Subjective health status and health values in the general population

Abstract

Objective: To explore the relationship between rating-scale evaluation of health-related quality of life ("health value") and two subjective evaluations of health: the SF-36 profile and the five-category perception of general health (excellent, very good, good, fair, and poor).

Methods: This relationship was explored by linear and nonlinear regression analysis of data obtained through face-to-face interviews with a sample of 2,030 persons aged 45-75 years representing the Israeli Jewish urban population in that age group.

Results: The main outcome is a mapping assigning health values to the subjective health-status scores, e.g., "good" general health is equivalent to a health value of 76-81, depending on the functional form of the relation. "Poor" health is equivalent to a value of 45-61. The R2 is about 0.3. While the eight scales of the SF-36 were found to be linearly related to health value (R2=0.51), the two summary measures-physical component scale (PCS) and mental component scale (MCS)-were not. The scales measuring general health, vitality, and physical functioning were the main determinants of health value, while the role-performance scales were insignificant. The PCS had a larger effect than the MCS.

Discussion: These relationships provide deeper insight into the structure and meaning of the two health-status measures in the general population. They also place earlier determinations of these relationships among sick persons in a broader context and raise several further questions regarding the relationship between health values and health status.