IDEAS home Printed from https://ideas.repec.org/a/eee/ehbiol/v35y2019icp207-221.html
   My bibliography  Save this article

On the measurement of health and its effect on the measurement of health inequality

Author

Listed:
  • Nesson, Erik T.
  • Robinson, Joshua J.

Abstract

We examine the extent to which self-reported health measures suffer from income-related reporting heterogeneity and then characterize how this reporting heterogeneity affects the estimation of income-related health inequality. We run a comprehensive set of tests of reporting heterogeneity using several self-reported health measures and several clinical measures of health from the National Health and Nutritional Examination Surveys. We propose the use of a multidimensional measure using clinical indicators of health in the context of measuring income-related health inequality, and we examine the extent of income-related health inequality, as measured by the concentration index, using both self-reported measures of health and the multidimensional clinical measure. Our results confirm the existence of significant, positive, income-related reporting heterogeneity and also suggest that higher income individuals react more strongly to a change in clinical health measures. Using self-assessed health suggests that income-related health inequality is about three times larger than when using more objective, self-reported health measures and ten times larger than when using the multidimensional clinical measure of health.

Suggested Citation

  • Nesson, Erik T. & Robinson, Joshua J., 2019. "On the measurement of health and its effect on the measurement of health inequality," Economics & Human Biology, Elsevier, vol. 35(C), pages 207-221.
    • Handle: RePEc:eee:ehbiol:v:35:y:2019:i:c:p:207-221
    DOI: 10.1016/j.ehb.2019.07.003
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S1570677X18300637
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.ehb.2019.07.003?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. van Doorslaer, Eddy & Gerdtham, Ulf-G., 2003. "Does inequality in self-assessed health predict inequality in survival by income? Evidence from Swedish data," Social Science & Medicine, Elsevier, vol. 57(9), pages 1621-1629, November.
    2. Erreygers, Guido, 2009. "Correcting the Concentration Index: A reply to Wagstaff," Journal of Health Economics, Elsevier, vol. 28(2), pages 521-524, March.
    3. Makdissi, Paul & Yazbeck, Myra, 2014. "Measuring socioeconomic health inequalities in presence of multiple categorical information," Journal of Health Economics, Elsevier, vol. 34(C), pages 84-95.
    4. Frijters, Paul & Ulker, Aydogan, 2008. "Robustness in health research: Do differences in health measures, techniques, and time frame matter?," Journal of Health Economics, Elsevier, vol. 27(6), pages 1626-1644, December.
    5. Deaton, Angus S & Paxson, Christina H, 1998. "Aging and Inequality in Income and Health," American Economic Review, American Economic Association, vol. 88(2), pages 248-253, May.
    6. Paul Contoyannis & Andrew M. Jones & Nigel Rice, 2004. "The dynamics of health in the British Household Panel Survey," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 19(4), pages 473-503.
    7. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications - Books, The World Bank Group, number 6896, December.
    8. Johnston, David W. & Propper, Carol & Shields, Michael A., 2009. "Comparing subjective and objective measures of health: Evidence from hypertension for the income/health gradient," Journal of Health Economics, Elsevier, vol. 28(3), pages 540-552, May.
    9. 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.
    10. Anna Choi & John Cawley, 2018. "Health disparities across education: The role of differential reporting error," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 1-29, March.
    11. Fernández-Val, Iván & Savchenko, Yevgeniya & Vella, Francis, 2017. "Evaluating the role of income, state dependence and individual specific heterogeneity in the determination of subjective health assessments," Economics & Human Biology, Elsevier, vol. 25(C), pages 85-98.
    12. Shmueli, Amir, 2003. "Socio-economic and demographic variation in health and in its measures: the issue of reporting heterogeneity," Social Science & Medicine, Elsevier, vol. 57(1), pages 125-134, July.
    13. Humphries, Karin H. & van Doorslaer, Eddy, 2000. "Income-related health inequality in Canada," Social Science & Medicine, Elsevier, vol. 50(5), pages 663-671, March.
    14. Teresa Bago d'Uva & Eddy Van Doorslaer & Maarten Lindeboom & Owen O'Donnell, 2008. "Does reporting heterogeneity bias the measurement of health disparities?," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 351-375, March.
    15. Nicolas R. Ziebarth, 2009. "Measurement of Health, the Sensitivity of the Concentration Index, and Reporting Heterogeneity," SOEPpapers on Multidisciplinary Panel Data Research 211, DIW Berlin, The German Socio-Economic Panel (SOEP).
    16. Wagstaff, Adam, 2002. "Inequality aversion, health inequalities and health achievement," Journal of Health Economics, Elsevier, vol. 21(4), pages 627-641, July.
    17. Adam Wagstaff & Eddy Van Doorslaer, 1994. "Measuring inequalities in health in the presence of multiple‐category morbidity indicators," Health Economics, John Wiley & Sons, Ltd., vol. 3(4), pages 281-291, July.
    18. Lindeboom, Maarten & van Doorslaer, Eddy, 2004. "Cut-point shift and index shift in self-reported health," Journal of Health Economics, Elsevier, vol. 23(6), pages 1083-1099, November.
    19. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February.
    20. Geronimus, A.T. & Hicken, M. & Keene, D. & Bound, J., 2006. ""Weathering" and age patterns of allostatic load scores among blacks and whites in the United States," American Journal of Public Health, American Public Health Association, vol. 96(5), pages 826-833.
    21. Zhang, Qi & Wang, Youfa, 2004. "Socioeconomic inequality of obesity in the United States: do gender, age, and ethnicity matter?," Social Science & Medicine, Elsevier, vol. 58(6), pages 1171-1180, March.
    22. Layes, Audrey & Asada, Yukiko & Kephart, George, 2012. "Whiners and deniers – What does self-rated health measure?," Social Science & Medicine, Elsevier, vol. 75(1), pages 1-9.
    23. M. Dolores Montoya Diaz, 2002. "Socio‐economic health inequalities in Brazil: gender and age effects," Health Economics, John Wiley & Sons, Ltd., vol. 11(2), pages 141-154, March.
    24. Doorslaer, Eddy van & Jones, Andrew M., 2003. "Inequalities in self-reported health: validation of a new approach to measurement," Journal of Health Economics, Elsevier, vol. 22(1), pages 61-87, January.
    25. Wagstaff, Adam & van Doorslaer, Eddy & Watanabe, Naoko, 2003. "On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam," Journal of Econometrics, Elsevier, vol. 112(1), pages 207-223, January.
    26. Mossey, J.M. & Shapiro, E., 1982. "Self-rated health: a predictor of mortality among the elderly," American Journal of Public Health, American Public Health Association, vol. 72(8), pages 800-808.
    27. Alkire, Sabina & Foster, James, 2011. "Counting and multidimensional poverty measurement," Journal of Public Economics, Elsevier, vol. 95(7), pages 476-487.
    28. Udo Schneider & Christian Pfarr & Brit Schneider & Volker Ulrich, 2012. "I feel good! Gender differences and reporting heterogeneity in self-assessed health," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(3), pages 251-265, June.
    29. Wagstaff, Adam & Paci, Pierella & van Doorslaer, Eddy, 1991. "On the measurement of inequalities in health," Social Science & Medicine, Elsevier, vol. 33(5), pages 545-557, January.
    30. Pedro Rosa Dias, 2009. "Inequality of opportunity in health: evidence from a UK cohort study," Health Economics, John Wiley & Sons, Ltd., vol. 18(9), pages 1057-1074, September.
    31. Kakwani, Nanok C, 1977. "Measurement of Tax Progressivity: An International Comparison," Economic Journal, Royal Economic Society, vol. 87(345), pages 71-80, March.
    32. Hirschberg, Joseph G. & Maasoumi, Esfandiar & Slottje, Daniel J., 1991. "Cluster analysis for measuring welfare and quality of life across countries," Journal of Econometrics, Elsevier, vol. 50(1-2), pages 131-150, October.
    33. Alain Trannoy & Sandy Tubeuf & Florence Jusot & Marion Devaux, 2010. "Inequality of opportunities in health in France: a first pass," Health Economics, John Wiley & Sons, Ltd., vol. 19(8), pages 921-938, August.
    34. Jenkins, Stephen, 1988. "Calculating Income Distribution Indices From Micro-Data," National Tax Journal, National Tax Association;National Tax Journal, vol. 41(1), pages 139-142, March.
    35. William H. Greene & Mark N. Harris & Bruce Hollingsworth, 2015. "Inflated Responses in Measures of Self-Assessed Health," American Journal of Health Economics, MIT Press, vol. 1(4), pages 461-493, Fall.
    36. Joseph G. Hirschberg & Esfandiar Maasoumi & Daniel J. Slottje, 2001. "Clusters of attributes and well-being in the USA," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 16(3), pages 445-460.
    37. Groot, Wim, 2000. "Adaptation and scale of reference bias in self-assessments of quality of life," Journal of Health Economics, Elsevier, vol. 19(3), pages 403-420, May.
    38. Matthew C. Harris & Jennifer L. Kohn, 2018. "Reference Health and the Demand for Medical Care," Economic Journal, Royal Economic Society, vol. 128(615), pages 2812-2842, November.
    39. Crossley, Thomas F. & Kennedy, Steven, 2002. "The reliability of self-assessed health status," Journal of Health Economics, Elsevier, vol. 21(4), pages 643-658, July.
    40. John Bound, 1991. "Self-Reported Versus Objective Measures of Health in Retirement Models," Journal of Human Resources, University of Wisconsin Press, vol. 26(1), pages 106-138.
    41. Vincenzo Carrieri & Andrew M. Jones, 2017. "The Income–Health Relationship ‘Beyond the Mean’: New Evidence from Biomarkers," Health Economics, John Wiley & Sons, Ltd., vol. 26(7), pages 937-956, July.
    42. Paul Makdissi & Myra Yazbeck, 2017. "Robust rankings of socioeconomic health inequality using a categorical variable," Health Economics, John Wiley & Sons, Ltd., vol. 26(9), pages 1132-1145, September.
    43. Jennifer L Kohn, 2012. "What is Health? A Multiple Correspondence Health Index," Eastern Economic Journal, Palgrave Macmillan;Eastern Economic Association, vol. 38(2), pages 223-250.
    44. Ziebarth, Nicolas, 2010. "Measurement of health, health inequality, and reporting heterogeneity," Social Science & Medicine, Elsevier, vol. 71(1), pages 116-124, July.
    45. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March.
    46. repec:dau:papers:123456789/268 is not listed on IDEAS
    47. Makdissi, Paul & Sylla, Daouda & Yazbeck, Myra, 2013. "Decomposing health achievement and socioeconomic health inequalities in presence of multiple categorical information," Economic Modelling, Elsevier, vol. 35(C), pages 964-968.
    48. Kakwani, Nanak & Wagstaff, Adam & van Doorslaer, Eddy, 1997. "Socioeconomic inequalities in health: Measurement, computation, and statistical inference," Journal of Econometrics, Elsevier, vol. 77(1), pages 87-103, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Olsen, Jan Abel & Lindberg, Marie Hella & Lamu, Admassu Nadew, 2020. "Health and wellbeing in Norway: Population norms and the social gradient," Social Science & Medicine, Elsevier, vol. 259(C).
    2. Davillas, Apostolos & Pudney, Stephen, 2020. "Biomarkers, disability and health care demand," Economics & Human Biology, Elsevier, vol. 39(C).
    3. Davillas, Apostolos & Jones, Andrew M, 2020. "Ex ante inequality of opportunity in health, decomposition and distributional analysis of biomarkers," Journal of Health Economics, Elsevier, vol. 69(C).
    4. Peng Nie & Andrew E. Clarck & Conchita D'Ambrosio & Lanlin Ding, 2020. "Income-related health inequality in urban China (1991-2015): The role of homeownership and housing conditions," Working Papers 524, ECINEQ, Society for the Study of Economic Inequality.
    5. 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).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Costa-Font, Joan & Hernández-Quevedo, Cristina, 2012. "Measuring inequalities in health: What do we know? What do we need to know?," Health Policy, Elsevier, vol. 106(2), pages 195-206.
    2. David Cantarero & Marta Pascual & Jose Maria Sarabia, 2004. "Can income inequality contribute to understand inequalities in health? An empirical approach based on the European Community Household Panel," ERSA conference papers ersa04p230, European Regional Science Association.
    3. Fabrice Etilé & Carine Milcent, 2006. "Income‐related reporting heterogeneity in self‐assessed health: evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 965-981, September.
    4. 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).
    5. Ziebarth, Nicolas, 2010. "Measurement of health, health inequality, and reporting heterogeneity," Social Science & Medicine, Elsevier, vol. 71(1), pages 116-124, July.
    6. Paul Makdissi & Myra Yazbeck, 2017. "Robust rankings of socioeconomic health inequality using a categorical variable," Health Economics, John Wiley & Sons, Ltd., vol. 26(9), pages 1132-1145, September.
    7. Juergen Jung, 2022. "Estimating transition probabilities between health states using US longitudinal survey data," Empirical Economics, Springer, vol. 63(2), pages 901-943, August.
    8. Philip Clarke & Tom Van Ourti, 2009. "Correcting the Bias in the Concentration Index when Income is Grouped," CEPR Discussion Papers 599, Centre for Economic Policy Research, Research School of Economics, Australian National University.
    9. H. Eme Ichoku & William Fonta & Michael Thiede, 2011. "Socioeconomic gradients in self-rated health: a developing country case study of Enugu State, Nigeria," Economic Change and Restructuring, Springer, vol. 44(3), pages 179-202, August.
    10. Van Ourti, Tom & van Doorslaer, Eddy & Koolman, Xander, 2009. "The effect of income growth and inequality on health inequality: Theory and empirical evidence from the European Panel," Journal of Health Economics, Elsevier, vol. 28(3), pages 525-539, May.
    11. Tom Van Ourti & Eddy Van Doorslaer & Xander Koolman, 2006. "The Effect of Growth and Inequality in Incomes on Health Inequality: Theory and Empirical Evidence from the European Panel," Tinbergen Institute Discussion Papers 06-108/3, Tinbergen Institute.
    12. Martin Siegel & Karl Mosler, 2014. "Semiparametric Modeling Of Age‐Specific Variations In Income Related Health Inequalities," Health Economics, John Wiley & Sons, Ltd., vol. 23(7), pages 870-878, July.
    13. FLEURBAEY, Marc & SCHOKKAERT, Erik, 2011. "Equity in health and health care," LIDAM Discussion Papers CORE 2011026, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    14. Qing Li & Alain A. Cohen & Linda P. Fried, 2017. "A novel health metric based on biomarkers," Cahiers de recherche 17-08, Departement d'économique de l'École de gestion à l'Université de Sherbrooke.
    15. Hajizadeh, Mohammad & Hu, Min & Bombay, Amy & Asada, Yukiko, 2018. "Socioeconomic inequalities in health among Indigenous peoples living off-reserve in Canada: Trends and determinants," Health Policy, Elsevier, vol. 122(8), pages 854-865.
    16. Clarke, Philip & Van Ourti, Tom, 2010. "Calculating the concentration index when income is grouped," Journal of Health Economics, Elsevier, vol. 29(1), pages 151-157, January.
    17. Cinzia Di Novi & Anna Marenzi & Dino Rizzi, 2018. "Do healthcare tax credits help poor-health individuals on low incomes?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 293-307, March.
    18. van Kippersluis, Hans & Van Ourti, Tom & O'Donnell, Owen & van Doorslaer, Eddy, 2009. "Health and income across the life cycle and generations in Europe," Journal of Health Economics, Elsevier, vol. 28(4), pages 818-830, July.
    19. Johnston, David W. & Propper, Carol & Shields, Michael A., 2009. "Comparing subjective and objective measures of health: Evidence from hypertension for the income/health gradient," Journal of Health Economics, Elsevier, vol. 28(3), pages 540-552, May.
    20. Kajal Lahiri & Zulkarnain Pulungan, 2006. "Health Inequality and Its Determinants in New York," Discussion Papers 06-03, University at Albany, SUNY, Department of Economics.

    More about this item

    Keywords

    Health inequality; Concentration index; Self-reported health; Self-assessed health; Allostatic load;
    All these keywords.

    JEL classification:

    • C43 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods: Special Topics - - - Index Numbers and Aggregation
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:ehbiol:v:35:y:2019:i:c:p:207-221. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/622964 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.