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Misreporting and misclassification: implications for socioeconomic disparities in body-mass index and obesity

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  • Åsa Ljungvall
  • Ulf Gerdtham
  • Ulf Lindblad

Abstract

Body-mass index (BMI) has become the standard proxy for obesity in social science research. This study deals with the potential problems related to, first, relying on self-reported weight and height to calculate BMI (misreporting), and, second, the concern that BMI is a deficient measure of body fat (misclassification). Using a regional Swedish sample, we analyze whether socioeconomic disparities in BMI are biased because of misreporting, and whether socioeconomic disparities in the risk of obesity are sensitive to whether BMI or waist circumference is used to define obesity. Education and income are used as socioeconomic indicators. The overall conclusion is that misreporting and misclassification may indeed matter for estimated educational and income disparities in BMI and obesity. In the misreporting part we find that women with higher education misreport less than those with lower education, leading to underestimation of the education disparity when using self-reported information. In the misclassification part we find that the probability of being misclassified decreases with income, for both men and women. Among women, the consequence is a steeper income gradient when obesity is defined using waist circumference instead of BMI. Among men the income gradient is statistically insignificant irrespective of how obesity is defined, but when estimating the probability of obesity defined by waist circumference, an educational gradient, which is not present when classifying men using BMI, arises. Copyright The Author(s) 2015

Suggested Citation

  • Åsa Ljungvall & Ulf Gerdtham & Ulf Lindblad, 2015. "Misreporting and misclassification: implications for socioeconomic disparities in body-mass index and obesity," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(1), pages 5-20, January.
    • Handle: RePEc:spr:eujhec:v:16:y:2015:i:1:p:5-20
    DOI: 10.1007/s10198-013-0545-5
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    Cited by:

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    2. Davillas, A.; Jones, A.M.; Benzeval, M.;, 2017. "The income-health gradient: Evidence from self-reported health and biomarkers using longitudinal data on income," Health, Econometrics and Data Group (HEDG) Working Papers 17/04, HEDG, c/o Department of Economics, University of York.
    3. 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.
    4. Dackehag, Margareta & Ellegård, Lina Maria & Gerdtham, Ulf-G & Nilsson, Therese, 2018. "Social Assistance and Mental Health: Evidence from Longitudinal Data on Pharmaceutical Consumption," Working Papers 2018:2, Lund University, Department of Economics.
    5. Dackehag, Margareta & Ellegård, Lina Maria & Gerdtham, Ulf-G. & Nilsson, Therese, 2016. "Day-to-Day Living Expenses and Mental Health," Working Papers 2016:19, Lund University, Department of Economics.
    6. Persson, Sofie & Gerdtham, Ulf-G. & Steen Carlsson, Katarina, 2016. "Labor market consequences of childhood onset type 1 diabetes," Economics & Human Biology, Elsevier, vol. 23(C), pages 180-192.
    7. Harris, Matthew C., 2017. "Imperfect information on physical activity and caloric intake," Economics & Human Biology, Elsevier, vol. 26(C), pages 112-125.
    8. Davillas, Apostolos & Benzeval, Michaela, 2016. "Alternative measures to BMI: Exploring income-related inequalities in adiposity in Great Britain," Social Science & Medicine, Elsevier, vol. 166(C), pages 223-232.

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    More about this item

    Keywords

    Misreporting; Misclassification; BMI; Obesity; Waist circumference; Education; Income; C18; I12; I14;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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