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Health Disparities Across Education: The Role of Differential Reporting Error

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  • John Cawley
  • Anna Choi

Abstract

One of the most robust findings in health economics is that higher-educated individuals tend to be in better health. This paper tests whether health disparities across education are to some extent due to differences in reporting error across education. We test this hypothesis using data from the pooled National Health and Nutrition Examination Survey (NHANES) Continuous for 1999-2012, which include both self-reports and objective verification for an extensive set of health behaviors and conditions, including smoking, obesity, high blood pressure, high cholesterol and diabetes. We find that college graduates are more likely to give false negative reports of obesity and high total cholesterol; one possible explanation for this is social desirability bias. However, college graduates are also significantly less likely to give false positive reports of smoking, obesity, high cholesterol, and diabetes. Because there are far more truly negative people (who are less likely to give a false positive report) than truly positive people (who are more likely to give a false negative report), we find that college graduates report their health significantly more accurately overall.

Suggested Citation

  • John Cawley & Anna Choi, 2015. "Health Disparities Across Education: The Role of Differential Reporting Error," NBER Working Papers 21317, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:21317
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    1. Cutler, David M. & Huang, Wei & Lleras-Muney, Adriana, 2015. "When does education matter? The protective effect of education for cohorts graduating in bad times," Social Science & Medicine, Elsevier, vol. 127(C), pages 63-73.
    2. Courtemanche, Charles & Pinkston, Joshua C. & Stewart, Jay, 2015. "Adjusting body mass for measurement error with invalid validation data," Economics & Human Biology, Elsevier, vol. 19(C), pages 275-293.
    3. Philipson, Tomas, 2001. "Data Markets, Missing Data, and Incentive Pay," Econometrica, Econometric Society, vol. 69(4), pages 1099-1111, July.
    4. 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.
    5. Damon Clark & Heather Royer, 2013. "The Effect of Education on Adult Mortality and Health: Evidence from Britain," American Economic Review, American Economic Association, vol. 103(6), pages 2087-2120, October.
    6. Teresa Bago d'Uva & Eddy Van Doorslaer & Maarten Lindeboom & Owen O'Donnell, 2008. "Does reporting heterogeneity bias the measurement of health disparities?," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 351-375, March.
    7. Tomas Philipson, 1997. "Data Markets and the Production of Surveys," Review of Economic Studies, Oxford University Press, vol. 64(1), pages 47-72.
    8. Cullinan, John & Cawley, John, 2017. "Parental misclassification of child overweight/obese status: The role of parental education and parental weight status," Economics & Human Biology, Elsevier, vol. 24(C), pages 92-103.
    9. Mackenbach, J.P. & Looman, C.W.N. & Van Der Meer, J.B.W., 1996. "Differences in the misreporting of chronic conditions, by level of education: The effect on inequalities in prevalence rates," American Journal of Public Health, American Public Health Association, vol. 86(5), pages 706-711.
    10. Suziedelyte, Agne & Johar, Meliyanni, 2013. "Can you trust survey responses? Evidence using objective health measures," Economics Letters, Elsevier, vol. 121(2), pages 163-166.
    11. Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding differences in health behaviors by education," Journal of Health Economics, Elsevier, vol. 29(1), pages 1-28, January.
    12. Justin McCrary & Heather Royer, 2011. "The Effect of Female Education on Fertility and Infant Health: Evidence from School Entry Policies Using Exact Date of Birth," American Economic Review, American Economic Association, vol. 101(1), pages 158-195, February.
    13. Kenkel, Donald S, 1991. "Health Behavior, Health Knowledge, and Schooling," Journal of Political Economy, University of Chicago Press, vol. 99(2), pages 287-305, April.
    14. 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.
    15. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    16. Burgard, Sarah A. & Chen, Patricia V., 2014. "Challenges of health measurement in studies of health disparities," Social Science & Medicine, Elsevier, vol. 106(C), pages 143-150.
    17. Gil, Joan & Mora, Toni, 2011. "The determinants of misreporting weight and height: The role of social norms," Economics & Human Biology, Elsevier, vol. 9(1), pages 78-91, January.
    18. Jaeger, David A & Page, Marianne E, 1996. "Degrees Matter: New Evidence on Sheepskin Effects in the Returns to Education," The Review of Economics and Statistics, MIT Press, vol. 78(4), pages 733-740, November.
    19. Jennifer Beam Dowd & Megan Todd, 2011. "Does Self-reported Health Bias the Measurement of Health Inequalities in U.S. Adults? Evidence Using Anchoring Vignettes From the Health and Retirement Study," Journals of Gerontology: Series B, Gerontological Society of America, vol. 66(4), pages 478-489.
    20. de Walque, Damien, 2007. "Does education affect smoking behaviors?: Evidence using the Vietnam draft as an instrument for college education," Journal of Health Economics, Elsevier, vol. 26(5), pages 877-895, September.
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    Cited by:

    1. Irina Kislaya & Julian Perelman & Hanna Tolonen & Baltazar Nunes, 2019. "Do self-reported data accurately measure health inequalities in risk factors for cardiovascular disease?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(5), pages 721-729, June.
    2. Arni, Patrick & Dragone, Davide & Goette, Lorenz & Ziebarth, Nicolas R., 2021. "Biased health perceptions and risky health behaviors—Theory and evidence," Journal of Health Economics, Elsevier, vol. 76(C).
    3. Cawley, John & Maclean, Johanna Catherine & Sikora Kessler, Asia, 2017. "Reporting error in weight and height among older adults: Implications for estimating healthcare costs," The Journal of the Economics of Ageing, Elsevier, vol. 9(C), pages 122-144.
    4. Cullinan, John & Cawley, John, 2017. "Parental misclassification of child overweight/obese status: The role of parental education and parental weight status," Economics & Human Biology, Elsevier, vol. 24(C), pages 92-103.
    5. Glenn W. Harrison & Andre Hofmeyr & Don Ross & J. Todd Swarthout, 2018. "Risk Preferences, Time Preferences, and Smoking Behavior," Southern Economic Journal, John Wiley & Sons, vol. 85(2), pages 313-348, October.
    6. Chad Cotti & Erik Nesson & Nathan Tefft, 2019. "Impacts of the ACA Medicaid expansion on health behaviors: Evidence from household panel data," Health Economics, John Wiley & Sons, Ltd., vol. 28(2), pages 219-244, February.
    7. Perry Singleton & Ling Li, 2016. "A Framework for Measurement Error in Self-Reported Health Conditions," Center for Policy Research Working Papers 191, Center for Policy Research, Maxwell School, Syracuse University.
    8. Cawley, John & Maclean, Johanna Catherine & Hammer, Mette & Wintfeld, Neil, 2015. "Reporting error in weight and its implications for bias in economic models," Economics & Human Biology, Elsevier, vol. 19(C), pages 27-44.
    9. Nesson, Erik T. & Robinson, Joshua J., 2019. "On the measurement of health and its effect on the measurement of health inequality," Economics & Human Biology, Elsevier, vol. 35(C), pages 207-221.
    10. Glenn W. Harrison, 2017. "Behavioral responses to surveys about nicotine dependence," Health Economics, John Wiley & Sons, Ltd., vol. 26(S3), pages 114-123, December.
    11. Nolan, Anne & Smyth, Emer, 2020. "Clusters of health behaviours among young adults in Ireland," Research Series, Economic and Social Research Institute (ESRI), number RS101, June.
    12. Harris, Matthew C., 2017. "Imperfect information on physical activity and caloric intake," Economics & Human Biology, Elsevier, vol. 26(C), pages 112-125.
    13. Vincenzo Carrieri & Andrew M. Jones, 2017. "The Income–Health Relationship ‘Beyond the Mean’: New Evidence from Biomarkers," Health Economics, John Wiley & Sons, Ltd., vol. 26(7), pages 937-956, July.

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    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I20 - Health, Education, and Welfare - - Education - - - General
    • I24 - Health, Education, and Welfare - - Education - - - Education and Inequality
    • I3 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty

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