GoodSamIAm

Self Healing Research: Good Sam I Am

 

The Validity of Measuring Health, Happiness and Longevity on Word Scales

a. Can we ask a "subjective" question like, "Would you describe your overall level of health as excellent, very good, good, fair or poor" and expect it to be a valid predictor of actual health?

Yes. A 1991 study by Idler and Kasl states, "Self-evaluations of health status have been shown to predict mortality, above and beyond the contribution to prediction made by indices based on the presence of health problems, physical disability, and biological or life-style risk factors." The risk of mortality increases as the scale rating decreases from excellent to poor.

The authors also cite five other recent studies that "…have found self-evaluations of health to be significant predictors of mortality in follow-up studies, despite stringent controls for physical health status at baseline. That is, above and beyond several other different indicators of health, this subjective perception appears to carry an independent ability to predict the individual's survival over a period of as many as six to nine years. The answer to this apparently simple question thus communicates life expectancy information, the sensitivity of which goes beyond the information contained in detailed assessments of health problems and disabilities."

The authors raise an interesting possibility to explain some of their data, "…that the perception of health status has some beneficial or detrimental effect on the individual's subsequent experience of morbidity. In this case people who report good health despite medical findings or, conversely, people whose health complaints are apparently unjustified, may actually alter their risk of mortality by bringing their health status into line with their self-perceptions." They say further research is needed.

The authors raised another interesting issue of whether peoples' ratings on the health scale are worse, the same or better at predicting mortality than physicians' evaluations.

"Health Perceptions and Survival: Do Global Evaluations of Health Status Really Predict Mortality?" Ellen L. Idler and Stanislav Kasl, Journal of Gerontology: SOCIAL SCIENCES, Vol. 46, No. 2, S55-65

b. Is it possible that the "subjective" rating by people on the health scale is a better predictor of actual health than the evaluation of physicians using "objective" data?

Yes. A 1999 study by Ferraro and Farmer states, "This study compares self-reported morbidity with indicators of morbidity from physicians' evaluations and examines the predictive validity of each indicator on self-assessed health and mortality in adulthood. Special attention is given to differences in the measures between white and African American adults. Adults from a large national survey received a detailed medical examination by a physician; they also were asked about the presence of 36 health conditions." The respondents' records were studied after a twenty year period.

"…This research evaluated the utility of morbidity data reported by respondents with that provided by physicians for predicting health assessments and mortality. The two types of morbidity were only modestly correlated. All four indicators of morbidity-two reflecting physician-evaluated morbidity and two reflecting self-reported morbidity-were predictive of self-assessed health among white respondents. The relationships between self-assessed health and the two indicators of self-reported morbidity, however, were stronger than were those with physician-evaluated morbidity in the white subsample. For the black subsample, neither indicator of physician-evaluated morbidity was significant in predicting self-assessed health, but both indicators of self-reported morbidity were significant. In summary, self-reported morbidity is the stronger predictor of self-assessed health among all respondents, and physician-evaluated morbidity is predictive of health assessments only among white respondents."

"It is not surprising that self-reported morbidity is the stronger predictor of self-assessed health, given that the outcome was a subjective appraisal of health. Yet, even when mortality is the outcome, physician-evaluated morbidity was not the superior predictor…."

Ferraro & Farmer, “Utility of Health Data from Social Surveys: Is There a Gold Standard for Measuring Morbidity?” American Sociological Review (1999)

c. In our Good Samaritans International research we have found that the excellent to poor health scale can predict differences in health between groups. Using large samples (n=750/group), a telephone questionnaire, and the question, "Would you say your overall level of health is excellent, very good, good, fair or poor?" we studied three groups, each with a different incidence of the same disease.

Group 1 had Disease A and the group was identified because all respondents were taking specific prescription drugs for the disease. Group 2 claimed to have Disease A but it was suspected from past research that about half of the people actually had what was claimed while the other half claimed to have the disease just to get unspecified free and discounted items. Group 3 was considered to be a normal group in that it should have had Disease A in proportion to the population as a whole, estimated to be 5%-10%.

From interviewing the people in the three groups the incidences of excellent or very good claimed health follows.
Group 1 Diseased 33%
Group 2 Half Diseased 49%
Group 3 Normal 66%

d. We conclude that claimed health on the overall health scale is a good predictor of actual health and even better than physicians' evaluations. But then why shouldn't we know more about ourselves than anyone else?

A change in claimed health on the scale is predictive of an actual change in health and when negative this is probably what causes us to go to the doctor. On the other hand when we experience no change on our overall health scale and we go to the doctor for a physical and he/she finds a change, maybe it is not as predictive of our actual health and morbidity as our internal scale. How many people have had a physical which has led to invasive heart procedures and now researchers are finding that the people refusing the procedures are fairing as well as those having the procedures, or those with the traumatic procedures fair no better than those refusing.

One of the most interesting issues raised is whether you can choose to move yourself up the health scale and cause your actual health to improve. We don't see why this is not possible. Becoming more positive and optimistic may create an internal environment and seek an external environment conducive and supportive of better health, happiness and longer life.

We, Good Samaritans, will research all of this to learn how to live better and help others.

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A View Of Healing & Health

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