Self-assessed health and physician-rated impairment were compared for 174 Anglo, black, and Cuban elderly medical outpatients. Level of disability was also recorded by the interviewer. A minimal correlation was found between patient and physician-rated health. Self-assessed health and level of functioning were associated significantly in each of the 3 cultures. The way patients perceived their health and functioned differed by culture, but impairment ratings of the physician did not discriminate among cultures. It seems likely that nonmedical factors may explain cultural differences in perception of health as well as how these perceptions influence ability to perform everyday activities of living. The patients' estimates of health appear to be an important factor in their overall health status, which physicians could use to augment their assessments of impairment. Since self-assessed health relates to level of functioning and to the way the elderly react to an illness, it can be seen as a useful component in evaluating health and predicting patient behavior.