Open Access Research article

Factors associated with self-rated health status in university students: a cross-sectional study in three European countries

Rafael T Mikolajczyk1, Patrick Brzoska2, Claudia Maier2, Veronika Ottova3, Sabine Meier1, Urszula Dudziak4, Snezhana Ilieva5 and Walid El Ansari6*

Author Affiliations

1 Department of Public Health Medicine, School of Public Health, University of Bielefeld, Bielefeld, Germany

2 Department of Epidemiology & International Public Health, School of Public Health, University of Bielefeld, Bielefeld, Germany

3 Department of Prevention & Health Promotion, School of Public Health, University of Bielefeld, Bielefeld, Germany

4 Institute of Family Sciences, Catholic University of Lublin, Lublin, Poland

5 Department of Social, Work and Educational Psychology, Faculty of Philosophy, Sofia University "St. Kl. Ohridski", Sofia, Bulgaria

6 Faculty of Sport, Health & Social Care, University of Gloucestershire, Gloucester, UK

For all author emails, please log on.

BMC Public Health 2008, 8:215  doi:10.1186/1471-2458-8-215

Published: 18 June 2008



Self-rated health status (SRHS) is a reliable and valid measure for assessing the subjective and objective health of individuals. Previous studies have either focused predominantly on the elderly or investigated only a narrow range of factors potentially associated with SRHS. In examining student populations, these past studies were limited to single countries. The objectives of this study were to assess which candidate variables were independently associated with SRHS in university students, to compare these variables by country and by gender, and to investigate which of the variables was most important as a rating frame for SRHS.


The data is from the Cross-National Student Health Survey, conducted in 2005 in universities in Germany, Bulgaria, and Poland (n = 2103; mean age = 20.7 years). SRHS was assessed with a single question using a five-point scale ranging from "excellent" to "poor". The study also measured a wide range of variables including: physical and psychological health, studying, social contacts/social support, and socio-demographic status.


Psychosomatic complaints (considered an aspect of physical health and, adjusted for psychological health) were the most important indicators in forming a rating frame for students' SRHS. There were few differences in the effects of variables associated with SRHS by gender (well-being: a measure of psychological health) and the variables associated with SRHS by country (well-being and self-efficacy). The remaining variables showed homogenous effects for both genders and for all three countries.


The results suggest that SRHS can be reasonably used to compare students' health across countries. SRHS is affected by different physical, psychological and psychosomatic aspects of health; however, its strongest association is with psychosomatic complaints.