Self-rated health: caught in the crossfire of the quest for 'true' health?

This issue of the International Journal of Epidemiology features three papers that assess the predictive power of self-rated health (SRH) for mortality between various socio-economic groups, respectively within three developed countries (France, The Netherlands and the United States). The studies published in this issue follow in the footsteps of Burstrom and Fredlund and Van Doorslaer and Gerdtham who found that the association of SRH with mortality does not differ by either occupational group or income in Sweden. However, the similarities end there, as all the studies presented here found some evidence for a modifying effect of socio-economic status (SES) on the relationship between SRH and mortality, albeit with gradients in sometimes opposite directions. Mixed findings such as these could be—misleadingly—taken as evidence that SRH is not a reliable measure of health for the study of social inequalities in health; instead, in this editorial, I will show how these differences provide fruitful insights for understanding how individuals assess their own health and thus point the way towards a need for more research designed to test these specific hypotheses.