Are interactional behaviors exhibited when the self-reported health question is asked associated with health status?

Abstract

The self-reported health question summarizes information about health status across several domains of health and is widely used to measure health because it predicts mortality well. We examine whether interactional behaviors produced by respondents and interviewers during the self-reported health question–answer sequence reflect complexities in the respondent’s health history. We observed more problematic interactional behaviors during question–answer sequences in which respondents reported worse health. Furthermore, these behaviors were more likely to occur when there were inconsistencies in the respondent’s health history, even after controlling for the respondent’s answer to the self-reported health question, cognitive ability, and sociodemographic characteristics. We also found that among respondents who reported “excellent” health, and to a lesser extent among those who reported their health was “very good,” problematic interactional behaviors were associated with health inconsistencies. Overall, we find evidence that the interactional behaviors exhibited during the question–answer sequence are associated with the respondent’s health status.

Introduction

The self-reported health question – e.g., “Would you say your health in general is excellent, very good, good, fair, or poor?” – summarizes information about health across several domains and is widely used to measure health status because of its ability to predict morbidity and mortality (Idler and Benyamini, 1997). Researchers have demonstrated that self-reported health is related to multiple domains of health including illnesses, symptoms of undiagnosed diseases, judgments about the severity of illness, family history, dynamic health trajectory, health behaviors, and the presence or absence of resources for good health (Idler and Benyamini, 1997). In sum, “a very long list of variables is required to explain the effect of one brief 4- or 5-point scale item…” (Idler and Benyamini, 1997, p. 31). We seek to demonstrate that there is additional health information to be gleaned from the self-reported health question; in particular, that information from the interviewer–respondent interaction during the self-reported health question–answer sequence may capture information about respondents’ health status beyond that provided solely by their answer to the self-reported health question.