Self-Report Methods of Assessing Health Status and Health Service Utilization: A Hierarchical Confirmatory Analysis

Self reports are often used to determine health status and extent of health service utilization. These assessments are frequently used as indicators of health quality. Using a sample of 739 young adults, this study examines gender differences and the factor structure of 15 self-reported measures of health and health seeking behavior. Women consistently reported more physical problems, less physical hardiness, more physical symptoms, and more utilization of medical services than men. These mean differences were apparent both on the individual variables and on the latent-factor means. However, the factor structure of the 15 variables was found to vary only slightly between men and women. Four primary-order factors were confirmed using latent-variable models. These factors included Physical Hardiness, Subjective Health Problems, Physical Symptomatology, and Health Service Utilization. The three health status factors were highly intercorrelated and were found to be generated by a second-order factor of Poor Physical Health. This general factor was correlated moderately with the Health Service Utilization construct, suggesting that seeking medical services is not an excellent indicator of health status: It probably grossly underestimates the extent of illness in a given population and measures attitudes toward help seeking and availability of medical services.