Predictors of self-rated health in older adults: insights from an anchoring vignettes study

Abstract Self-rated health is one of the most used measures of subjective health in research. At the same time, it presents several methodological challenges. Self-rated health requires individuals to translate their complex, multifaceted health experiences into a single response on the self-rated health scale. When different groups interpret and rate their health differently e.g. by gender or birth cohorts, the risk of misinterpretation increases. Older adults tend to rate their health as good or very good despite the increasing physical degeneration associated with ageing. To address these challenges, the anchoring vignette method was developed to improve the comparability of survey responses. In this study, anchoring vignettes were used to investigate the association between demographic and health-related predictors and both unadjusted and adjusted self-rated health in later life. Data were collected through the Swedish Citizen Panel; a total of 4,300 individuals aged 60–85 were invited, stratified by age and sex. 3,083 participants completed more than 80% of the questionnaire. The associations between demographic and health-related factors and self-rated health changed between the unadjusted and adjusted analyses. In the unadjusted analysis, women reported better health than men; this reversed in the CHOPIT model. After adjustment, there was no significant association between self-rated health and age or educational level. Living with others remained positively associated with self-rated health, whereas dependency in daily activities, number of diseases, and somatic symptoms remained negatively associated. We conclude that anchoring vignettes can be a suitable tool for evaluating self-rated health in later life and a valuable addition to simpler, traditional approaches.