Dichotomising poor self-reported health status: Using secondary cross-sectional survey data for Jamaica

Background: Caribbean scholars continue to dichotomise self-reported health status without empirical justification for inclusion or exclusion of moderate health status in the dichotomisation of poor health.

Aims: This study will 1) evaluate which cut-off point should be used for self-reported health status; 2) assess whether dichotomisation of self-reported data should be practiced; 3) ascertain any disparity in dichotomisation by some covariates (i.e., marital status, age cohort, social class); and 4) examine the odds of reporting poor or moderate-to-very poor self-reported health status if one has an illness.

Materials and methods: The current study used cross-sectional survey data for 2007. The survey used stratified probability sampling techniques to collect the data from Jamaicans. The sample consisted of 6,783 respondents, with a focus on participants aged 46+ years (n=1,583 respondents). Self-reported health status was a 5-item Likert scale question. The dichotomisation was poor health status or otherwise and poor (including moderate) self-reported health. Odds ratios were calculated in order to estimate the effect of the covariates.

Result: When moderate self-reported health status was used in poor health status, the cut-off revealed moderate effect on specified covariates across the age cohorts for women. However, for men, exponential effects were used on social class, but not on area of residence or marital status across the different age cohorts.

Conclusions: The cut-off point in the dichotomisation of self-reported health status does not make a difference for women and must be taken into consideration in the use of self-reported health data for Jamaica.