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

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Author Info
Sandy Tubeuf () (Leeds Institute of Health Sciences, Academic Unit of Health Economics)
Florence Jusot () (IRDES institut for research and information in health economics)
Marion Devaux () (IRDES institut for research and information in health economics)
Catherine Sermet () (IRDES institut for research and information in health economics)

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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.

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File URL: http://www.irdes.fr/EspaceAnglais/Publications/WorkingPapers/DT12SocialHeterogeSelfReportHealthStatus.pdf
File Format: application/pdf
File Function: First version, 2008
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Publisher Info
Paper provided by IRDES institut for research and information in health economics in its series Working Papers with number DT12.

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Length: 25 pages
Date of creation: Jun 2008
Date of revision: Jun 2008
Handle: RePEc:irh:wpaper:dt12

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Related research
Keywords: inequalities in health - MIMIC - reporting bias - structural equations;

Find related papers by JEL classification:
C51 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Model Construction and Estimation
I10 - Health, Education, and Welfare - - Health - - - General

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References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Sandy Tubeuf & Marc Perronnin, 2008. "New prospects in the analysis of inequalities in health: a measurement of health encompassing several dimensions of health," Health, Econometrics and Data Group (HEDG) Working Papers 08/01, HEDG, c/o Department of Economics, University of York. [Downloadable!]
  2. 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!]
  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. [Downloadable!]
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