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

  • Jusot, Florence
  • Sermet, Catherine
  • Devaux, Marion
  • Tubeuf, Sandy

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://basepub.dauphine.fr/xmlui/bitstream/123456789/7004/2/DT12SocialHeterogeSelfReportHealthStatus.pdf
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Paper provided by Paris Dauphine University in its series Economics Papers from University Paris Dauphine with number 123456789/7004.

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Date of creation: Jun 2008
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Publication status: Published in Document de travail - IRDES, 2008
Handle: RePEc:dau:papers:123456789/7004
Contact details of provider: Web page: http://www.dauphine.fr/en/welcome.html

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  1. Didier Blanchet & Thierry Debrand, 2007. "Souhaiter prendre sa retraite le plus tôt possible : santé, satisfaction au travail et facteurs monétaires," Économie et Statistique, Programme National Persée, vol. 403(1), pages 39-62.
  2. Sermet, Catherine & Tubeuf, Sandy & Devaux, Marion & Jusot, Florence, 2008. "Hétérogénéité sociale de déclaration de l’état de santé et mesure des inégalités de santé," Economics Papers from University Paris Dauphine 123456789/423, Paris Dauphine University.
  3. John Bound, 1991. "Self-Reported Versus Objective Measures of Health in Retirement Models," Journal of Human Resources, University of Wisconsin Press, vol. 26(1), pages 106-138.
  4. Fabrice Etilé & Carine Milcent, 2006. "Income-related reporting heterogeneity in self-assessed health: evidence from France," PSE Working Papers halshs-00590524, HAL.
  5. 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.
  6. Salim Lardjane & Paul Dourgnon, 2007. "Les comparaisons internationales d'etat de sante subjectif sont-elles pertinentes ? Une evaluation par la methode des vignettes-etalon," Working Papers DT2, IRDES institut for research and information in health economics, revised Feb 2007.
  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. Shmueli, Amir, 2003. "Socio-economic and demographic variation in health and in its measures: the issue of reporting heterogeneity," Social Science & Medicine, Elsevier, vol. 57(1), pages 125-134, July.
  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.
  10. Baron-Epel, Orna & Kaplan, Giora, 2001. "General subjective health status or age-related subjective health status: does it make a difference?," Social Science & Medicine, Elsevier, vol. 53(10), pages 1373-1381, November.
  11. 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.
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