Dichotomous or categorical response? Analysing self-rated health and lifetime social class

Int J Epidemiol. 2000 Feb;29(1):149-57. doi: 10.1093/ije/29.1.149.


Background: Self-rated health is a commonly used measure of health status, usually having three to five categories. The measure is often collapsed into a dichotomous variable of good versus less than good health. This categorization has not yet been justified.

Methods: Using data from the 1958 British birth cohort, we examined the relationship between socioeconomic conditions, indicated by occupational class at four ages, and self-rated health. Results obtained for a dichotomous variable using logistic regression were compared with alternative methods for ordered categorical variables including polytomous regression, cumulative odds, continuation ratio and adjacent categories models.

Results and conclusions: Findings concerning the relationship between socioeconomic position and self-rated health yielded by a logistic regression model were confirmed by alternative statistical methods which incorporate the ordered nature of self-rated health. Similarity of results was found regarding size and significance of main effects, type of association and interactive effects.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • England / epidemiology
  • Female
  • Follow-Up Studies
  • Health Status*
  • Humans
  • Logistic Models
  • Male
  • Models, Statistical
  • Occupations
  • Risk
  • Scotland / epidemiology
  • Social Class*
  • Wales / epidemiology