Self-rated health between psychology and biology. A response to Huisman and Deeg

In their commentary on my article “What is self-rated health and why does it predict mortality? Towards a unified conceptual model”, Martin Huisman and Dorly Deeg argue, first, that the model I suggest may exaggerate the rational elements in the process of assessment and ignore the irrational and illogical influences; and, second, that self-rated health should be best understood not as a measure of “true health”, but as a measure of people's perceptions about their health. My response to these comments attempts to clarify the nature of the model as a tool for describing the conceptual and logical structure of the evaluation, not the empirical process itself. Psychological and external influences, including “irrational” elements, can be understood as belonging to the contextual framework of evaluation. There is no question that self-rated health represents individual self-perceptions, but to explain its association with mortality it is crucial to understand its relationship to the biological and physiological states of the organism.