The increasing predictive validity of self-rated health

PLoS One. 2014 Jan 22;9(1):e84933. doi: 10.1371/journal.pone.0084933. eCollection 2014.


Using the 1980 to 2002 General Social Survey, a repeated cross-sectional study that has been linked to the National Death Index through 2008, this study examines the changing relationship between self-rated health and mortality. Research has established that self-rated health has exceptional predictive validity with respect to mortality, but this validity may be deteriorating in light of the rapid medicalization of seemingly superficial conditions and increasingly high expectations for good health. Yet the current study shows the validity of self-rated health is increasing over time. Individuals are apparently better at assessing their health in 2002 than they were in 1980 and, for this reason, the relationship between self-rated health and mortality is considerably stronger across all levels of self-rated health. Several potential mechanisms for this increase are explored. More schooling and more cognitive ability increase the predictive validity of self-rated health, but neither of these influences explains the growing association between self-rated health and mortality. The association is also invariant to changing causes of death, including a decline in accidental deaths, which are, by definition, unanticipated by the individual. Using data from the final two waves of data, we find suggestive evidence that exposure to more health information is the driving force, but we also show that the source of information is very important. For example, the relationship between self-rated health and mortality is smaller among those who use the internet to find health information than among those who do not.

MeSH terms

  • Alcohol Drinking
  • Cross-Sectional Studies
  • Data Collection / methods*
  • Data Collection / statistics & numerical data*
  • Educational Status
  • Female
  • Health Status*
  • Humans
  • Male
  • Mortality / trends
  • Proportional Hazards Models
  • Reproducibility of Results
  • Self Disclosure*
  • Smoking
  • Social Class
  • United States

Grant support

The authors have no support or funding to report.