RESEARCH ON AGING Idler et al. / SELF-RATINGS OF HEALTH The Meanings of Self-Ratings of Health A Qualitative and Quantitative Approach

Self-ratings of health are central measures of health status that predict outcomes such as mortality and declines in functional ability. Qualitative and quantitative data are used to test the hypothesis that definitions of health that are narrowly biomedical are associated with underestimates of self-ratings relative to respondents ’ medical histo-ries, while definitions that are broad and inclusive are related to relatively better self-ratings. A sample of 159 elderly African Americans rates their health and reports “what went through your mind. ” Analysis of variance shows that respondents who overestimate their health are more likely to report ratings based on social activities and relationships, or psychological, emotional, or spiritual characteristics, rather than biomedical criteria. The authors conclude that inclusive definitions of health facilitate more positive self-ratings of health, given a fixed health status; methodologically, they conclude that this is a promising method for exploring self-ratings of health. Self-ratings of health have become an increasingly important topic of study, particularly for elderly populations. For one thing, their ability to predict mortality in long-term follow-up studies has been demon-strated so repeatedly now that it is almost becoming a cliché (Idler and Benyamini 1997). Even when more objective measures of health status are included in the study, simple, global self-ratings predict sur-vival during short follow-up periods of just 2 years (Ho 1991; Rakowski, Mor, and Hiris 1991) and long periods of up to 13 year