The Perception Gap in Health: Comparing Self-Rated and Objective Indicators across Age and Sex in Italy

Benedetta Marcozzi , Sapienza University of Rome
Eleonora Trappolini, University of Milan-Bicocca
Alessandra De Rose, Sapienza University of Rome, Italy
Cinzia Lo Noce, Italian National Institute of Health, Rome
Luigi Palmieri, Italian National Institute of Health, Rome
Chiara Donfrancesco, Italian National Institute of Health, Rome

Self-rated health (SRH) represents a synthetic and multidimensional measure of individual health integrating physical, psychological, and social components. However, its consistency with objective health indicators may vary across populations, age groups, and health domains. Evidence suggests that subjective evaluations often reflect actual health status, while also revealing systematic biases in perception and awareness. This study aims to assess the alignment between SRH and objectively measured health across cardiovascular and metabolic domains, including blood pressure, cholesterol, diabetes, and BMI, and to explore how this relationship evolves with ageing and differs by sex. We use data from the Italian Health Examination Survey (HES), conducted within the CUORE Project by the Italian National Institute of Health between 2008 and 2012. The survey collected detailed sociodemographic, behavioural, and clinical information from a representative sample of adults aged 35–79 years. Objective health is assessed using standardized indicators of blood pressure, cholesterol, fasting blood glucose, and BMI, classified into clinically relevant categories of awareness and control. SRH was assessed through the question “In general, how is your health?” (very good/good/fair/poor/very poor) and compared with objective indicators to quantify a perception gap, distinguishing between overestimation and underestimation of personal health. Analyses are stratified by age and sex. The analytical framework will be replicated using data from the 2018–2019 HES. Based on previous evidence, we expect a moderate association between SRH and objective indicators, with a widening perception gap among older adults and gender-specific patterns reflecting differences in health awareness and reporting.

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 Presented in Session P6. Health, Mortality, and Ageing 2