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The importance of correcting for health-related survey non-response when estimating health expectancies: Evidence from The HUNT Study

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  • Fred Schroyen

    (Norges Handelshøyskole)

Abstract

Background: Most studies on health expectancies rely on self-reported health from surveys to measure the prevalence of disabilities or ill health in a population. At best, such studies only correct for sample selection based on a limited number of characteristics observed on the invitees. Objective: Using longitudinal data from the Trøndelag Health Study (HUNT), I investigate the extent to which adjustments for a health-related sample selection affect the age profiles for the prevalence of functional impairment (FI) and the associated disability-free life expectancy (DFLE). Methods: I estimate a probit model with sample selection under the identifying restriction that the strength of the health-related selection is of similar order to the strength of the selection on observable characteristics. I then compute the selection-adjusted FI prevalence rates and trace out the implications for DFLE using the Sullivan method. Results: The analysis confirms that poor health measured at younger ages correlates with nonresponse behaviour in later waves of the survey, and that even for a conservative lower bound for the assumed degree of health-related selection, the estimated age profiles for DFLE lie systematically below the corresponding profiles when controlling only for selection on observable characteristics. Conclusions: Health related non-response downwardly biases the raw sample prevalence rates for FI obtained from survey data and contributes to overestimating the expansion in DFLE. Contribution: I present a statistical framework for taking health-related survey non-responses into account when estimating the prevalence rate of FI. The framework can be used to gauge the sensitivity of estimated (changes in) DFLE to health-related sample selection.

Suggested Citation

  • Fred Schroyen, 2024. "The importance of correcting for health-related survey non-response when estimating health expectancies: Evidence from The HUNT Study," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 50(25), pages 667-732.
  • Handle: RePEc:dem:demres:v:50:y:2024:i:25
    DOI: 10.4054/DemRes.2024.50.25
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    References listed on IDEAS

    as
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    More about this item

    Keywords

    healthy life expectancy; functional impairment risk; functionally impaired life expectancy; disability-free life expectancy; attrition; sample selection; inverse-probability weighting; the HUNT Study;
    All these keywords.

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • Z0 - Other Special Topics - - General

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