Is the disease risk associated with good self-reported health constant across the socio-economic spectrum?

Background: Self-reported health is likely to be dependent on two key assessments: that of one's own health and that of the best health that could be expected. As many health outcomes are known to vary according to socio-economic position (SEP), it is possible that assessments of the best health that could be expected will vary with SEP. It is, therefore, possible that the disease risk associated with different levels of self-reported health varies according to SEP. We investigated this using data from the 1998 Health Survey for England. Methods: Disease risk was measured as systolic blood pressure and body mass index (BMI), and SEP was measured as occupational social class. Associations between social class and the markers of disease risk were investigated in those reporting different levels of self-reported health using linear regression in order to control for age. Results: There were statistically significant socio-economic variations in systolic blood pressure and BMI (in women only) in those who reported their health as good or very good. No such socio-economic variations in disease risk were seen amongst those reporting their health as less than good. Conclusions: The meaning of self-reported health, in terms of disease risk, may not be comparable across the socio-economic spectrum. (c) 2005 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.