Int. J. Environ. Res. Public Health 2012, 9 952 high-density lipoprotein (HDL), C-reactive protein, pro-inflammatory immune markers (e.g., TNFa, IL-1, IL-6) and a Th2 shift of immunity [27–30]. All these stress biomarkers have been also correlated with poor sleep fatigue, morning fatigue and poor psychomotor performance [24,29,31]. Interestingly, good health ratings are favoured by high social support, self-esteem and sense of coherence that buffer the detrimental effects of excessive stress [28]. This study has a number of limitations. Firstly, the cross-sectional design hampers causality inference. Secondly, measurements are self-reports, thus subject to information and recall bias. Seasonal variation in responses during the three-year period of the study may further contribute to information bias. Thirdly, we have used simple questions to address complex factors such as religiosity which is an inclusive variable, integrating not only praying and church attendance but also psychosocial variables pertinent to social networks and social recourses or support. In that way, validity of our measurements may be impaired. For this reason, adding spirituality measurements could be a suitable choice for future studies. On the other hand, it is advantageous for this rural survey that our sample was representative across all the communities studied and included a very large proportion (37.05%) of the total population of Tripoli — A region of the Peloponnese — (census 2001). Conclusively, the results of the present and previous studies concur that health status and lifestyle factors are main determinants of SRH in rural populations such as this in Greece. Future studies, should extend research on the role of biological pathogenetic processes and biomarkers on SRH, which could validate the interoception hypothesis mentioned in the introduction. Stress psychology and neuroendocrinology research may pose a new turning point not only of SRH research, but also of public health conceptualization. We would like to thank all health professionals that helped us in data collection. The authors declare no conflict of interest. The study was funded by Georgoulio Foundation, Tegea, Greece. Acknowledgments Conflict of Interest Funding Ethical approval The study was ethically and methodologically approved by The Research Committee of the Technological and Educational Institute of Athens.