How health conditions translate into self-ratings: A comparative study of older adults across Europe

Using data from the Survey of Health, Ageing and Retirement in Europe, we examine how respondents translate morbidity and disability into self-rated health (SRH), how national populations differ in SRH, and how normative and person-specific reporting styles shape SRH. We construct proxy variables that allow us to specify cultural differences in reporting styles and individual differences in relative rating behavior. Using generalized logistic regression, we find that both of these dimensions of subjectivity are related to SRH; however, their inclusion does not significantly alter the connection between SRH and the set of disease and disability indicators. Further, country differences in SRH persist after controlling for all these factors. Our findings suggest that observed country differences in SRH reflect compositional differences, cultural differences in reporting styles, and perceptions of how health restricts typical activities. SRH also seems to capture underlying but unmeasured health differences across populations.