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


  • Sandy Tubeuf

    () (Leeds Institute of Health Sciences, Academic Unit of Health Economics)

  • Florence Jusot

    () (IRDES institut for research and information in health economics)

  • Marion Devaux

    () (IRDES institut for research and information in health economics)

  • Catherine Sermet

    () (IRDES institut for research and information in health economics)


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.

Suggested Citation

  • Sandy Tubeuf & Florence Jusot & Marion Devaux & Catherine Sermet, 2008. "Social heterogeneity in self-reported health status and measurement of inequalities in health," Working Papers DT12, IRDES institut for research and information in health economics, revised Jun 2008.
  • Handle: RePEc:irh:wpaper:dt12

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    References listed on IDEAS

    1. 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.
    2. 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.
    3. 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.
    4. 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.
    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'état de santé subjectif sont-elles pertinentes ? Une évaluation par la méthode des vignettes-étalons," Économie et Statistique, Programme National Persée, vol. 403(1), pages 165-177.
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    Cited by:

    1. Eve Caroli & Mathilde Godard, 2013. "Does Job Insecurity Deteriorate Health ? A Causal Approach for Europe," Working Papers 2013-13, Center for Research in Economics and Statistics.
    2. Caroli, Eve & Weber-Baghdiguian, Lexane, 2016. "Self-reported health and gender: The role of social norms," Social Science & Medicine, Elsevier, vol. 153(C), pages 220-229.
    3. Florence Jusot & Sabine Mage & Marta Menendez, 2014. "Inequality of Opportunity in Health in Indonesia," Working Papers DT/2014/06, DIAL (Développement, Institutions et Mondialisation).
    4. DEUTSCH Joseph & PI ALPERIN Maria Noel & SILBER Jacques, 2016. "Disentangling the impacts of circumstances and efforts on health inequality: the case of Luxembourg," LISER Working Paper Series 2016-07, LISER.
    5. repec:dau:papers:123456789/13753 is not listed on IDEAS
    6. Dourgnon, Paul, 2013. "Evaluation des politiques publiques et inégalités sociales d'accès aux services de santé," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/12221 edited by Wittwer, Jérôme, March.
    7. Emmanuelle Cambois & Caroline Laborde & Isabelle Romieu & Jean-Marie Robine, 2011. "Occupational inequalities in health expectancies in France in the early 2000s: Unequal chances of reaching and living retirement in good health," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 25(12), pages 407-436, August.

    More about this item


    inequalities in health - MIMIC - reporting bias - structural equations;

    JEL classification:

    • C51 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Model Construction and Estimation
    • I10 - Health, Education, and Welfare - - Health - - - General

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