A comparison of two multidimensional measures of health status: the Nottingham Health Profile and the RAND 36-Item Health Survey 1.0.

In this study the applicability of two multidimensional instruments, the NHP and the RAND 36-item Health Survey 1.0, for measuring health status in population surveys was examined. A population sample of 1,063 persons aged over 17 years participated in the study. It was shown that, as compared with the NHP, the RAND 36-Item Health Survey 1.0 is a more reliable measure of health status. Second, within a group of subjects who scored 'zero' on the NHP, considerable dispersion in RAND 36-Item Health Survey 1.0 scores was found. For the whole group, no significant differences were found in the amount of variance explained by the corresponding scales from both instruments in the prevalence of chronic diseases. However, among subjects with a zero score on the NHP, the RAND 36-Item Health Survey 1.0 scores were still predictive of the occurrence of chronic diseases. It was concluded that, compared with the NHP, the RAND 36-Item Health Survey 1.0 seems to be a more sensitive instrument for the use in population samples.

Social comparison as a mediator between health problems and subjective health evaluations.

The role of social comparison in mediating the relation between 'objective' health status and subjective health evaluations was examined. In a random population sample (N = 361) it was shown that health problems were related to psychological distress, which in turn induced a downward comparison process. This downward comparison resulted in a perception of being better off than others in a similar situation (relative evaluation). While both health problems and psychological distress had strong direct effects on general health evaluations, relative evaluations explained further significant variance. In addition, it was found that although women reported more psychological and physical problems than men, they engaged more often in downward comparison and consistently felt more than men did that their health was better than that of most others. No gender differences in general health evaluations were found. Interestingly, social comparison had a stronger impact on the general subjective well-being of women than of men.