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Self‐reported health: reliability and consequences for health inequality measurement

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  • Philip M. Clarke
  • Chris Ryan

Abstract

Self‐reported health (SRH) is one of the most frequently employed measures for assessing income‐related health inequalities between counties. A previous study has shown that 28% of respondents changed their assessment of their health status when asked a SRH question on two occasions in the same survey (first as part of self‐completed questionnaire and then in a personal interview). This study re‐examines this issue using another survey where SRH was again asked twice of respondents, but this time the personal interview was first and self‐completion second. We find the same variation in responses, but the predominant direction is away from the ‘extreme’ categories ‘Excellent’ and ‘Poor’ which is the opposite direction to the previous study. We therefore conclude that the most likely explanation is a mode of administration effect that makes people less likely to choose the extreme categories in a self‐completion questionnaire, but not a personal interview. However, this effect has a relatively minor impact on measures of inequality. This is due to a large proportion of the movement (i.e. movement to the middle) not being related to income and hence does not systematically impact on the cumulative distribution of health across this measure of socio‐economic status. Copyright © 2006 John Wiley & Sons, Ltd.

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  • Philip M. Clarke & Chris Ryan, 2006. "Self‐reported health: reliability and consequences for health inequality measurement," Health Economics, John Wiley & Sons, Ltd., vol. 15(6), pages 645-652, June.
    • Handle: RePEc:wly:hlthec:v:15:y:2006:i:6:p:645-652
    DOI: 10.1002/hec.1089
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    4. Chen, Linkun & Clarke, Philip M. & Petrie, Dennis J. & Staub, Kevin E., 2021. "The effects of self-assessed health: Dealing with and understanding misclassification bias," Journal of Health Economics, Elsevier, vol. 78(C).
    5. Juergen Jung, 2022. "Estimating transition probabilities between health states using US longitudinal survey data," Empirical Economics, Springer, vol. 63(2), pages 901-943, August.
    6. Bautista, María Angélica & González, Felipe & Martinez, Luis R. & Muñoz, Pablo & Prem, Mounu, 2020. "Does Higher Education Reduce Mortality? Evidence from a Natural Experiment in Chile," SocArXiv 5s2px, Center for Open Science.
    7. Roland G. Fryer, Jr, 2013. "Information and Student Achievement: Evidence from a Cellular Phone Experiment," NBER Working Papers 19113, National Bureau of Economic Research, Inc.
    8. Felipe Rivera, 2017. "Health opportunities in Colombia," Lecturas de Economía, Universidad de Antioquia, Departamento de Economía, issue 87, pages 125-164, Julio - D.
    9. Yang, Qingqing & Rosenman, Robert, 2015. "Adjusting Self-Assessed Health for Potential Bias Using a Random-Effects Generalized Ordered Probit model," 2015 AAEA & WAEA Joint Annual Meeting, July 26-28, San Francisco, California 205217, Agricultural and Applied Economics Association.
    10. Lahiri, Kajal & Pulungan, Zulkarnain, 2007. "Income-related health disparity and its determinants in New York state: racial/ethnic and geographical comparisons," MPRA Paper 21694, University Library of Munich, Germany.
    11. Davillas, Apostolos & de Oliveira, Victor Hugo & Jones, Andrew M., 2023. "Is inconsistent reporting of self-assessed health persistent and systematic? Evidence from the UKHLS," Economics & Human Biology, Elsevier, vol. 49(C).
    12. Shu-Hsi Ho, 2016. "A Study of Outpatient Utilization Between Widowers and Widows among the Elderly in Taiwan," Review of Economics & Finance, Better Advances Press, Canada, vol. 6, pages 79-90, February.
    13. Liam Delaney & Pat Wall & Fearghal O'hAodha, 2007. "Social Capital & Self-Rated Health in the Republic of Ireland. Evidence from the European Social Survey," Working Papers 200707, Geary Institute, University College Dublin.
    14. repec:ucn:wpaper:10197/576 is not listed on IDEAS
    15. Kajal Lahiri & Zulkarnain Pulungan, 2006. "Health Inequality and Its Determinants in New York," Discussion Papers 06-03, University at Albany, SUNY, Department of Economics.
    16. Black, Nicole & Johnston, David W. & Shields, Michael A. & Suziedelyte, Agne, 2017. "Who provides inconsistent reports of their health status? The importance of age, cognitive ability and socioeconomic status," Social Science & Medicine, Elsevier, vol. 191(C), pages 9-18.
    17. Black, Nicole & Johnston, David W. & Suziedelyte, Agne, 2017. "Justification bias in self-reported disability: New evidence from panel data," Journal of Health Economics, Elsevier, vol. 54(C), pages 124-134.
    18. Peña-Longobardo, L.M. & Rodríguez-Sánchez, B. & Oliva-Moreno, J., 2021. "The impact of widowhood on wellbeing, health, and care use: A longitudinal analysis across Europe," Economics & Human Biology, Elsevier, vol. 43(C).
    19. Denise Doiron & Glenn Jones & Elizabeth Savage, 2008. "Healthy, wealthy and insured? The role of self‐assessed health in the demand for private health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 317-334, March.
    20. Denise Doiron & Glenn Jones & Elizabeth Savage, 2006. "Healthy, wealthy and insured? The role of self-assessed health in the demand for private health insurance, CHERE Working Paper 2006/2," Working Papers 2006/2, CHERE, University of Technology, Sydney.
    21. Liam Delaney & Patrick G. Wall & Fearghal O'hAodha, 2007. "Social capital and self-rated health in the Republic of Ireland : evidence from the European Social Survey," Open Access publications 10197/574, School of Economics, University College Dublin.
    22. Reisinger, James, 2022. "Subjective well-being and social desirability," Journal of Public Economics, Elsevier, vol. 214(C).
    23. Alejandro Arrieta & Ariadna García Prado & Giota Panopoulou, 2012. "Enrolling the Self-Employed in Mandatory Health Insurance in Colombia: are we missing other factors?," Documentos de Trabajo - Lan Gaiak Departamento de Economía - Universidad Pública de Navarra 1213, Departamento de Economía - Universidad Pública de Navarra.

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