Does our own idea of our health compare to objective measures?

Research using Understanding Society shows that our self-rated health is linked to objective measures of our health - and that the link varies according to people's age, gender and social class.

It’s one of the recent findings of research using biomarker data, which we collected in Waves 2 and 3 of Understanding Society from around 20,000 adults in the Study. Biomarkers are objective measures of health, such as blood pressure, grip strength and lung function, plus indicators of health found in blood samples (including certain proteins, and iron levels).

Researchers compared the biomarker data with results from the question in our survey which asks people to say whether, in general, their health is excellent, very good, good, fair, or poor.

They found that the worse a person’s biomarker ‘score’ was, the less likely they were to report good health. They also found that it’s the measures of our health that we can see – such as waist size and body fat – which are particularly likely to affect our self-rated health.

The researchers divided biomarkers into four groups:

  • Visible – such as body-mass index and waist size
  • Fitness – such as grip strength and heart rate
  • Fatigue – measured by iron levels and other proteins in the blood
  • Disease risk – including cholesterol levels and blood pressure

They created an index for each one, with each one point increase in the index being an objective sign of worsening or potentially poor health.

There is a strong association between self-rated health and biomarkers that measure fitness. If someone’s fitness biomarker score got worse by one point, the person concerned was 20% less likely to report good health.

Gender differences

The research also showed gender differences when it comes to the relationship between our self-rated health and our objectively measured health.

Women are more likely to respond to visible biomarkers than men, for example. For women, a one-point worsening of their score in this category made them 18% less likely to report good health. For men, the figure was 13%.

The researchers suggest that visible biomarkers affect people’s self-rated health because we see so many health messages about obesity, making us more conscious of the implications of being overweight. They add that this association might be stronger for women because women often describe someone healthy in terms of being or feeling slim, whereas men are more likely to define health in terms of physical strength.

Age differences

Biological indicators of fatigue affects people’s self-rated health differently depending on their age. If a retired person’s score for fatigue got worse by one point, they were 22% less likely to report good health, compared to 14% for people of working age.


The research also showed that the higher a person’s income, the more likely their self-reported health was to be associated with their biomarker score. For visible biomarkers, a one point worsening in their score meant that people with a high income were 18% less likely to report good health, compared to 13% of people on a low income.

Read the full paper