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GSS > Policy and guidance hub > General health harmonised principle

General health harmonised principle

Policy details

Metadata item Details
Publication date:5 June 2020
Author:Ollie Nixon
Approver:William Perks
Who this is for:Users and producers of statistics
Type:Harmonisation guidance and principles

What is harmonisation?

Harmonisation is the process of making statistics and data more comparable, consistent and coherent. Harmonised principles set out how to collect and report statistics to ensure comparability across different data collections in the Government Statistical Service (GSS). Harmonisation produces more useful statistics that give users a greater level of understanding.


What do we mean by general health?

General health is a topic of interest across government. The 2021 Census will collect data on this topic in all four countries of the United Kingdom.

This harmonised principle measures an individual’s subjective opinion of their health. This measurement is important because it is a good indicator of an individual’s demand for healthcare. It can also be used to determine an individual’s healthy life expectancy.


Questions and response options (inputs)

The harmonised question on this topic is designed to collect basic information, for use in the majority of surveys. It is not designed to replace questions used in specialist surveys where more detailed analysis is required.

The question

Question Response options
How is your health in general? Is it…1. Very good
2. Good
3. Fair
4. Bad
5. Very bad


Using this principle

Guidance for data collection

This question is a subjective measure and should not be asked by proxy.

Types of data collection this principle is suitable for

This question measures subjective wellbeing related to health. It is for use in social surveys.

The principle can be used for:

  • interviewer led questionnaires
  • Computer Assisted Personal Interviewing (CAPI)
  • Computer Assisted Telephone Interviewing (CATI)
  • paper based and online self-completion forms


Presenting and reporting the data (outputs)

These tables show the output categories for general health. We are not prescribing a code but have given examples. The coding used should comply with the coding conventions used in the specific survey source.

Five point scale

ResponseExample code
Very good1
Very bad 5

Dichotomous output categories

ResponseExample code
Good health 1 or 2
Poor health 3 or 4 or 5

Trichotomous output categories

Response Example code
Good health 1 or 2
Fair health 3
Poor health 4 or 5



This harmonised principle is not just harmonised within the United Kingdom, but also across the European Union. It is harmonised with the European Union Survey on Income and Living Conditions (EU-SILC) and it is identical to the self-perceived health question of the Minimum European Health Module.

Outputs that use this principle are comparable with other surveys that also use this principle. However, we would not recommend comparing levels of general health from outputs using this principle with other outputs that use an alternative measure.


Examples of when this principle has been used

Surveys that used this principle

Some surveys have not adopted the harmonised principle but do still produce comparable data, including:

Use in the census

This principle has been chosen for use in the 2021 Census in England, Wales, Scotland and Northern Ireland.

In all four nations, census questions need parliamentary approval. This will be sought during 2020. It is not anticipated that any of the questions on this topic will change.


Development of this principle

The Office for National Statistics (ONS) adopted this question from 2008. It replaced a previous general health question which used a scale with three response options. An article in Health Statistics Quarterly investigated the effect of this change on the time series and the impact on estimates of healthy life expectancy.


Further information

Longitudinal and cross sectional data sources

In longitudinal sources, this principle is used to measure change in general health status among individuals. In cross sectional data sources, it is used to measure changes in the proportion of the population classified to each category over time.

Healthy life expectancy

The ONS dichotomises this variable to calculate Healthy Life Expectancy (HLE). If you want to know more, the ONS explains how it calculates HLE.


Contact us

We are always interested in hearing from users so we can develop our work. If you use or produce statistics based on this topic, get in touch:


Review frequency:

This page will be reviewed annually.


Date Changes
5 June 2020

The harmonised principle was reviewed and updated.

1 May 2020

The list of surveys that use this principle was updated.

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