Self-reported health assessments in the 2002 World Health Survey: how do they correlate with education?

OBJECTIVE: To assess the value of self-rated health assessments by examining the association between education and self-rated poor health. METHODS: We used the globally representative population-based sample from the 2002 World Health Survey, composed of 219,713 men and women aged 25 and over in 69 countries, to examine the association between education and self-rated poor health. In a binary regression model with a logit link function, we used self-rated poor health as the binary dependent variable, and age, sex and education as the independent variables. FINDINGS: Globally, there was an inverse association between years of schooling and self-rated poor health (odds ratio, OR: 0.929; 95% confidence interval, CI: 0.926-0.933). Compared with the individuals in the highest quintile of years of schooling, those in the lowest quintile were twice as likely to report poor health (OR: 2.292; 95% CI: 2.165-2.426). We found a dose-response relationship between quintiles of years of schooling and the ORs for reporting poor health. This association was consistent among men and women; low-, middle- and high-income countries; and regions. CONCLUSION: Our findings suggest that self-reports of health may be useful for epidemiological investigations within countries, even in low-income settings.