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Social heterogeneity in self-reported health status and measurement of inequalities in health

Author

Listed:
  • Sandy Tubeuf

    (Leeds Institute of Health Sciences, Academic Unit of Health Economics)

  • Florence Jusot

    (IRDES Institute for research and information in health economics)

  • Marion Devaux

    (IRDES Institute for research and information in health economics)

  • Catherine Sermet

    (IRDES Institute for research and information in health economics)

Abstract

This study aims to analyse the impact of the measurement of health status on socioeconomic inequalities in health. A MIMIC model with structural equations is used to create a latent variable of health status from four health indicators: self-assessed health, report of chronic diseases, report of activity limitations and mental health. Then, we disentangle the impact of sociodemographic characteristics on latent health from their direct impact on each heath indicator and discuss their effects on the assessment of socioeconomic inequalities in health. This study emphasises differences in inequalities in health according to latent health. In addition, it suggests the existence of reporting heterogeneity biases. For a given latent health status, women and old people are more likely to report chronic diseases. Mental health problems are over-reported by women and isolated people and under-reported by the oldest people. Active and retired people as well as non manual workers in the top of the social hierarchy more often report activity limitations. Finally, highly educated and socially advantaged people more often report chronic diseases whereas less educated people under-report a poor self-assessed health. To conclude, the four health indicators suffer from reporting heterogeneity biases and the report of chronic diseases is the indicator which biases the most the measurement of socioeconomic inequalities in health.

Suggested Citation

  • Sandy Tubeuf & Florence Jusot & Marion Devaux & Catherine Sermet, 2008. "Social heterogeneity in self-reported health status and measurement of inequalities in health," Working Papers DT12, IRDES institut for research and information in health economics, revised Jun 2008.
    • Handle: RePEc:irh:wpaper:dt12
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    File URL: https://www.irdes.fr/EspaceAnglais/Publications/WorkingPapers/DT12SocialHeterogeSelfReportHealthStatus.pdf
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    References listed on IDEAS

    as
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    Cited by:

    1. Or, Zeynep & Cases, Chantal & Lisac, Melanie & Vrangbæk, Karsten & Winblad, Ulrika & Bevan, Gwyn, 2010. "Are health problems systemic? Politics of access and choice under Beveridge and Bismarck systems," Health Economics, Policy and Law, Cambridge University Press, vol. 5(3), pages 269-293, July.
    2. Eve Caroli & Mathilde Godard, 2016. "Does job insecurity deteriorate health?," Health Economics, John Wiley & Sons, Ltd., vol. 25(2), pages 131-147, February.
    3. Emmanuelle Cambois & Caroline Laborde & Isabelle Romieu & Jean-Marie Robine, 2011. "Occupational inequalities in health expectancies in France in the early 2000s: Unequal chances of reaching and living retirement in good health," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 25(12), pages 407-436.
    4. Florence Jusot & Sabine Mage & Marta Menendez, 2014. "Inequality of Opportunity in Health in Indonesia," Working Papers DT/2014/06, DIAL (Développement, Institutions et Mondialisation).
    5. Eve Caroli & Mathilde Godard, 2013. "Does Job Insecurity Deteriorate Health ? A Causal Approach for Europe," Working Papers 2013-13, Center for Research in Economics and Statistics.
    6. Marion Devaux, 2015. "Income-related inequalities and inequities in health care services utilisation in 18 selected OECD countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(1), pages 21-33, January.
    7. María Noel Pi Alperin, 2016. "A multidimensional approach to measure health," Economics Bulletin, AccessEcon, vol. 36(3), pages 1553-1568.
    8. DEUTSCH Joseph & PI ALPERIN Maria Noel & SILBER Jacques, 2016. "Disentangling the impacts of circumstances and efforts on health inequality: the case of Luxembourg," LISER Working Paper Series 2016-07, Luxembourg Institute of Socio-Economic Research (LISER).
    9. Thierry Debrand & Nicolas Sirven, 2009. "What are the Motivations of Pathways to Retirement in Europe: Individual, Familial, Professional Situation or Social Protection Systems?," Working Papers DT28, IRDES institut for research and information in health economics, revised Oct 2009.
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    11. Caroli, Eve & Weber-Baghdiguian, Lexane, 2016. "Self-reported health and gender: The role of social norms," Social Science & Medicine, Elsevier, vol. 153(C), pages 220-229.
    12. Nunzia Nappo, 2019. "Is there an association between working conditions and health? An analysis of the Sixth European Working Conditions Survey data," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-15, February.
    13. repec:dau:papers:123456789/13753 is not listed on IDEAS
    14. Dourgnon, Paul, 2013. "Evaluation des politiques publiques et inégalités sociales d'accès aux services de santé," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/12221 edited by Wittwer, Jérôme.
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    16. Emmanuelle Cambois & Aïda Solé-Auró & Jean-Marie Robine, 2019. "Gender Differences in Disability and Economic Hardship in Older Europeans," European Journal of Population, Springer;European Association for Population Studies, vol. 35(4), pages 777-793, October.
    17. Joseph Deutsch & María Noel Pi Alperin & Jacques Silber, 2018. "Using the Shapley Decomposition to Disentangle the Impact of Circumstances and Efforts on Health Inequality," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 138(2), pages 523-543, July.

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    More about this item

    Keywords

    Inequalities in health; MIMIC; reporting bias; structural equations;
    All these keywords.

    JEL classification:

    • C51 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Model Construction and Estimation
    • I10 - Health, Education, and Welfare - - Health - - - General

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