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How Survey Design Affects Inference Regarding Health Perceptions and Outcomes

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  • Anneke Exterkate
  • Robin L. Lumsdaine
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    Abstract

    This paper considers the role of survey design and question phrasing in evaluating the subjective health assessment responses using the Survey of Health, Ageing and Retirement in Europe (SHARE) dataset. A unique feature of this dataset is that respondents were twice asked during the survey to evaluate their health on a five-point scale, using two different sets of descriptors to define the five points, with the ordering of which set was first given determined randomly. We find no evidence to refute the assertion that the order was determined by random assignment. Yet we document differences in the response distributions between the two questions, as well as differences in inference in comparing the two populations (those that were asked one question first versus those that were asked the other). We then consider determinants of the degree of concordance between the two questions, as well as the determinants of individuals that provide conflicting responses. There appears to be evidence to suggest that individuals’ assessments of their health in response to the second question may be influenced by the battery of health questions that were asked following the first assessment. We find that information in self-assessed health responses is useful in examining health outcomes. Our results suggest that adjusting such responses to take into account framing and sequencing of questions may improve inference. In addition, we show that accounting for survey design may be important in models for predicting outcomes of interest, such as the probability of a major health event.

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    File URL: http://www.nber.org/papers/w17244.pdf
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    Bibliographic Info

    Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 17244.

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    Date of creation: Jul 2011
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    Publication status: published as "How Survey Design Affects Self-Assessed Health Responses in the Survey of Health, Ageing, and Retirement in Europe (SHARE)," European Economic Review, 63, pp. 299-307, 2013[with Anneke Exterkate].
    Handle: RePEc:nbr:nberwo:17244

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    1. Erik Meijer & Arie Kapteyn & Tatiana Andreyeva, 2008. "Health Indexes and Retirement Modeling in International Comparisons," Working Papers 614, RAND Corporation Publications Department.
    2. Moum, Torbjo–rn, 1992. "Self-assessed health among Norwegian adults," Social Science & Medicine, Elsevier, vol. 35(7), pages 935-947, October.
    3. Cristina Hernández-Quevedo & Andrew M Jones & Nigel Rice, 2005. "Reporting bias and heterogeneity in selfassessed health. Evidence from the British Household Panel Survey," Health, Econometrics and Data Group (HEDG) Working Papers 05/04, HEDG, c/o Department of Economics, University of York.
    4. 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.
    5. Agar Brugiavini & Tullio Jappelli & Guglielmo Weber, 2002. "The Survey on Health, Aging and Wealth," CSEF Working Papers 86, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy.
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