ARTIGO ARTICLE S54 Cad. Saúde Pública, Rio de Janeiro, 21 Sup:S54-S64, 2005 Socio-demographic determinants of self-rated health in Brazil Determinantes sócio-demográficos da auto-avaliação da saúde no Brasil 1 Centro de Informação Científica e Tecnológica, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. Correspondence C. L. Szwarcwald Departamento de Informações em Saúde, Centro de Informação Científica e Tecnológica, Fundação Oswaldo Cruz. Av. Brasil 4365, Rio de Janeiro, RJ 21045-900, Brasil. celials@cict.fiocruz.br Célia Landmann Szwarcwald 1 Paulo Roberto Borges de Souza-Júnior 1 Maria Angela Pires Esteves 1 Giseli Nogueira Damacena 1 Francisco Viacava 1 Abstract Self-rated health has been used extensively in epi- demiologic studies, not only due to its importance per se but also due to the validity established by its association with clinical conditions and with greater risk of subsequent morbidity and mortali- ty. In this study, the socio-demographic determi- nants of good self-rated health are analyzed using data from the World Health Survey, adapted and carried out in Brazil in 2003. Logistic regression models were used, with age and sex as covari- ables, and educational level, a household assets index, and work-related indicators as measures of socioeconomic status. Besides the effects of sex and age, with consistently worst health percep- tion among females and among the eldest, the re- sults showed pronounced socioeconomic inequal- ities. After adjusting for age, among females the factors that contributed most to deterioration of health perception were incomplete education and material hardship; among males, besides materi- al hardship, work related indicators (manual work, unemployment, work retirement or inca- pable to work) were also important determining factors. Among individuals with long-term illness or disability, the socioeconomic gradient persist- ed, although of smaller magnitude. Health Status; Socioeconomic Survey; Epidemi- ologic Studies Introduction Self-rated health has been used extensively in epidemiologic studies to gauge a population’s state of health 1 . Considered a useful measure due to its easy accessibility in population sur- veys, self-rated health has been used to estab- lish differences in morbidity between popula- tion subgroups, to compare health service and resource needs between geographical areas, and to calculate morbi-mortality indicators, such as healthy life expectancy 2,3 . Although an individual’s “objective” health state, from a medical point of view, refers to a pathologic abnormality indicated by an assem- blage of signs and symptoms, self-evaluation is subjective, combining physical and emotional components, including sense of wellbeing and satisfaction with life. The state of feeling sick does not refer exclusively to feelings of physical pain and discomfort, but also to the psychological and social consequences of having a problem 4 . The individual perception of health is, thus, an important indicator per se, since an individ- ual’s level of wellbeing can influence, relatively, his motivation and quality of life. Besides, the utility of self-rated health also derives from its validity derived from its relationship to clinical conditions and to indicators of morbidity and mortality 5,6 . Research has demonstrated that the per- ception of health appears to be reasonably re-