Self-reported health among older Bangladeshis: how good a health indicator is it?

PURPOSE This study examines the value of self-reported health (SRH) as an indicator of underlying health status in a developing country setting. DESIGN AND METHODS Logistic regression methods with adjustments for multistage sampling are used to examine the factors associated with SRH in 2,921 men and women aged 50 and older in rural Bangladesh. RESULTS SRH incorporates multiple dimensions of health status (including physical disability assessed by measured physical performance; self-reported limitations in activities of daily living, or ADLs; self-reported chronic morbidity; and self-reported acute morbidity), severity, comorbidity, and trajectory in a similar fashion for both men and women and for different age groups. Older individuals are more likely to report poor SRH than their younger counterparts, and women report significantly worse SRH than their male peers at each age group. In both cases, this disadvantage can be fully accounted for by differences in measured physical performance, ADL limitations, and chronic and acute morbidity. IMPLICATIONS Among older Bangladeshis, SRH is an easily recorded, multifaceted, nuanced indicator of underlying health status that is significantly associated with measured physical performance. Moreover, SRH appears to be independent of age- and gender-related norms.