Background: The older adult population is expected to grow, presenting potential challenges for individuals and society. Maintenance of older adults' health will be an important factor for healthy aging. It will also be a challenge for health professionals who work to promote health and care equity. To promote healthy aging and equal care, an overview of older adults' self-rated health is needed. The aim of this study was to describe self rated health among older adults' living at home describe age group and gender-based health differences.Methods: A descriptive and a comparative cross-sectional study. The questionnaire study was part of a Swedish national population study. Randomly selected older adults 65-84 years living in five counties in central Sweden. The response rates were 79% and 75% for those 65-79 years and 80-84 years, respectively. Participants (n = 13922) were divided into two age groups: 65-79 years (n = 5926 male, n = 5755 female) and 80-84 years (n = 1208 male. n = 1033 female).Results: Older adults generally self -rated their health as good, especially in the age group aged 65-79 years. Females self-rated their health as poorer than males, especially among those aged 65-79 years. Gender-based health differences decreased in those aged 80-84 years.Conclusions: It is important to address these gender -based health differences; health policies and programmes are needed that promote equitable healthy aging.