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Does reporting heterogeneity bias the measurement of health disparities?

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Author Info
Teresa Bago d’Uva
Eddy Van Doorslaer
Maarten Lindeboom
Owen O’Donnell
Somnath Chatterji

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Abstract

Heterogeneity in reporting of health by socio-economic and demographic characteristics potentially biases the measurement of health disparities. Responses to anchoring vignettes have been proposed as a means of identifying reporting heterogeneity. We apply the vignette methodology to data from Indonesia, India and China in order to test for systematic differences in reporting of health by sex, age, urban/rural location, education and income and to establish the sensitivity of estimated disparities in health to the purging of reporting differences. The hypothesis of homogeneous reporting across all socio-demographics is rejected. Homogeneity tends to be most consistently and decisively rejected across urban/rural, income and age differences and less consistently across sex and education groups. In general, younger, male (not Indonesia), better educated (not China) low income and urban respondents display lower health expectations. Correcting for reporting heterogeneity tends to reduce disparities in health by age, sex (not Indonesia), urban/rural and education (not China) and to increase income disparities in health. Overall, while homogeneous reporting is significantly rejected, the results suggest that the size of the reporting bias in measures of health disparities is not large.

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Paper provided by HEDG, c/o Department of Economics, University of York in its series Health, Econometrics and Data Group (HEDG) Working Papers with number 06/03.

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Date of creation: Mar 2006
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Handle: RePEc:yor:hectdg:06/03

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Related research
Keywords: health measurement; vignettes; self-reported health; reporting heterogeneity;

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Find related papers by JEL classification:
D30 - Microeconomics - - Distribution - - - General
D31 - Microeconomics - - Distribution - - - Personal Income and Wealth Distribution
I10 - Health, Education, and Welfare - - Health - - - General
I12 - Health, Education, and Welfare - - Health - - - Health Production

References listed on IDEAS
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  1. Deaton, A., 1998. "Aging and Inequality in Income and Health," Papers 181, Princeton, Woodrow Wilson School - Development Studies.
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  2. Arie Kapteyn & James P. Smith & Arthur van Soest, 2005. "Self-reported Work Disability in the US and The Netherlands," Labor and Demography 0504006, EconWPA. [Downloadable!]
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  3. 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)
    Other versions:
  4. 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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  5. Ettner, Susan L., 1996. "New evidence on the relationship between income and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 67-85, February. [Downloadable!] (restricted)
  6. James P. Smith, 1999. "Healthy Bodies and Thick Wallets: The Dual Relation between Health and Economic Status," Journal of Economic Perspectives, American Economic Association, vol. 13(2), pages 145-166, Spring. [Downloadable!] (restricted)
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  8. Michael Baker & Mark Stabile & Catherine Deri, 2001. "What do Self-Reported, Objective, Measures of Health Measure?," NBER Working Papers 8419, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  9. 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!]
  10. 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)
  11. Van Ourti, Tom, 2003. "Socio-economic inequality in ill-health amongst the elderly: Should one use current or permanent income?," Journal of Health Economics, Elsevier, vol. 22(2), pages 219-241, March. [Downloadable!] (restricted)
  12. Kreider, Brent, 2002. "Latent Work Disability and Reporting Bias," Staff General Research Papers 5185, Iowa State University, Department of Economics.
  13. van Doorslaer, Eddy & Wagstaff, Adam & Bleichrodt, Han & Calonge, Samuel & Gerdtham, Ulf-G. & Gerfin, Michael & Geurts, Jose & Gross, Lorna & Hakkinen, Unto & Leu, Robert E., 1997. "Income-related inequalities in health: some international comparisons," Journal of Health Economics, Elsevier, vol. 16(1), pages 93-112, February. [Downloadable!] (restricted)
  14. Stephen Pudney & Michael Shields, 2000. "Gender, race, pay and promotion in the British nursing profession: estimation of a generalized ordered probit model," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 15(4), pages 367-399. [Downloadable!]
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  15. Frijters, Paul & Haisken-DeNew, John P. & Shields, Michael A., 2005. "The causal effect of income on health: Evidence from German reunification," Journal of Health Economics, Elsevier, vol. 24(5), pages 997-1017, September. [Downloadable!] (restricted)
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  16. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income-related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647. [Downloadable!]
  17. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September. [Downloadable!] (restricted)
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Cited by:
(explanations, 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. Arthur Van Soest & Liam Delaney & Colm Harmon & Arie Kapteyn & James P. Smith, 2007. "Validating the Use of Vignettes for Subjective Threshold Scales," Working Papers 200714, Geary Institute, University College Dublin. [Downloadable!]
    Other versions:
  2. David W.Johnston & Carol Propper & Michael A.Shields, 2007. "Comparing Subjective and Objective Measures of Health: Evidence from Hypertension for the Income/Health Gradient," The Centre for Market and Public Organisation 07/171, Department of Economics, University of Bristol, UK. [Downloadable!]
    Other versions:
  3. Franco Peracchi & Claudio Rossetti, 2009. "Gender and regional differences in self-rated health in Europe," CEIS Research Paper 142, Tor Vergata University, CEIS, revised 30 Sep 2009. [Downloadable!]
  4. Alfredo R. Paloyo, 2009. "Co-pay and Feel Okay: Evidence of Illusory Health Gains from a Health Insurance Reform," Ruhr Economic Papers 0142, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen. [Downloadable!]
    Other versions:
  5. Viola Angelini, Danilo Cavapozzi, Luca Corazzini, Omar Paccagnella., . "Do Danes and Italians Rate Life Satisfaction in the Same Way? Using Vignettes to Correct for Individual-Specific Scale Biases," ISLA Working Papers 31, ISLA, Centre for research on Latin American Studies and Transition Economies, Universita' Bocconi, Milano, Italy. [Downloadable!]
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  6. van Doorslaer, Eddy & O'Donnell, Owen, 2008. "Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings," Working Papers DP2008/04, World Institute for Development Economic Research (UNU-WIDER). [Downloadable!]
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