Extract

Self-rated health is a widely used measure in population health surveys and clinical settings. The question to respondents commonly reads: ‘How in general would you describe your health?’ with 3–5 response alternatives ranging from poor to excellent.1 The first studies suggesting that poor self-rated health predicted increased mortality among elderly persons were published in the early 1980s.2,3 These were followed by numerous studies confirming that this simple self-reported measure can predict subsequent mortality, often more accurately than doctors.4

Why does self-rated health predict mortality? Self-rated health often retains an independent effect even when controlling for other health-related measures.1 Different explanations have been proposed, including (i) that self-rated health is more inclusive than the covariates used in many studies; (ii) self-rated health is a dynamic evaluation also judging the trajectory of health; (iii) self-rated health influences behaviours that subsequently influence health status; and that self-rated health reflects resources to cope with health threats.1,4

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