How do respondents understand survey questions on ill-health?

Survey research examining the prevalence of ill-health frequently use global single-item questions such as on long standing illness often combined with an inquiry about the consequences of ill-health in everyday life. These kinds of questions appear to tap a response with face validity and comparability. However, a survey interview is also an interactional event and the way the respondents understand the meaning of questions is important. The purpose of this study is to explore how the meaning of survey questions on long-standing illness and restrictions posed by it are understood by respondents. Qualitative interview data collected from a subgroup of 42 participants in a nation wide 1994 Finnish Survey on Living Conditions is used. This study is based on qualitative content analysis of verbatim transcripts of these semi-structured interviews. Two relevant aspects of ill-health were distinguished: 'disease' and 'illness'. Only medically diagnosed chronic diseases were considered long-standing illnesses by the respondents. Experienced, non-diagnosed illnesses were, rather, considered 'normal', i.e. consequences of ageing or the life situation or too insignificant to be considered long-standing illnesses. Whether long-standing illness was assessed as restricting everyday life was relative not only to the severity of the disease and the life situation of the respondents but also to adaptation to ill health. The results suggest that the survey question on long-standing illness captures people's sense of chronic disease rather than the 'illness, infirmity or disability' the wording of the question suggests.