Poor or fair health

Self-reported health status is a general measure of health-related quality of life (HRQoL) in a population. This measure is based on survey responses to the question: “In general, would you say that your health is excellent, very good, good, fair, or poor?” The value reported in the County Health Rankings is the percentage of adult respondents who rate their health “fair” or “poor.” The measure is modeled and age-adjusted to the 2000 US population. Please note that the methods for calculating this measure changed in the 2016 Rankings.

Measure Tabs

Reason for Ranking

Measuring HRQoL helps characterize the burden of disabilities and chronic diseases in a population. Self-reported health status is a widely used measure of people’s health-related quality of life. In addition to measuring how long people live, it is important to also include measures that consider how healthy people are while alive.

Measurement Strengths and Limitations

A strong association between self-reported health status and mortality has been well documented; thus it is a useful indicator of morbidity within a community. In his examination of its advantages and limitations, Jylhä concludes that the use of self-rated health as a measure to compare health status benefits from its comprehensive, inclusive, and non-specific nature.[1] Furthermore, a meta-analysis of the association between mortality and a single item assessing self-rated health found that people with “poor” self-rated health had a twofold higher mortality risk than persons with “excellent” self-rated health.[2] This analysis concludes that a single measure that takes little time to collect and can be captured routinely is appropriate for measuring health among large populations.[2] A study that investigated the reliability of the HRQoL questions included in BRFSS found high retest reliability for the self-reported health measure.[3]

Please note that changes in the method CDC used to create this measure in 2016, 2017, and 2018 mean that new estimates should not be compared with earlier years. To see more about these changes, look in the Data Source tab.