Despite rising rates of obesity and diabetes, 90 percent of Americans still rate their health as "good" or better, according to a report from the Centers for Disease Control and the National Center for Health Statistics.
The report details the results of a national survey that probed 15 health indicators including obesity, diabetes, smoking, vaccinations and insurance coverage. Responders also rated their overall health as excellent, very good, good, fair or poor.
Although the percentage of people who rated their health as excellent or very good decreased from 69 in 1997 to 66 in 2010, the proportion of Americans who rate their health as good or better is surprisingly high given the nine-point boost in obesity to 28.2 percent and the three-point rise in diabetes to 8.4 percent.
"I think it just demonstrates the challenges we face in making people aware at the difference between how they feel right now and what their health risks are," said Dr. Jim Jirjis, director of the Adult Primary Care Center at Vanderbilt University Medical Center in Nashville, Tenn.
Jirjis said health care providers would not rate an obese person's health as good because of the increased risk for other conditions like heart disease, stroke and diabetes.
"Just because you're not in the middle of an acute health complication doesn't mean your health is good."
Dr. Albert Levy, assistant professor of medicine at Mount Sinai School of Medicine in New York City, said multiple factors play into a person's subjective view of his health -- factors no less important than weight and blood sugar levels.
"The doctor may see measures of unhealthiness, like weight and blood sugar. But good health is not only physical; it's psychological and emotional. It depends on family, work, economics, spirituality."
Levy cautioned that the increase in rates of obesity and diabetes may also be a result of better detection, which is a good thing.
But the report also drew attention to the growing population of Americans who can't afford health care when they need it. The percentage of people who failed to obtain medical coverage because of cost increased from 4.5 percent in 1997 to 7 percent in 2010.
"I think number one barrier to wellness and illness management is cost," Jirjis said. "I see people who, because of the economy and not having affordable health care, are gambling with their health care."
Jirjis said he recently saw a married couple who refused to take their medications because they could only afford the drugs for one.
"Society does not have an answer to provide affordable health care, so there's an increasing number of citizens who just don't have a safety net," Jirjis said.
But other health indicators are moving in the right direction.
More people are getting vaccinated, with flu shot rates climbing nine points to 40.7 percent and pneumococcal vaccination rates rising 18 points to 60.6 percent.
"In the past I had to really explain the benefits of vaccination," Jirjis said. "I think public efforts to inform people have been successful."
Jirjis, who is also assistant chief medical officer for electronic medical records, said improvements in recordkeeping make it more likely that patients will be offered vaccines their eligible for.
In another change for the better, Americans are also smoking less. The proportion of adults who smoke decreased five points to 19.5 percent.
"I think public policies that make it more and more difficult for people to smoke combined with the message that smoking is ugly and bad for your health is really taking effect, and that's good news" Jirjis said.
And physical activity is up, rising five points to 34.8 percent.
"If you are mobile -- if you can walk and move your arms -- you must exercise," Levy said. "You can start exercising at 60, 70, whatever age you are."
Levy said among his patients, those who exercise regularly are "far better in every measure of health compared to those who don't."
Levy said people who like to eat should exercise even more.
"You don't have to go to a gym," he said. "You can walk, you can run, you can play ball with your children."