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Measurement of Health, the Sensitivity of the Concentration Index, and Reporting Heterogeneity

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Author Info
Nicolas R. Ziebarth

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Abstract

Using representative survey data from the German Socio-Economic Panel Study (SOEP) for 2006, we show that the magnitude of such health inequality measures as the concentration index (CI) depends crucially on the underlying health measure. The highest degree of inequality is found when dichotomized subjective health measures like health satisfaction or self-assessed health (SAH) are employed. Measures of medical care usage like doctor visits result in substantially lower concentration indices. Moreover, with the use of SF12, a generic health measure, the inequality indicator is reduced by a factor of ten. Scaling SAH by means of the SF12 leads to similar results to those with the pure SF12 measure. Employing generic health measures used with other populations like the Canadian HUI-III or the Finish 15D to cardinalize SAH has a significant impact on the degree of inequality measured. Finally, by contrasting the physical health component of the SF12 to the unambiguously objective grip strength measure, we provide evidence of the presence of income-related reporting heterogeneity in generic health measures.

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File URL: http://www.diw.de/documents/publikationen/73/diw_02.c.298946.de/dp916.pdf
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Paper provided by DIW Berlin, German Institute for Economic Research in its series Discussion Papers of DIW Berlin with number 916.

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Length: 39 p.
Date of creation: 2009
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Handle: RePEc:diw:diwwpp:dp916

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Related research
Keywords: health measures; health inequality; SF12; grip strength; German Socio-Economic Panel Study (SOEP);

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Find related papers by JEL classification:
D30 - Microeconomics - - Distribution - - - General
D31 - Microeconomics - - Distribution - - - Personal Income and Wealth Distribution
D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
I10 - Health, Education, and Welfare - - Health - - - General
I12 - Health, Education, and Welfare - - Health - - - Health Production

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  1. Magnus Lindelow, 2006. "Sometimes more equal than others: how health inequalities depend on the choice of welfare indicator," Health Economics, John Wiley & Sons, Ltd., vol. 15(3), pages 263-279. [Downloadable!]
  2. 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. [Downloadable!] (restricted)
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  3. Fabrice Etilé & Carine Milcent, 2006. "Income-related reporting heterogeneity in self-assessed health: evidence from France," PSE Working Papers 2006-09, PSE (Ecole normale supérieure). [Downloadable!]
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  4. 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). [Downloadable!] (restricted)
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  5. Eddy van Doorslaer & Xander Koolman, 2004. "Explaining the differences in income-related health inequalities across European countries," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 609-628. [Downloadable!]
  6. 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. [Downloadable!] (restricted)
  7. 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. [Downloadable!] (restricted)
  8. Hendrik Jürges, 2007. "True health vs response styles: exploring cross-country differences in self-reported health," Health Economics, John Wiley & Sons, Ltd., vol. 16(2), pages 163-178. [Downloadable!]
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  9. Erreygers, Guido, 2009. "Correcting the Concentration Index," Journal of Health Economics, Elsevier, vol. 28(2), pages 504-515, March. [Downloadable!] (restricted)
  10. Adam Wagstaff & Naoko Watanabe, 2003. "What difference does the choice of SES make in health inequality measurement?," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 885-890. [Downloadable!]
  11. Adam Wagstaff, 2005. "The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 429-432. [Downloadable!]
  12. JØrgen Lauridsen & Terkel Christiansen & Jens Gundgaard & Unto Häkkinen & Harri Sintonen, 2007. "Decomposition of health inequality by determinants and dimensions," Health Economics, John Wiley & Sons, Ltd., vol. 16(1), pages 97-102. [Downloadable!]
  13. Hendrik Jürges, 2008. "Self-assessed health, reference levels and mortality," Applied Economics, Taylor and Francis Journals, vol. 40(5), pages 569-582. [Downloadable!] (restricted)
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