of the population reporting "excellent" or "very good" health decreased with age. Similarly, Canadians tend to score highly in HUI. Our regression results suggest that HUI tends to be higher for younger, richer, married, educated and urban populations. However, these associations are muted as the cutpoint used to dichotomize self-reported health is raised. The model with the lowest cutpoint, distinguishing between poor health and all other health statuses, was associated with the greatest and most consistent negative changes in HUI among different sociodemographic groups. Conclusions Dichotomizing self-rated health using lower cutpoints captures more pronounced differences in health status measured by HUI and tends to capture more consistent differences across sociodemographic variables. That is, lower cutpoints produce more valid and reliable results. However, lower cutpoints isolate less commonly reported health levels and may lead to less accurate results in smaller populations.

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Section: Discussionmentioning

confidence: 99%