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Research
Is the single self-rated health item reliable in India? A construct validity study
  1. Stéphane Cullati1,2,3,
  2. Simantini Mukhopadhyay4,
  3. Stefan Sieber1,3,
  4. Achin Chakraborty4,
  5. Claudine Burton-Jeangros1,3
  1. 1 Institute of Sociological Research, University of Geneva, Geneva, Switzerland
  2. 2 Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
  3. 3 Swiss NCCR 'LIVES—Overcoming Vulnerability: Life Course Perspectives', University of Geneva, Geneva, Switzerland
  4. 4 Institute of Development Studies, Kolkata, India
  1. Correspondence to Stéphane Cullati; stephane.cullati{at}unige.ch

Abstract

Introduction In high-income countries, the self-rated health (SRH) item is used in health surveys to capture the population’s general health because of its simplicity and satisfactory validity and reliability. Despite scepticism about its use in low-income and middle-income countries, India implemented the SRH item in many of its demographic and population health surveys, but evidence of its validity is lacking. The objective was to assess the construct validity of the SRH item in India.

Methods Data for 4492 men and 4736 women from the Indian sample of the World Health Survey (2003) were used. Overall, 43 health status indicators were grouped into health dimensions (physical, mental and functional health, chronic diseases, health behaviours) and the SRH item was regressed on these indicators by using sex-stratified multivariable linear regressions, adjusted with demographic and socioeconomic variables.

Results Respondents (participation rate 95.6%; mean age 38.9 years) rated their health as very good (21.8%), good (36.4%), moderate (26.6%), bad (13.2%) or very bad (2.0%). Among men, the adjusted explained SRH variance by health dimensions ranged between 18% and 41% (physical 33%, mental 32%, functional health 41%, chronic diseases 23%, health behaviours 18%). In multivariable models, the overall explained variance increased to 45%. The 43 health status indicators were associated with SRH and their effect sizes were in the expected direction. Among women, results were similar (overall explained variance 48%).

Conclusion The SRH item has satisfactory construct validity and may be used to monitor health status in demographic and population health surveys of India.

  • self-rated health
  • construct validation
  • India
  • population health measurement

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0

https://doi.org/10.1136/bmjgh-2018-000856

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    Footnotes

    • Handling editor Soumitra Bhuyan

    • Contributors Conceived and designed the study: all coauthors. Analysed the data: SS, SC. Drafted the manuscript: CB-J, SC. Read and commented on the paper: all authors.

    • Funding This project, ‘Health inequalities in India and Switzerland: Measurement and distribution of well-being and vulnerability’, was funded by the Indo-Swiss Joint Research Programme in the Social Sciences and supported by the Swiss State Secretariat for Education and Innovation and the Indian Council for Social Science Research.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.