What Does Self-rated Health Mean? Changes and Variations in the Association of Obesity with Objective and Subjective Components Of Self-rated Health

Ethnoracial Disparities in Self-Rated Health: Exploring the Impact of Skin Color and Other Ethnoracial Characteristics in Mexico

OBJECTIVES

This manuscript aims to understand the association between self-rated health and ethnic-racial characteristics (i.e., skin color, self-ascription, and Indigenous language) in the context of the Mexican population.

DESIGN

Logistic regression analyses, using the 2019 PRODER (N = 7187)-a representative survey at the national level. We centered the analysis on two measures of skin color: the interviewer assessment of color skin (that has been used in previous studies), and the ITA scale, a measure constructed from optical digital colorimeter readings (a novel method in ethnoraciality studies in Mexico, included in the PRODER survey).

RESULTS

In comparison to the interviewer's assessment of skin color, the ITA score shows a significant association with self-rated health, even in the presence of individual conditions, sociodemographic traits, and life-course events. In contrast, ethnic-racial self-ascriptions and speaking of an Indigenous language do not show any statistical associations.

CONCLUSION

Contrary to previous research, our results suggest a positive association between skin color and self-rated health, when the former is assessed with the colorimeter readings; it means that those with lighter color skin are more prone to report a better health perception. It has methodological implications in the way skin color is observed.

Ideal Weight and Weight Discrepancy: A Study of Life Course Trajectories and Intercohort Change in the Netherlands

Objective: This study examined how individuals' ideal weight and weight discrepancy (between ideal and actual weight) changed over the life course and across cohorts. Methods: The study used population-representative longitudinal data collected in the Netherlands (N = 61,431 observations between 2007 and 2018 among N = 13,409 individuals aged 16 to 80 and born 1927-2000). Results: Ideal weight increased linearly with age. Weight discrepancy showed a bell-shaped age pattern. Approximately half of the age-related increase in ideal weight was associated with concurrent increases in actual weight. Ideal weight and weight discrepancy increased slightly across cohorts. The cohort-related increase in ideal weight vanished after adjusting for change in actual weight. Analyses of population heterogeneity showed similar patterns of change in both outcomes across groups, although levels differed by gender, education, and migration status even after adjusting for differences in actual weight between these groups. Conclusion: These results show that ideal weight and weight discrepancy in the Netherlands change substantially with age and modestly across cohorts. Potential explanations include changes in physical appearance and in the importance of physical appearance.

Impaired sleep, multimorbidity, and self-rated health among Canadians: Findings from a nationally representative survey

Background

Self-rated health (SRH) is a globally recognized measure of health status. Both impaired sleep (IS) and the presence of multimorbidity are related to poorer SRH, but the precise nature of these associations remains unclear. This study explored the association between IS, multimorbidity, and SRH among Canadian adults.

Method

We used 2017-18 Canadian Community Health Survey (CCHS) data for this study. The main variable of interest, self-rated health (SRH), measured participants' health on a 5-point Likert scale, later categorized as "good or better" vs. "fair or poor". The primary predictor, IS, was derived from two variables and categorized into four groups: no sleep issues; fewer sleeping hours (<7 hours) only; trouble sleeping only; and fewer hours & trouble sleeping. Multimorbidity was present (yes/no) if a participant indicated being diagnosed with two or more chronic conditions.

Results

Just over one in ten Canadians reported fair/poor SRH and approximately one-quarter had multimorbidity or experienced few sleep hours in combination with trouble sleeping. The adjusted model indicated greater odds of fair/poor SRH associated with the 40-64 years age group, male sex, and lower socio-economic status. It also suggested the presence of multimorbidity (AOR= 4.63, 95% CI: 4.06-5.28) and a combination of fewer sleep hours and troubled sleep (AOR= 4.05, 95% CI: 2.86-5.74) is responsible for poor SRH. Forty-four percent of the total effect of IS on SRH was mediated by multimorbidity.

Conclusion

This unique finding highlights the mediating role of multimorbidity, emphasizing the importance of addressing it alongside sleep issues for optimal health outcomes.

Understanding Internal Migration: A Research Note Providing an Assessment of Migration Selection With Genetic Data

Migration is selective, resulting in inequalities between migrants and nonmigrants. However, investigating migration selection is empirically challenging because combined pre- and post-migration data are rarely available. We propose an alternative approach to assessing internal migration selection by integrating genetic data, enabling an investigation of migration selection with cross-sectional data collected post-migration. Using data from the UK Biobank, we utilized standard tools from statistical genetics to conduct a genome-wide association study (GWAS) for migration distance. We then calculated genetic correlations to compare GWAS results for migration with those for other characteristics. Given that individual genetics are determined at conception, these analyses allow a unique exploration of the association between pre-migration characteristics and migration. Results are generally consistent with the healthy migrant literature: genetics correlated with longer migration distance are associated with higher socioeconomic status and better health. We also extended the analysis to 53 traits and found novel correlations between migration and several physical health, mental health, personality, and sociodemographic traits.

COVID-19-Induced Inequalities and Mental Health: Testing the Moderating Roles of Self-rated Health and Race/Ethnicity

This study examines the relationship among COVID-19-induced social, economic, and educational inequalities on mental health (i.e., anxiety and depression). This study also examines if levels of self-rated health (SRH) moderate the relationship (i.e., COVID-induced inequalities [CII] and mental health), as well as examines the racial/ethnic group differences among 567 young adults in the mid-Atlantic region. Using a moderation model, results indicate that CII were significantly related to depression (b = .221, t(554) = 4.59, p = .000) and anxiety (b = .140, t(555) = 3.23, p = .001). SRH and race/ethnicity also moderated both relationships. At above-average SRH (i.e., moderator), higher CII were also significantly related to lower anxiety (Asian young adults only) and lower depression (Asian and White young adults only). Overall, SRH and race/ethnicity are important factors in the mental health impact of COVID-19 on young adults.

Education and age trajectories of chronic conditions: Are tests of the cumulative advantage and disadvantage hypothesis biased by underreporting?

OBJECTIVE

This study examined the impact of underreporting on tests of the cumulative advantage and disadvantage hypothesis (CAD), which predicts age-related increases in health disparities between individuals with higher and lower education.

METHODS

Using the English Longitudinal Study of Ageing (ELSA), we identified underreporting by comparing self-reported hypertension and diabetes with biomedically measured hypertension (systolic blood pressure≥140 mm Hg and/or diastolic blood pressure≥90 mm Hg) and diabetes (fasting glucose level≥7 mmol/l and/or HbA1c≥6.5%). In a sample of 11,859 respondents aged 50 to 85 (54% women, 97% White), we assessed the associations between underreporting and the main analytic constructs in tests of the CAD (education, age, sex, and cohort).

RESULTS

The results showed that self-reported measures underestimated the prevalence of hypertension and diabetes. Underreporting showed weak to moderate associations with the main constructs in tests of the CAD, being more pronounced in individuals with lower education, in older age, in more recent cohorts, and among men. When correcting for underreporting using biomedical measures, the overall prevalence of hypertension and diabetes increased substantially, but education differences in age trajectories of both conditions remained similar.

CONCLUSIONS

Underreporting affected conclusions about the prevalence of hypertension and diabetes, but it did not affect conclusions about the CAD hypothesis for either condition.

Pathways to healthy aging - Exploring the determinants of self-rated health in older adults

OBJECTIVE

The decade 2021-2030 has been declared the Decade of Healthy Aging by the United Nations General Assembly, underlining that health is central to the experience of older age and the opportunities that aging brings. Self-rated health (SRH) appears consistent with the state of objective health, and therefore can serve as a simple core indicator of healthy aging. SRH can be affected by psychological and lifestyle factors, and by the developmental and sociodemographic context, which can directly and indirectly influence subjective health status. The aim of the present study was to establish the structure of the relationships between SRH, health-related behavior, subjective wellbeing, developmental tasks attainment and sociodemographic factors in the late-life period.

METHODS

The study group consisted of 340 Polish retired seniors, aged 61 to 94 (M = 70.75, SD = 6.48): 88 men (25.9 %) and 252 women (74.1 %). The respondents completed the following measures: 10-point numerical scale for SRH, Health-Related Questionnaire for Seniors, Satisfaction with Life Scale, Developmental Tasks Questionnaire for Seniors and a sociodemographic survey.

RESULTS

The group demonstrated a medium level of SRH and other variables. SHR was positively correlated with health-related behavior, wellbeing, developmental tasks attainment and perceived economic status, and negatively with age. Structural equation model revealed that health-related behavior, wellbeing, age and economic status have a direct influence on SRH. Developmental tasks attainment was found to predict health behavior, although no direct relationship with SRH was found.

CONCLUSIONS

A broader understanding of healthy aging is achieved by considering the context of its factors. Psychological interventions should promote a healthy lifestyle and adapt it to the late life period to promote health among seniors.

Gratitude Strengthens the Relationship Between Leisure Social Support and Self-Rated Health Among Nursing Home Residents

A central outcome indicator of person-oriented services in primary health care is self-rated health (SRH). Therefore, promoting SRH among nursing home residents is valuable. We examined whether demographic variables, gratitude, and leisure social support (LSS) related to SRH, and whether gratitude moderated the relationship between LSS and SRH. To collect demographic information and measure gratitude, LSS, and SRH, we conducted face-to-face interviews with 237 participants from four nursing homes in Taiwan. We used hierarchical regression analysis to examine data. Results demonstrated that duration of residence, gratitude, and LSS predicted SRH, and that gratitude interacted with LSS. We discuss implications of these results in terms of facilitating gratitude to promote SRH among nursing home residents and guiding them to seek sources of LSS. In particular, we further discuss how gratitude strengthens the relationship between LSS and SRH. [Journal of Gerontological Nursing, 48(2), 23-30.].

The Association Between Childhood Adversity and Self-Rated Physical Health in US College Students

Purpose:

Adverse childhood experiences (ACEs) are related to unhealthy behaviors and poor self-rated health. Poor self-rated physical health (SRPH) is negatively associated with college students’ grades and overall academic achievement. This study examined the effects of ACEs on SRPH among undergraduate and graduate students (n = 568; 18-30 years) from a public university in the southeast.

Methods:

Students completed a cross-sectional online survey in October 2018. We conducted unadjusted and adjusted logistic regressions to examine the relationship between ACEs and SRPH among US college students.

Results:

Most participants reported 1 to 4 ACEs; one-fourth reported poor SRPH. Higher ACE exposure increased the odds for poor SRPH in a curvilinear relationship. Unadjusted results indicate ACE exposure increased risk between 82% and 228%, and that higher levels of resilience and adherence to diet and physical activity guidelines reduced risk for poor SRPH. In adjusted models, moderate ACE exposure was associated with 2.46 times greater odds (95% CI = 1.28-9.34) of reporting poor SRPH. Graduate students (odds ratio [OR] = .52, 95% CI = .27-.99) and those who met healthy diet (OR = .12, 95% CI = .02-.93) and physical activity recommendations (OR = .36, 95% CI = .23-.58) had reduced odds of poor SRPH.

Conclusions:

Students who have experienced ACEs are at a greater risk for poor health. Student health programs on campus should take a holistic approach by screening students for childhood adversity and promoting healthy behaviors to improve physical health.

Association between body mass index and self-rated health: A Swedish population-based longitudinal study

Aims: We aimed to investigate (a) the association between body mass index (BMI) and self-rated health (SRH) and (b) BMI's predicted value for SRH within a representative population in the Skaraborg Project. Methods: This was a longitudinal observational study. A random population of 2816 individuals were included in the study between 2002 and 2005, and a representative sample of these individuals were invited consecutively for a follow-up visit between 2012 and 2014. At follow-up, data from 1327 participants were collected concerning anthropometric variables, blood samples and validated questionnaires regarding lifestyle factors. Results: A significant inverse association was observed between BMI and SRH both at baseline and at follow-up, with all p-values for trend being ⩽0.001 in both men and women. This association was observed even after adjusting for confounders such as co-morbidity, age, sex, education, marital status and lifestyle factors. In addition, the longitudinal analyses showed that BMI at baseline was inversely associated with SRH at follow-up in both sexes (odds ratio (OR)=1.1, confidence interval (CI) 1.02-1.16, p=0.017 in men; and OR=1.1, CI 1.04-1.14, p=0.001 in women). These findings remained in participants whose weight increased (p=0.022) or was stable (p=0.004), while it was not seen in individuals who lost weight over the years (p=0.340). Conclusions: SRH is inversely associated with BMI in Swedish men and women. High BMI predicted low SRH from a longitudinal perspective, independent of co-morbidities, except for individuals who lost weight over the years. This knowledge emphasises the importance of an understanding and empathetic attitude towards these individuals.

Assessment of self-rated health 5 years after Roux-en-Y gastric bypass for severe obesity

Background

Patients' perceptions of health change after bariatric surgery are complex. The aim of this study was to explore whether self‐rated health (SRH), a widely used tool in public health research, might be relevant as an outcome measure after Roux‐en‐Y gastric bypass (RYGB) for severe obesity.

Methods

This was a single‐centre retrospective study of a local quality registry. SRH score was registered at baseline and 5 years after RYGB. SRH, one of the 36 items in the quality‐of‐life Short Form 36 (SF‐36®) questionnaire, is the answer to this single question: ‘In general, would you say your health is excellent (1), very good (2), good (3), fair (4) or poor (5)?’ Change in SRH was analysed in relation to change in weight, co‐morbidities and quality of life after 5 years.

Results

Of a total of 359 patients who underwent RYGB between September 2006 and February 2011, 233 (64·9 per cent) reported on SRH before and 5 years after surgery. Of these, 180 (77·3 per cent) were women, and the mean(s.d.) age was 40(9) years. Some 154 patients (66·1 per cent) reported an improvement in SRH, 60 (25·8 per cent) had no change, and SRH decreased in 19 patients (8·2 per cent). SRH in improvers was related to better scores in all SF‐36® domains, whereas SRH in non‐improvers was related to unchanged or worsened scores in all SF‐36® domains except physical function.

Conclusion

Two‐thirds of patients reported improved SRH 5 years after RYGB for severe obesity. In view of its simplicity, SRH may be an easy‐to‐use outcome measure in bariatric surgery.

Neighborhood Disadvantage and Biological Aging: Using Marginal Structural Models to Assess the Link Between Neighborhood Census Variables and Epigenetic Aging

OBJECTIVES

Past research has reported an association between neighborhood disadvantage and healthy aging, but most of these studies utilize self-report measures of health or physical functioning and do not properly account for neighborhood selection effects, creating concerns regarding inflated associations. To overcome these limitations and provide a more stringent estimate of effects, the current study investigated the effect of neighborhood disadvantage on aging using newly developed epigenetic methods to assess rate of biological aging and marginal structural modeling (MSM) to account for potential confounds due to neighborhood selection.

METHODS

We tested the hypothesis that neighborhood disadvantage accelerates aging using U.S. census data and five waves of interview data from a sample of 100 middle-aged African American women. Using a recently developed epigenetic index of aging, biological age was measured using weighted methylation values at 71 CpG sites. We calculated a measure of accelerated methylomic aging (in years) based upon the residual scores resulting from a regression of methylomic age on chronological age.

RESULTS

Controlling for a variety of individual difference factors that could be confounded with neighborhood effects, including various health behaviors, neighborhood disadvantage was associated with accelerated biological aging. Using MSM to account for selection effects, a standard deviation increase in neighborhood disadvantage accelerated aging an average of 9 months.

CONCLUSIONS

Our findings converge with prior work to provide strong evidence that neighborhood context is a significant determinant of healthy aging.

The association between self-rated health and underlying biomarker levels is modified by age, gender, and household income: Evidence from Understanding Society - The UK Household Longitudinal Study

The goal of this study was to evaluate how self-rated health (SRH) and objective measures of health (biomarkers) are associated, and if this association varies by gender, age, and socioeconomic position (measured by household income). Data come from the UK Household Longitudinal Study nurse visit (2010–2012), including a representative sample of adults in Great Britain (N = 15 687 maximum sample). SRH was assessed by the question “In general, would you say your health is excellent, very good, good, fair, or poor?” and dichotomized into good or poor. Indices were created for four biomarker categories based on the aspects of health they are likely to reflect, including visible weigh-related, fitness, fatigue, and disease risk biomarkers. Logistic regression models were run with SRH as the outcome and each biomarker index as a predictor, adjusting by gender, age, and income. Further, interaction terms between each biomarker index and gender, age, and income (independently) were added to test for effect modification. All biomarker indices were associated with SRH in expected directions, with the fitness index most strongly predicting SRH. Gender, age, or income modified the associations between SRH and all biomarker indices to different extents. The association between the visible weight-related biomarker index (including body mass/fat variables) and SRH was stronger for women than men and for those in higher income groups than lower income groups. Income also modified the association between SRH and the fitness biomarker index, whereas age modified the association between SRH and the fatigue biomarker index. When using SRH to investigate health inequalities, researchers and policy makers should be clear that different social groups may systematically consider different dimensions of health when reporting their SRH.

•

The association between self-rated global health and underlying objective health as measured by biomarkers varies by type of biomarker, age, sex and socioeconomic status.

•

Biomarkers that measure different aspects of fitness most strongly predicting self-rated health.

•

The association between the visible biomarkers (including body mass/fat variables) and self-rated health was stronger for women than men and for those in higher income groups than lower income groups.

•

Income also modified the association between self-rated health and biomarkers of disease, with a stronger association for higher income groups.

•

When rating own health individuals from different social groups may systematically consider different dimensions of health.

Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women

Background. Although chronic medical conditions (CMCs), depression, and self-rated health (SRH) are associated, their associations may depend on race, ethnicity, gender, and their intersections. In predominantly White samples, SRH is shown to better reflect the risk of mortality and multimorbidity for men than it is for women, which suggests that poor SRH among women may be caused not only by CMCs, but also by conditions like depression and social relations-a phenomenon known as "the sponge hypothesis." However, little is known about gender differences in the links between multimorbidity, depression, and SRH among African Americans (AAs). Objective. To study whether depression differently mediates the association between multimorbidity and SRH for economically disadvantaged AA men and women. Methods. This survey was conducted in South Los Angeles between 2015 to 2018. A total number of 740 AA older adults (age ≥ 55 years) were enrolled in this study, of which 266 were AA men and 474 were AA women. The independent variable was the number of CMCs. The dependent variable was SRH. Age and socioeconomic status (educational attainment and marital status) were covariates. Depression was the mediator. Gender was the moderator. Structural Equation Modeling (SEM) was used to analyze the data. Results. In the pooled sample that included both genders, depression partially mediated the effect of multimorbidity on SRH. In gender specific models, depression fully mediated the effects of multimorbidity on SRH for AA men but not AA women. For AA women but not AA men, social isolation was associated with depression. Conclusion. Gender differences exist in the role of depression as an underlying mechanism behind the effect of multimorbidity on the SRH of economically disadvantaged AA older adults. For AA men, depression may be the reason people with multimorbidity report worse SRH. For AA women, depression is only one of the many reasons individuals with multiple CMCs report poor SRH. Prevention of depression may differently influence the SRH of low-income AA men and women with multimorbidity.

Body mass index trajectories preceding first report of poor self-rated health: A longitudinal case-control analysis of the English Longitudinal Study of Ageing

Background

Studies have consistently found that obesity is associated with poor self-rated health, but how body mass index (BMI) developed in the lead up to poor self-rated health is unknown.

Methods

We nested a longitudinal case-control study in the English Longitudinal Study of Ageing (1998–2015) to investigate BMI trajectories in the years preceding a first self-report of poor health. Participants rated their health at each data collection; every other collection included a BMI assessment by a nurse. Case status was defined as a first report of poor health during follow-up. Three age- and sex-matched controls were identified per case using density sampling. BMI trajectories were fitted to time backwards prior to first report of poor health using mixed-effects models. Age and sex were potential modifiers. We conducted subgroup analyses of those not reporting certain chronic diseases or smoking.

Results

We identified 732 cases and 2195 controls. Age, but not sex, modified the association between BMI and self-rated health. Participants reporting poor health at age 60 had a 1.5 kg/m² (95%CI: 0.8 to 2.1) higher BMI at the time of reporting than controls, and their BMI had previously increased markedly (1.3 kg/m² 95%CI: 0.9 to 1.8 over ten years). After age 75, cases no longer had higher BMI than controls, and their BMI had decreased sharply prior to reporting poor health (e.g. -2.0 kg/m² 95%CI: -2.6 to -1.5 per decade on average for those reporting poor health at age 90). Age was also an effect modifier among those without diabetes, however BMI trajectories were more similar among the middle-aged. The subgroup analysis of those without cardiovascular disease, cancer and chronic lung disease showed similar results to the main findings.

Conclusion

Development of BMI was associated with poor self-rated health; however, the nature of the association depended markedly on age.

Stigma doesn't discriminate: physical and mental health and stigma in Canadian military personnel and Canadian civilians

Background

Illness-related stigma has been identified as an important public health concern. Past research suggests there is a disproportionate risk of mental-health stigma in the military, but this same finding has not yet been established for physical-health stigma. The current study aimed to assess the independent contribution of mental and physical health on both enacted stigma (discriminatory behaviour) and felt stigma (feelings of embarrassment) and to determine whether these associations were stronger for military personnel than civilians.

Methods

Data were obtained from the 2002 Canadian Community Health Survey - Mental Health and Well-being and its corresponding Canadian Forces Supplement. Logistic regressions were used to examine a potential interaction between population (military [N = 1900] versus civilian [N = 2960]), mental health, and physical health in predicting both enacted and felt stigma, with adjustments made for socio-demographic information, mental health characteristics, and disability.

Results

Mental health did not predict enacted or felt stigma as a main effect nor in an interaction. There was a strong link between physical health and enacted and felt stigma, where worse physical health was associated with an increased likelihood of experiencing both facets of stigma. The link between physical health and enacted stigma was significantly stronger for military personnel than for civilians.

Conclusions

Physical health stigma appears to be present for both civilians and military personnel, but more so for military personnel. Elements of military culture (e.g., the way care is sought, culture of toughness, strict fitness requirements) as well as the physical demands of the job could be potential predictors of group differences.

Integrating Biomarkers in Social Stratification and Health Research

This article provides an overview of the integration of biomarkers and biological mechanisms in social science models of stratification and health. The goal in reviewing this literature is to highlight research that identifies the social forces that drive inequalities over the life course and across generations. The article is structured in the following way. First, descriptive background information on biomarkers is presented, followed secondly by a review of the general theoretical paradigms that lend themselves to an integrative approach. Third, the biomarkers used to capture several biological systems that are most responsive to social conditions are described. Fourth, research that explicates how social exposures "get under the skin" to affect physiological functioning and downstream health is discussed, using socioeconomic disadvantage as an illustrative social exposure. The review ends with emerging directions in the use of biomarkers in social science research. This article endeavors to encourage sociologists to embrace biosocial approaches in order to elevate the importance of social factors in biomedical processes and to intervene on the social conditions that create inequities.

Barrios, ghettos, and residential racial composition: Examining the racial makeup of neighborhood profiles and their relationship to self-rated health

Racial/ethnic disparities in self-rated health persist and according to the social determinants of health framework, may be partially explained by residential context. The relationship between neighborhood factors and self-rated health has been examined in isolation but a more holistic approach is needed to understand how these factors may cluster together and how these neighborhood typologies relate to health. To address this gap, we conducted a latent profile analysis using data from the Chicago Community Adult Health Study (CCAHS; N = 2969 respondents in 342 neighborhood clusters) to identify neighborhood profiles, examined differences in neighborhood characteristics among the identified typologies and tested their relationship to self-rated health. Results indicated four distinct classes of neighborhoods that vary significantly on most neighborhood-level social determinants of health and can be defined by racial/ethnic composition and class. Residents in Hispanic, majority black disadvantaged, and majority black non-poor neighborhoods all had significantly poorer self-rated health when compared to majority white neighborhoods. The difference between black non-poor and white neighborhoods in self-rated health was not significant when controlling for individual race/ethnicity. The results indicate that neighborhood factors do cluster by race and class of the neighborhood and that this clustering is related to poorer self-rated health.

Research in and Prospects for the Measurement of Health Using Self-Rated Health

Self-rated health (SRH)-for example, "in general would you say your health is excellent, very good, good, fair, or poor?"-is the most widely used measure of health across a range of survey research studies. This paper synthesizes extant research and provides a framework for future research on the measurement of health using SRH, focusing on four interrelated topics: the factors that influence respondents' health ratings, the survey measurement features of SRH, how SRH answers are analyzed, and the stated purpose of SRH as a proxy for more objective health or as a perception of health. Extant research on the health, psychological, and social factors influencing respondents' SRH answers is reviewed, as is research concerned with the survey measurement features of SRH that influence how respondents rate their health. The synthesis proposes a framework for future research that focuses on further explicating the factors that underlie respondents' SRH answers and improving features of SRH measurement and analysis in ways that are consistent with the various goals of the researchers who both collect and analyze the data.

The Role of the Five–factor Personality Traits in General Self–rated Health

Self–ratings of health (SRH) are widely used in large surveys and have been shown to predict mortality over and above more objective health measures. However, the debate still continues about what SRH actually represents and what the processes underlying people's assessments of their health are. The main aim of this study is to examine the role of the Five–Factor Model personality traits in general SRH assessment while controlling for the effects of objective health indicators, health–related quality of life and subjective well–being in a large population–based dataset of Estonian adults. A hierarchical linear regression analysis showed that only self–rated, but not informant–rated, neuroticism explained additional variance in SRH when the other aforementioned variables were taken into account. Our findings indicate that people's general SRH is a relatively good reflection of their objectively measured health status, but also that the way in which people experience and evaluate the quality of their lives—both in terms of subjective well–being and more specific aspects of health—plays a significant role in general SRH assessments. Copyright © 2016 European Association of Personality Psychology

Gender and genetic contributions to weight identity among adolescents and young adults in the U.S

In this paper, we investigate the possibility that genetic variation contributes to self-perceived weight status among adolescents and young adults in the U.S. Using samples of identical and fraternal twins across four waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health) study, we calculate heritability estimates for objective body mass index (BMI) that are in line with previous estimates. We also show that perceived weight status is heritable (h(2) ∼ 0.47) and most importantly that this trait continues to be heritable above and beyond objective BMI (h(2) ∼ 0.25). We then demonstrate significant sex differences in the heritability of weight identity across the four waves of the study, where h(2)women = 0.39, 0.35, 0.40, and 0.50 for each wave, respectively, and h(2)men = 0.10, 0.10, 0.23, and 0.03. These results call for a deeper consideration of both identity and gender in genetics research.