How is your health in general? A qualitative study on self-assessed health

BACKGROUND: The single-item measure on self-assessed health has been widely used, as it presents researchers with a summary of an individual's general state of health. A qualitative study was initiated to find out which particular aspects are included in health self-assessments; which aspects do people consider when answering the question 'How is your health in general?'. Subgroup differences were studied with respect to gender, age, health status and health assessment. METHODS: Qualitative study with stratification by background characteristic, health status and health assessment (n=40). RESULTS: Almost 80% of the participants referred to one or more physical aspects (chronic illness, physical problems, medical treatment, age-related complaints, prognosis, bodily mechanics, and resilience). However, when assessing their health, participants also include aspects that go beyond the physical dimension of health. In total, 80 percent of the participants-whether or not in addition to physical aspects-referred to other health dimensions. Besides physical aspects, participants considered the extent to which they are able to perform (functional dimension -28%), the extent to which they adapted to, or their attitude towards an existing illness (coping dimension -28%), and simply the way they feel (wellbeing dimension -20%). In this study, health behaviour or lifestyle factors (behavioural dimension -3%) proved to be relatively unimportant in health self-assessments. CONCLUSIONS: Self-assessed health proved to be a multidimensional concept. For most part, subgroup differences in self-assessed health could be attributed to experience with ill health: being relatively inexperienced with health problems versus having a history of health problems.