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Comparing self-rated health and self-assessed change in health in a longitudinal survey: Which is more valid?

  • Gunasekara, Fiona Imlach
  • Carter, Kristie
  • Blakely, Tony
Registered author(s):

    Self-rated health (SRH) is commonly used in longitudinal analyses as a repeated outcome measure. This assumes that computed changes in SRH over time truly represent within-individual changes in underlying health. The longitudinal validity of SRH, however, is threatened by ceiling effects (where people reporting the highest level of SRH cannot report subsequent improved health), insensitivity to small changes within SRH categories, reference group effects (where individuals assess their health changes relative to their peers) and stability in SRH even when change in underlying health is occurring. We assessed the longitudinal validity of SRH by comparing computed changes in SRH with a measure of self-assessed change in health (SACH). We used two waves of data (2003–2005) from the New Zealand longitudinal Survey of Family, Income and Employment (SoFIE). Computed change in SRH and SACH were compared directly and also in regression models using an objective measure of health outcome change (hospitalisations within the past year).

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    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 74 (2012)
    Issue (Month): 7 ()
    Pages: 1117-1124

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    Handle: RePEc:eee:socmed:v:74:y:2012:i:7:p:1117-1124
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    1. Hugo Benitez-Silva & Huan Ni, 2007. "Health Status and Health Dynamics in an Empirical Model of Expected Longevity," Department of Economics Working Papers 07-04, Stony Brook University, Department of Economics.
    2. Paul Frijters, 2004. "Income and life satisfaction in post-transition russia A new empirical methodology for panel data," Paul Frijters Discussion Papers 2004-2, School of Economics and Finance, Queensland University of Technology.
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    5. 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.
    6. Kris Inwood & Evan Roberts, 2010. "Longitudinal Studies of Human Growth and Health: A Review of Recent Historical Research," Working Papers 1013, University of Guelph, Department of Economics and Finance.
    7. van Doorslaer, Eddy & Gerdtham, Ulf-G., 2003. "Does inequality in self-assessed health predict inequality in survival by income? Evidence from Swedish data," Social Science & Medicine, Elsevier, vol. 57(9), pages 1621-1629, November.
    8. Janelle Seymour & Paul McNamee & Anthony Scott & Michela Tinelli, 2010. "Shedding new light onto the ceiling and floor? A quantile regression approach to compare EQ-5D and SF-6D responses," Health Economics, John Wiley & Sons, Ltd., vol. 19(6), pages 683-696.
    9. Wim Groot, 2003. "Scale of reference bias and the evolution of health," The European Journal of Health Economics, Springer, vol. 4(3), pages 176-183, September.
    10. Gunasekara, Fiona Imlach & Carter, Kristie & Blakely, Tony, 2011. "Change in income and change in self-rated health: Systematic review of studies using repeated measures to control for confounding bias," Social Science & Medicine, Elsevier, vol. 72(2), pages 193-201, January.
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    12. McDonough, Peggy & Worts, Diana & Sacker, Amanda, 2010. "Socioeconomic inequalities in health dynamics: A comparison of Britain and the United States," Social Science & Medicine, Elsevier, vol. 70(2), pages 251-260, January.
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    17. Perruccio, Anthony V. & Badley, Elizabeth M. & Hogg-Johnson, Sheilah & Davis, Aileen M., 2010. "Characterizing self-rated health during a period of changing health status," Social Science & Medicine, Elsevier, vol. 71(9), pages 1636-1643, November.
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