International Journal of Epidemiology 2000;29:149-157
© International Epidemiological Association 2000
Dichotomous or categorical response? Analysing self-rated health and lifetime social class
a School of Public Health and Community Medicine, The Hebrew University and Hadassah, P.O. Box 12272, Jerusalem 91010, Israel. E-mail: om{at}cc.huji.ac.il.
b Department of Epidemiology & Public Health, Institute of Child Health,30 Guilford Street, London WC1N 1EH, UK.
Background Self-rated health is a commonly used measure of health status, usually having three to five categories. The measure is often collapsed into a dichotomous variable of good versus less than good health. This categorization has not yet been justified.
Methods Using data from the 1958 British birth cohort, we examined the relationship between socioeconomic conditions, indicated by occupational class at four ages, and self-rated health. Results obtained for a dichotomous variable using logistic regression were compared with alternative methods for ordered categorical variables including polytomous regression, cumulative odds, continuation ratio and adjacent categories models.
Results and Conclusions Findings concerning the relationship between socioeconomic position and self-rated health yielded by a logistic regression model were confirmed by alternative statistical methods which incorporate the ordered nature of self-rated health. Similarity of results was found regarding size and significance of main effects, type of association and interactive effects.
Keywords Self-rated health, social class, logistic regression, polytomous regression, cumulative odds model, continuation ratio model, adjacent categories model
Accepted 29 June 1999
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