IDEAS home Printed from https://ideas.repec.org/a/eee/jhecon/v78y2021ics0167629621000485.html
   My bibliography  Save this article

The effects of self-assessed health: Dealing with and understanding misclassification bias

Author

Listed:
  • Chen, Linkun
  • Clarke, Philip M.
  • Petrie, Dennis J.
  • Staub, Kevin E.

Abstract

Self-assessed health (SAH) is often used in health econometric models as the key explanatory variable or as a control variable. However, there is evidence questioning its test-retest reliability, with up to 30% of individuals changing their response. Building on recent advances in the econometrics of misclassification, we develop a way to consistently estimate and account for misclassification in reported SAH by using data from a large representative longitudinal survey where SAH was elicited twice. From this we gain new insights into the nature of SAH misclassification and its potential for biasing health econometric estimates. The results from applying our approach to nonlinear models of long-term mortality and chronic morbidities reveal that there is substantial heterogeneity in misclassification patterns. We find that adjusting for misclassification is important for estimating the impact of SAH. For other explanatory variables of interest, we find significant but generally small changes to their estimates when SAH misclassification is ignored.

Suggested Citation

  • 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).
    • Handle: RePEc:eee:jhecon:v:78:y:2021:i:c:s0167629621000485
    DOI: 10.1016/j.jhealeco.2021.102463
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0167629621000485
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.jhealeco.2021.102463?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 look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Kevin E. Staub, 2009. "Simple tests for exogeneity of a binary explanatory variable in count data regression models," SOI - Working Papers 0904, Socioeconomic Institute - University of Zurich.
    2. Michael Baker & Mark Stabile & Catherine Deri, 2004. "What Do Self-Reported, Objective, Measures of Health Measure?," Journal of Human Resources, University of Wisconsin Press, vol. 39(4).
    3. Battistin, Erich & De Nadai, Michele & Sianesi, Barbara, 2014. "Misreported schooling, multiple measures and returns to educational qualifications," Journal of Econometrics, Elsevier, vol. 181(2), pages 136-150.
    4. Thomas J. Kane & Cecilia Elena Rouse & Douglas Staiger, 1999. "Estimating Returns to Schooling When Schooling is Misreported," NBER Working Papers 7235, National Bureau of Economic Research, Inc.
    5. Terza, Joseph V. & Basu, Anirban & Rathouz, Paul J., 2008. "Two-stage residual inclusion estimation: Addressing endogeneity in health econometric modeling," Journal of Health Economics, Elsevier, vol. 27(3), pages 531-543, May.
    6. 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.
    7. Denise Doiron & Denzil G. Fiebig & Meliyanni Johar & Agne Suziedelyte, 2015. "Does self-assessed health measure health?," Applied Economics, Taylor & Francis Journals, vol. 47(2), pages 180-194, January.
    8. repec:eee:labchp:v:3:y:1999:i:pc:p:3309-3416 is not listed on IDEAS
    9. Anirban Basu & Norma B. Coe & Cole G. Chapman, 2018. "2SLS versus 2SRI: Appropriate methods for rare outcomes and/or rare exposures," Health Economics, John Wiley & Sons, Ltd., vol. 27(6), pages 937-955, June.
    10. Au, Nicole & Johnston, David W., 2014. "Self-assessed health: What does it mean and what does it hide?," Social Science & Medicine, Elsevier, vol. 121(C), pages 21-28.
    11. Hu, Yingyao, 2008. "Identification and estimation of nonlinear models with misclassification error using instrumental variables: A general solution," Journal of Econometrics, Elsevier, vol. 144(1), pages 27-61, May.
    12. Idler, E.L. & Angel, R.J., 1990. "Self-rated health and mortality in the NHANES-I epidemiologic follow-up study," American Journal of Public Health, American Public Health Association, vol. 80(4), pages 446-452.
    13. Amanda Gosling & Eirini‐Christina Saloniki, 2014. "Correction Of Misclassification Error In Disability Rates," Health Economics, John Wiley & Sons, Ltd., vol. 23(9), pages 1084-1097, September.
    14. McCallum, J. & Shadbolt, B. & Wang, D., 1994. "Self-rated health and survival: A 7-year follow-up study of Australian elderly," American Journal of Public Health, American Public Health Association, vol. 84(7), pages 1100-1105.
    15. 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.
    16. Teresa Bago d'Uva & Maarten Lindeboom & Owen O'Donnell & Eddy van Doorslaer, 2011. "Education‐related inequity in healthcare with heterogeneous reporting of health," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 174(3), pages 639-664, July.
    17. 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.
    18. repec:fth:prinin:419 is not listed on IDEAS
    19. Butler, J S, et al, 1987. "Measurement Error in Self-reported Health Variables," The Review of Economics and Statistics, MIT Press, vol. 69(4), pages 644-650, November.
    20. Susanne M. Schennach, 2016. "Recent Advances in the Measurement Error Literature," Annual Review of Economics, Annual Reviews, vol. 8(1), pages 341-377, October.
    21. Currie, Janet & Madrian, Brigitte C., 1999. "Health, health insurance and the labor market," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 3, chapter 50, pages 3309-3416, Elsevier.
    22. Newey, Whitney K., 1994. "Series Estimation of Regression Functionals," Econometric Theory, Cambridge University Press, vol. 10(1), pages 1-28, March.
    23. 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.
    24. Maarten Lindeboom & Marcel Kerkhofs, 2009. "Health and work of the elderly: subjective health measures, reporting errors and endogeneity in the relationship between health and work," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 24(6), pages 1024-1046.
    25. 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.
    26. Sarah Brown & Mark N. Harris & Preety Srivastava & Xiaohui Zhang, 2018. "Modelling illegal drug participation," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 181(1), pages 133-154, January.
    27. Hu, Yingyao, 2017. "The econometrics of unobservables: Applications of measurement error models in empirical industrial organization and labor economics," Journal of Econometrics, Elsevier, vol. 200(2), pages 154-168.
    28. William Greene & Mark N. Harris & Preety Srivastava & Xueyan Zhao, 2018. "Misreporting and econometric modelling of zeros in survey data on social bads: An application to cannabis consumption," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 372-389, February.
    29. 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.
    30. Thomas J. Kane & Cecilia Rouse & Douglas Staiger, 1999. "Estimating Returns to Schooling When Schooling is Misreported," Working Papers 798, Princeton University, Department of Economics, Industrial Relations Section..
    31. Wooldridge, Jeffrey M., 2014. "Quasi-maximum likelihood estimation and testing for nonlinear models with endogenous explanatory variables," Journal of Econometrics, Elsevier, vol. 182(1), pages 226-234.
    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. Nie, Peng & Wang, Lu & Dragone, Davide & Lu, Haiyang & Sousa-Poza, Alfonso & Ziebarth, Nicolas R., 2022. "“The better you feel, the harder you fall”: Health perception biases and mental health among Chinese adults during the COVID-19 pandemic," China Economic Review, Elsevier, vol. 71(C).
    2. 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. 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).
    2. 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.
    3. 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.
    4. 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.
    5. Roozbei Hosseini & Karen Kopecky & Kai Zhao, 2022. "The Evolution of Health over the Life Cycle," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 45, pages 237-263, July.
    6. Roozbei Hosseini & Karen Kopecky & Kai Zhao, 2022. "The Evolution of Health over the Life Cycle," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 45, pages 237-263, July.
    7. Takahide Yanagi, 2019. "Inference on local average treatment effects for misclassified treatment," Econometric Reviews, Taylor & Francis Journals, vol. 38(8), pages 938-960, September.
    8. Greene, William & Harris, Mark N. & Knott, Rachel & Rice, Nigel, 2023. "Reporting heterogeneity in modeling self-assessed survey outcomes," Economic Modelling, Elsevier, vol. 124(C).
    9. 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.
    10. Gimenez-Nadal, J. Ignacio & Molina, Jose Alberto, 2015. "Health status and the allocation of time: Cross-country evidence from Europe," Economic Modelling, Elsevier, vol. 46(C), pages 188-203.
    11. Datta Gupta, Nabanita & Jürges, Hendrik, 2012. "Do workers underreport morbidity? The accuracy of self-reports of chronic conditions," Social Science & Medicine, Elsevier, vol. 75(9), pages 1589-1594.
    12. Wossen, Tesfamicheal & Abay, Kibrom A. & Abdoulaye, Tahirou, 2022. "Misperceiving and misreporting input quality: Implications for input use and productivity," Journal of Development Economics, Elsevier, vol. 157(C).
    13. Daniel Wilhelm, 2018. "Testing for the presence of measurement error," CeMMAP working papers CWP45/18, Centre for Microdata Methods and Practice, Institute for Fiscal Studies.
    14. Kasahara, Hiroyuki & Shimotsu, Katsumi, 2022. "Identification Of Regression Models With A Misclassified And Endogenous Binary Regressor," Econometric Theory, Cambridge University Press, vol. 38(6), pages 1117-1139, December.
    15. Richard Blundell & Jack Britton & Monica Costa Dias & Eric French, 2023. "The Impact of Health on Labor Supply near Retirement," Journal of Human Resources, University of Wisconsin Press, vol. 58(1), pages 282-334.
    16. Christian vom Lehn & Cache Ellsworth & Zachary Kroff, 2022. "Reconciling Occupational Mobility in the Current Population Survey," Journal of Labor Economics, University of Chicago Press, vol. 40(4), pages 1005-1051.
    17. Emmanuelle Piérard, 2016. "The effect of health care expenditures on self-rated health status and the Health Utility Index: Evidence from Canada," International Journal of Health Economics and Management, Springer, vol. 16(1), pages 1-21, March.
    18. Lixin Cai & Guyonne Kalb, 2007. "Health status and labour force status of older working-age Australian men," Australian Journal of Labour Economics (AJLE), Bankwest Curtin Economics Centre (BCEC), Curtin Business School, vol. 10(4), pages 227-252.
    19. Beni­tez-Silva, Hugo & Ni, Huan, 2008. "Health status and health dynamics in an empirical model of expected longevity," Journal of Health Economics, Elsevier, vol. 27(3), pages 564-584, May.
    20. Francis DiTraglia & Camilo Garcia-Jimeno, 2015. "On Mis-measured Binary Regressors: New Results And Some Comments on the Literature, Third Version," PIER Working Paper Archive 15-040, Penn Institute for Economic Research, Department of Economics, University of Pennsylvania, revised 24 Nov 2015.

    More about this item

    Keywords

    Misreporting; Measurement error; Multinomial regressor; Discrete and limited dependent variables; Subjective health; Mortality; Chronic conditions;
    All these keywords.

    JEL classification:

    • C35 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

    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:jhecon:v:78:y:2021:i:c:s0167629621000485. 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/505560 .

    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.